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When the Who's Who Say What's What

November 18, 2008
by Mark Hagland
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When the “Who’s Who” of healthcare quality and policy leaders speak, the industry had better listen. That’s my read, anyway, of the release this week of a new report, “National Priorities & Goals: Aligning Our Efforts to Transform America’s Healthcare,” from an organization called the National Priorities Partnership. That group’s name may sound new, but its component leaders and member organizations are a virtual roster of the quality and accountability movement in healthcare. The group’s co-chairs are Donald Berwick, M.D., the famous head of the Institute for Healthcare Improvement, and Margaret (Peggy) O’Kane, president of NCQA. And the rest of the roster reads the same, encompassing Leah Binder of the Leapfrog Group, Mark Chassin, M.D., of the Joint Commission, Carolyn Clancy, M.D., of AHRQ, Janet Corrigan of the National Quality Forum, Helen Darling of the National Business Group on Health, Peter Lee of the Pacific Business Group on Health, John Rother of AARP—and so on.

But what’s far more important than the composition of the partnering organizations coming together under the National Priorities Partnership umbrella is their speaking out in one voice to call for fundamental change within the healthcare system, and, even better (in my humble opinion), to have reached a public consensus on “The National Priorities and Goals”: a set of top priorities and objectives that these industry leaders believe the healthcare system must pursue, even as the nation ponders the potential for reform of our health insurance and access system.

Below, in the organization’s own words, are the top healthcare system reform priorities and goals its leaders have identified and agreed on:

Ø Engage patients and families in managing their health and making decisions about their care.

Ø Improve the health of the population.

Ø Improve the safety and reliability of America’s healthcare system.

Ø Ensure patients receive well-coordinated care within and across all healthcare organizations, settings, and levels of care.

Ø Guarantee appropriate and compassionate care for patients with life-limiting illnesses.

Ø Eliminate overuse while ensuring the delivery of appropriate care.

Furthermore, each of these priorities/goals is further elaborated in some detail. For example, under “Improve the safety and reliability of America’s healthcare system,” the group indicates that “The Partners will work together to ensure that all healthcare organizations and their staff will strive to ensure a culture of safety while driving to lower the incidence of healthcare-induced harm, disability, or death toward zero.” Among the actions to be addressed, the group agrees, should be massive reductions in patient care-acquired infections, such as catheter-associated blood stream infections, surgical site infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. (For the full report, please go to www.nationalprioritiespartnership.org.)

Of course, even these eminences grises of healthcare recognize that their having come together in this way is only the beginning of what most thoughtful people recognize is the beginning of the internal reform of the healthcare system. The report they’ve just published goes on to state that “Identifying a starter set of National Priorities and Goals is a major accomplishment, but it is only the first step in what must be a more expansive and ongoing implementation aimed at achieve the performance goals” (which are then articulated).

Still, the timing of this assemblage of Extremely Important Persons in healthcare couldn’t be better. As a new administration comes into the White House, and a new Congress prepares to assemble in January, a great deal of focus will be on external healthcare reform, meaning providing health insurance and care access to more people in this country. At the same time, the purchasers and payers of healthcare have the right to demand that the healthcare delivery system begin to reform itself from the inside. And, importantly, the heel-draggers in hospitals and health systems across the country who’ve been able to skate along operating in a business-as-usual mode can consider themselves to have been put on notice with this important step by leaders from across the field. As I’ve argued in two recently published books, we in healthcare are facing an undeniable imperative to fundamentally improve care delivery on many levels.

And it’s heartening to know that, at least among the policy leaders within the healthcare industry, a consensus is emerging on what issues are most important to address in order to profoundly improve healthcare delivery in this country. Futhermore, as this consensus plays out in the industry, CIOs and other healthcare IT executives will necessarily be part of the national “team” that will be required to make the improvements we all know need to be made. The challenges ahead are manifold; but at least we are collectively beginning to achieve the clarity we’ll need to begin the hard work of reforming our industry from within.



Joe Bormel,

Thank you so much for your thoughtful comments. And thank you also for your very kind words!

I look forward to reading your blog post on relativitywhat a fascinating perspective on the systemic challenges facing our industry at this moment in time. And finally, I agree completely per NQF, AHRQ, IHI, et alfrom my standpoint, the fact that these organizations are coming together to achieve a conceptual consensus on all this going forward. Thank you again for your very thoughtful remarks!

Thank you so much, both for keeping us briefed (e.g. this report), your commentary on it, and the way you cover the larger healthcare arena. I wanted to use the 'healthcare system' instead of 'arena,' but we know better!

I'm a student of several of the leaders you cited; their clarity and passion are exemplary. And, in the same spirit as blogging, most have shared personal stories, relevant to us all. These stories underscore and drive their leadership.

Don Berwick's "My [Don's] Right Knee" and his depiction of his wife's care in "Escape Fire" illustrate every bullet you shared above. The videos of those presentations have been on the IHI site in the past.  I've used both for years, before switching over more recently to the PBS series, "Remaking American Medicine."  I've purchased and distributed dozen's of copies, and used clips in my national speaking engagements.  Stories and the resulting humanization are so critical.

I've written a 'soon-to-be-released' blog post on relativity (as in Einstein). My conclusion is that the arena can transform itself, but not the individual constituencies alone.  As in relativity, the location of the observer profoundly impacts what can be observed and acted upon.

NQF, AHRQ, and IHI, in my experience, are fundamental to that multi-level transformation. I'm thrilled to read your post. It should strengthen everyone's hope, as well as provide clarity on proven measures and methods to move toward the listed goals.  Thanks again, Mark.