Publication Date: January 14, 2015
Alide Chase, MS
IHI Senior Fellow
Senior Vice President, Quality and Service, Kaiser Foundation Health Plan, Inc., and Kaiser Foundation Hospitals (retired)
Q: Can you describe your career path leading up to becoming a Senior Fellow at IHI?
I’ve been in health care for over 40 years. My last 34 years have been at Kaiser Permanente [KP], doing work I love in various roles, most recently as a Senior Vice President. As I was moving toward retiring, which I did in April 2014, I wasn’t sure exactly what I wanted for my next journey. But one thing I was sure of was that I didn’t want to step entirely away from health care. I still had energy and passion for it; still felt I had something to contribute. It was just time to move on from a big, every-day-super-busy full-time job.
In the meantime, I also realized how personally rewarding my connections with IHI have been throughout my Kaiser career; that our work together was very high on my list of the areas that brought me the most fun, the most exhilaration in my career. I believe the first IHI project I was involved with was a Collaborative on improving service, improving the care experience for patients, back in the early 1990s. I also started going to IHI's annual National Forum [on Quality Improvement in Health Care].
Then in 2005, under the leadership of Louise Liang [former Kaiser Permanente Senior Vice President for Quality and Clinical Systems Support], Kaiser and IHI entered into a strategic partnership. I saw it as an important relationship that could really help to speed up Kaiser’s improvement work. As a senior vice president nationally, I was able to be quite involved in setting up the overall design, which included the building of Kaiser Permanente’s patient safety and quality improvement programs and the enterprise performance measurement system. I was blessed to work with the most amazing leaders, and together we learned the importance of having the voice of our patients in every step of our improvement work.
Since I was also accountable for the relationship with IHI, I had oversight of the yearly strategic planning sessions with IHI and Kaiser executives where we mapped out the year, and quarterly updates on each workstream. IHI, in turn, was in the process of developing the formal infrastructure around strategic partnerships with large systems, learning from the Kaiser relationship what the bond should look like, what activities both parties should do to support moving forward together. It was very exhilarating stuff … lots of ups and downs. We started out with our “training wheels” on.
Last December at the IHI Board meeting during the National Forum, we had a 10-year strategic partnership anniversary celebration. Both Dr. Jed Weissberg [Senior Vice President, Quality and Care Delivery Excellence, following Louise Liang’s retirement] and I presented, reflecting on the evolution of the KP/IHI relationship, the advancement of the workstreams, and our actual performance improvement results.
In addition, IHI executives, including Maureen Bisognano [President Emerita and Senior Fellow], Don Berwick [President Emeritus and Senior Fellow], Bob Lloyd [Executive Director], Kathy Luther [Vice President], and Frank Federico [Executive Director], had been keynote speakers at Kaiser’s own quality and safety meetings. So, as I was facing retirement, I knew I wanted to continue my relationship with IHI — the people, the stimulation, the global view, the rapid access to leaders globally, the opportunity to get a much deeper appreciation for what’s happening in health care, new designs, and more.
With that in mind, I began talking to Maureen about my interests and how I might possibly play a useful role for IHI.
Q: What is the focus of your work with IHI as Senior Fellow?
There are several areas. One is an effort to help IHI establish a more formal network or community among Senior Fellows. Historically, as Maureen and I have discussed, Senior Fellows have been quite independent; they’re valued experts in their own specific areas who contribute to IHI on an informal, as-needed basis. As I see it, the kernel of what Maureen is trying to do, with my help, is strengthen the bonds among the Senior Fellows; try to develop a culture closer to that of the mid-career alumni of the IHI Fellowship Program following their one-year fellowship at IHI. This group has a cohesion that has grown organically over time. They enjoy staying in touch, have a natural synergy, and make themselves available to IHI in different ways.
Maureen is looking to see something like that with the Senior Fellows, and also to more effectively incorporate them into IHI’s strategy and program development. She asked me if I’d be interested in helping her pursue this idea and I said, “Yes!” This is a role I do pretty well: network people, provide opportunities to learn together, and host discussions and meetings.
Is it going to work? Possibly, if there’s interest. We’ve had two conference calls already, with a 250 percent increase in participation — from four to 10 Senior Fellows on the call. That’s encouraging in and of itself, considering how very busy these people are.
The second role I’m going to serve is on strategic teams: one, as a member of IHI’s internal Strategic Advisory Board; and two, supporting the IHI Leadership Alliance, the initiative of health care system executives focused on specific aims to drive down cost, optimize patient outcomes and experience, and improve the health of populations.
Apart from IHI, I’m also doing some consulting work for several large health care systems, developing whole system measurement systems for them and setting up a performance improvement infrastructure.
Q: What are some of the challenges you see for IHI’s work ahead?
I think it is the evolving nature of the health care environment. In the US, in the dominantly hospital-based industry, there is and will continue to be improvement work, particularly in safety, flow, and getting costs down — our cost structure is so expensive in the US. So there’s still a need for IHI’s expertise in these key areas, the bread and butter, if you will, of IHI’s work.
In the meantime, there is a lot of expansion in the US in the thinking around the importance of community health — the health of communities. What’s happening with safety net organizations, for example, in the public health arena, attracts a different audience from those IHI is used to working with. Those of us who come from a hospital or commercial primary care systems have to have humility about how much expertise is already present in community and public health programs, and explore how we can learn from these partners. I see IHI’s strategy and work expanding into that area.
It’s a challenge. How do you continue to be accessible to the needs of IHI’s current customer base, hospitals and health care organizations, which are likely going to be there for the next several years? And, not just support them, but continue to refresh yourself and offer new ideas in that zone. How do you do that while expanding in this new way, broadening your view to new definitions of health care and new goals around health?
On top of all this, there’s global health, which presents so many wonderful opportunities for growth in terms of reach, stretch.
How do you meet all three challenges — the needs of your health care industry community, the needs of new communities to support them in creating health, and the needs of growing global populations you serve? You have to support all three groups and not lose sight of any of them, while remaining a reasonably small organization, by desire.
So, you ask, can you be all things for all players? Probably not. And that’s fine: I don’t think of IHI as the expert in everything — in new technologies, for instance. That isn’t the foundational work of IHI. It’s a matter of asking, “What is the work that we do the best?” While also widening the "where" we do that work and the kinds of problems for which we develop services to solve those problems going forward. It’s a lot of change and uncertainty. To remain vital, IHI has to evolve along with the world around you.
Q: What are you most excited about?
Well, I’m about to leave for two months traveling in India, someplace I’ve always wanted to see. And I have a new grandbaby in Portland, Oregon. What could be more exciting than that?
In terms of work, I’m excited about my next journey in health care. I’ve decided there are three main approaches to retirement. Some people, when they retire, just cut the cord. They feel like, “That was wonderful, now I’m ready for golf, travel, getting in better shape,” and so on. Then there are some who think, “I want to step down from my job, but I’m not prepared to step down entirely. So I’m going to still hang onto some pieces for a year or two.”
Then there are the people who, maybe for four or five years or more, are still making a contribution in some way. I’m either in group two or three; I’m not sure — and I’m okay that I don’t know. It’s a process. I don’t have to predict what’s going to happen in a year. We’ll see what comes.