Thanks to generous support from the Center for Patient Safety and Health Policy at the University of Texas Health Science Center at San Antonio (UTHSCSA), Darin Hall (IHIOS SA Fundraising Chair) and I were able to attend the 24th IHI Annual Forum in Orlando. The purpose of the trip was primarily twofold: enhancing our improvement skills and sharing best practices with other IHI Open School communities around the world. I want to emphasize the truly global nature of the conference: of the 5500+ attendees this year, 49 different countries were present to share their own improvement journeys and learn from what other nations are doing. The theme this year was “Defining Moments,” so I’d like to share a few of mine from my first Forum experience below.
Defining Moment 1 – “Blue Shirts”: Upon our arrival to the conference on Sunday to pick up our badges, we were greeted by a sea of blue shirts eager to help us make the most of our time there. These “blue shirts,” as they are fondly referred to by IHI leaders, are all IHI staff members who give up a week of their life to help produce this magnificent global conference. The sheer number of workers and their unending patience, friendliness, and intelligence was a testament to just how far the improvement movement (and IHI) has come over the past decade.
Defining Moment 2 – “Patient-Centeredness”: We had the privilege of attending a special session sponsored by the Picker Institute which focused on successes and challenges related to patient-centeredness. If you are unfamiliar with the Picker Institute, I encourage you to learn more about their incredible history and work. This was a two-part session with the first half focusing on a select number of patient-centered improvements certain health care organizations have instituted using grants awarded by the Picker Institute. These included innovations such as including a “My Story” section into the EMR and offering a “pain/comfort menu” for patients to utilize throughout their stay. The second half was a panel moderated by IHI founder and improvement visionary Don Berwick. Dr. Berwick welcomed several notable panelists to the stage to discuss the past, present, and future of patient-centered care. The session was an excellent reminder of how all of us need to place patients in the center of everything we do. In San Antonio, our IHI Open School Chapter is in discussions with the Patient Institute to see how we can partner to advance patient-centeredness in our local community and beyond.
Defining Moment 3 – “Make it Stick”: As IHI Open School Chapter Leaders, we were invited to an exclusive session with best-selling author and keynote speaker Dan Heath. Dan and his brother Chip wrote the best-selling book Made to Stick in which they journeyed to discover the common themes surrounding ideas that stick. More specifically, they wanted to know why “some ideas thrive and others die.” They ultimately concluded that there were six principles that defined all “sticky” ideas: simplicity, unexpectedness, concreteness, credibility, emotions, and stories. Dan walked us through a compelling exploration of each of these principles and how they relate to making the improvement movement (and IHI Open School) “stick” in our own organizations and communities. At the conclusion of the session, we were tasked with collaborating with the IHI Open School Southwest Region (including members present from San Antonio, Houston, and Oklahoma City Chapters) to come up with a two-minute elevator pitch about the IHI Open School/improvement movement that effectively leveraged the principles outlined in his research. Each region then shared its final pitch and received feedback from both Dan and the broader audience. I was very impressed with our final product and hope our own Chapter can benefit from our collaborative work as a region at the conference.
Defining Moment 4 – “Throw your hat over the wall”: IHI CEO Maureen Bisognano gave an inspirational speech in which she detailed the many challenges and opportunities we face as an improvement community going forward. Two key quotes really stood out to me from her presentation:
“When you come upon a wall, throw your hat over it, and then go get your hat.”
“We need to move from “What’s the matter?” to “What matters to you?”
The first quote comes from an old Irish proverb and really characterizes the need to be visionary and see great possibilities amidst a field of seemingly unending walls. This is what IHI and thousands of others have done and will continue to do as the improvement movement marches forward. The second quote highlights the idea of moving towards a more patient-centered system in which patient values and preferences drive our core processes, not disease characteristics or the wants of providers. As Don Berwick so elegantly stated at the conference, “we are all guests in the lives of our patients.”
Defining Moment 5 – “High Reliability”: High Reliability Organizations (HRO’s) are those extremely complex organizations which effectively leverage culture and science to produce “zero-harm.” Some examples of these traditionally include aircraft carriers, nuclear submarines, power plants, and select aviation companies. There is a nascent but growing movement in health care to study and apply the principles of high reliability to ultimately produce zero harm. While we are far from this as an industry, certain providers have committed to a high-reliability journey. One of these pioneering organizations is Memorial Hermann in Houston, and I had the privilege of hearing their senior leaders talk about their own journey to high reliability. What impressed me the most about the presentation was the fact that their CEO, Board Chair, and Chief Medical Officer were all so involved with the process and were so visible in their support for this critical cause. I hope that one day we will see this kind of commitment to improvement from senior leadership being replicated across all systems. Too often we see improvement initiatives relegated to the “quality department” rather than a core vision of the organization.
Thomas Methvin (right) and Darin Hall present a storyboard at the 24th Annual National Forum.
Click here to view a full gallery of pictures from Methvin at the National Forum.
Defining Moment 6 – “Improvement as a Universal Language”: One of the most powerful parts of the Annual Forum is the opportunity to learn from improvers from all across the nation and the world. Indeed health care improvement is everyone’s job, and it was clear that people from all nations share in a common desire to pursue some version of the Triple Aim. I was able to attend two particularly powerful sessions related to this topic. The first was related to workforce development and was led by two representatives from Southcentral Foundation, an award-winning organization serving Alaskan Natives. The second was a presentation by leaders from NHS Scotland who detailed their incredible vision and improvement journey. Each of these offered concrete ideas that participants could bring back to their own organizations.
Defining Moment 7 – “Face the Giraffe”: A true hallmark feature of the Annual Forum is the traditional keynote address delivered by Dr. Don Berwick. I like to think of this as the “State of the Union” for the health care improvement movement (see the Escape Fire book for key speeches from earlier years). His address (suitably) was the final event of the Forum and provided an energizing message about the barriers we face going forward in health care. He started with a story about his own son and his longstanding terror when he was a child of a particularly large and scary-looking giraffe in a local museum. The story culminated with his son overcoming the fear of this creature and facing it head on. This set the stage for a powerful explication of the evils or “giraffes” that we face as an improvement community. There is a certain fulfillment and empowerment that comes with specifically naming our “demons” in health care, and Dr. Berwick did a tremendous job helping us to frame these appropriately so we can begin to think about “throwing our hat” over them.
Overall, my experience at the annual Forum was incredibly enlightening and I highly recommend that anyone interested in improving our health care system, especially students, make a good faith effort to attend this important event each year!
Chapter Leader and President, IHI Open School San Antonio Chapter
Healthcare Administration, Trinity University