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25th National Forum: From Adverse Events Reporting to Taking it to the Streets

By Maureen Bisognano | Monday, December 9, 2013
The following is part of a series of guest posts celebrating the 25th Anniversary of the IHI National Forum. Jens Winther Jensen, MD, is the Danish Society for Patient Safety Senior Fellow at IHI 2013-2014. He is on leave from an executive position in the North Denmark Region overlooking the health and health care for a population of 580,000. Prior to the assignment in the North Denmark region he was the President and Chair of the Board at the Danish Medical Association. 

Jens Jensen

The IHI National Forums have played a major role in the development of the Danish Health Care System, and the Danish Society for Patient Safety. More than a decade ago, the National Forum helped create an awareness that the status quo wasn’t sustainable. As early as 2003, Denmark set up, by law, an adverse reporting system with a system-level focus. And inspired by IHI’s 100,000 Lives Campaign, Denmark launched Operation Life in 2009. Operation Life led to Patient Sikker Sygehus (The Danish Safer Hospital program), with the goals of reducing mortality by 15% and harm by 30% in five pilot hospitals. These goals are about to be reached.

At the same time, the Forum has led to accelerated thinking about the Triple Aim, resulting in new projects focusing on mental health and on improving health in communities.

In recent years, the Forum’s consistent emphasis on using patient stories as drivers for change has led to the program, Safe Patient, which includes three recommendations about how families can play an important role in improving safety for their loved ones when they are sick and in need of health care. As part of this program, patient safety was “taken to the streets” in four public events held at large train stations in Denmark. More than 110,000 citizens were directly exposed to the message. There is a direct line from these events to the incredibly engaging keynotes by Maureen Bisognano and Don Berwick.

For me, this patient-centered approach – always bringing the patient perspective into the conversation – is one of the unique attributes of IHI. I feel it every day in the office, where my medical and political brain is being “de-toxed” these past months; and I feel it in conversations with numerous patient advocates whom I have met through work accelerated by the Forum. One experience, while I was President of the Danish Medical Association working on a program encouraging physicians to say “Sorry” to patients after a harmful event, has a particular place in my heart. At a national hearing, a patient advocate said to me “It is human to make mistakes – but it should not be the only human thing about health care!”

I am now attending the Forum for the third time. I do this with excitement because I look forward to what this year’s engagement with attendees will inspire me to work on.

-Jens Jensen

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