In December, 2004, Don Berwick announced a campaign with the mission of saving 100,000 lives. Declaring in his speech that “some is not a number, soon is not a time,” the 100,000 Lives Campaign posed the challenge of producing measurable results in patient care within a specific time frame, on a national scale. It was bold, it was direct, and it was necessary. It called the US health care quality improvement community to action to improve our current system by eliminating needless harm and deaths.
While the system is improving, change continues to require a sense of urgency. There are still deeply rooted cultural beliefs that act as barriers to improvement; policy reform continues to be reactive instead of proactive, and payment models remain antiquated. However, there are those who will not wait for the passage of time to create the change that is needed – they have taken the moral responsibility that is the provision of health care for all people, and have decided to nurture an often underappreciated system of mobile health clinics around the country, a system that already responds efficiently and effectively to the needs of their communities. These determined and impatient clinical and community leaders have realized that in order to achieve health equity, “now” is the time and the number is “everyone.”
Across the country, mobile health clinics have moved to bring health care to those who need it most. Last year, an estimated 6.5 million patients benefited from the attention of some 2,000 mobile clinics nationwide. These vans provide a variety of services: primary, preventative, dental, and specialty care, to name a few. They are staffed by patients, providers, community health workers, nutritionists, educators, and students. These providers realize that the constraints of our current system do not allow for the realization of equitable outcomes and employ innovative methods to combat this. They foster relationships between the health care system and the communities in which they work and create lasting partnerships with patients that allow often disenfranchised individuals to dictate for the first time what they want their health to look like. Moreover, despite being largely unrecognized by our health care system as a robust source of care, mobile health clinics can increasingly demonstrate that they’re improving health outcomes while curbing the cost of care.
In a health care environment shifting toward population health management, understanding and sharing innovative delivery models is necessary to achieve better community health. Working within the Triple Aim framework will require collaboration between previously disparate sectors of the care delivery system. There are many approaches to delivering better patient care – mobile health clinics provide a particularly innovative one. Mobile health clinics across the country have brought the right care, at the right time, to the right community for decades. Let us celebrate their work and provide encouragement to those in our community who are working to be the change they seek.
And, we will celebrate. Starting with pizza and ending with champagne. We will celebrate ourselves because the patients whose lives we save cannot join us, because their names can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken and work completed and books read and symphonies heard and gardens tended that, without our work, would have been only beds of weeds.
-Donald Berwick, December, 2004
Starting today, IHI’s Diversity and Inclusion Council, in partnership with mobile health clinic leaders, will spotlight the unique contributions of mobile health delivery with a tour of clinics in Boston, New York City, and Washington, DC. Taking place just ahead of IHI’s 15th Annual International Summit on Improving Patient Care in the Office Practice and the Community, the tour is the first of its kind to underscore the alignment of the goals of a national network of mobile health clinics with those of the Triple Aim and quality improvement.
Come along for the ride over at the IHI Blogs and on IHI’s Facebook and Twitter pages using #IHI15Summit and #mobileclinics.