The Institute for Healthcare Improvement took a major directional change at the 2017 National Forum. One of the Keynote Speakers, General Stanley McChrystal, may even call it an about-face. Some of the frequently-used words include:
LOVE, POWER, JUSTICE, JOY, MUTUALITY, HUMILITY and HEALING.
IHI CEO, Derek Feeley asked us to explore “MUTUALITY” in healthcare, where healthcare professionals and patients thrive because power is evenly distributed between each party. As healthcare professionals, our goal should be to create “mobilizing partnerships”, and to do this we need “to become comfortable with complexity and generous with power.” By using Humble Inquiry, healthcare professionals free themselves from “having to know the answers to extending the right questions” to their patients. “We can’t keep the power distribution the way it is now, we need to evolve to the patient leading the team.” He reminded us that joy is possible for those working in healthcare.
Rana Awdish, MD shared the transformation of her personal identity from physician to patient, and her return to practice as “a healing instrument and humble Sherpa.” With new eyes, she experienced the limitations of her medical training to address human suffering and loss. The emotional distance employed by many in healthcare is at odds with the art of providing care, “our ability to partner with patients and families… to build reciprocal bonds of passion and trust.” She shared a vision for healing the care we provide and hope for those who do.
Tiffany Christensen, author of Sick Girl Speaks, shared her personal journey through illness. Unexpectedly, joy became an aspect of her end-of-life preparations and decision making. She received a second transplant, which changed her life yet again. She is now leading the charge at the Beryl Institute to improve the patient experience by asking questions like, “How might it change healthcare delivery if we admired patients instead of pitying them?”
Bryan Stevenson gave a keynote that has been described by attendees as: “towering,” “a call to arms,” “game changing,” and “the reason why I traveled half way around the world.” As a lawyer, he stated “I represent the broken people; broken by poverty; broken by racism; broken by fear…and I realize, I’m broken too.” He challenged healthcare in four primary areas:
- get proximate to the disenfranchised;
- change the narratives that foster inequality;
- keep the hope that change is possible (because hopelessness is the enemy of justice);
- do what’s uncomfortable when needed.
Don Berwick, MD closed the plenary by saying, “We need a fundamentally different system…The dominant approaches and prevailing theories are not founded on science. They are founded on myths.” Throughout the conference Berwick highlighted the ‘ominous signs of failure’, noting that one third of our healthcare spending is spent on waste. He also discussed the shift as we deal with an aging population and an epidemic of chronic disease. Very simply put he stated, “we are not meeting the triple aim – it’s a pipe dream and our healthcare system has been built on a set of bankrupt beliefs.” Healthcare needs “cooperation over competition, resilience, adaption and innovation” more than ever before.
Berwick shared the very personal story of his brother’s near-death experience and what helped him to survive:
All of the sessions were filled with people working to co-create new futures by sharing healthcare initiatives happening across the globe. Vivek Murthy, former U.S. Surgeon General, stated “Creating love is at the center of our calling as healers. The most powerful medicines are love and compassion.”
Simply put, the US healthcare system needs this shift.