Health in Livonia, Michigan
Dr. Berwick noted in his 2011 IHI National Forum Keynote
that when he first got the job at CMS, the best advice he got was to remember the
My background is non-clinical. My MPH is in health policy
and management. My work as an
Administrative Fellow focuses on the finances, the operations, and the politics
of a large health system. Still, I strive to remember the patient. This is
health care, after all, and we should always remember the patient. Shouldn’t
this be obvious?
I recently shadowed two nurses: one in the surgical ICU
(SICU) and the other in an emergency department. The SICU nurse I shadowed was
seamless in her work. He floated from one task to the next, but he took his
time when it came to his patients. He was gentle. He asked what else he could
do for each patient. One elderly man, feeble and weak, said to this nurse, “You’re
so patient with me.”
Was this one of the few places where this person felt truly
I then saw the hectic shift of an ED nurse. Her patients’
symptoms ranged from vomiting, to a head injury, to a suicide attempt. She,
too, was seamless in her work, and took her time with her patients. One patient
was solemn and calm, and then started sobbing. Through her sobs, she
communicated why she wanted to take her own life. The nurse cared for her and
My shadowing experience reminded of why I love health care
so much. It helped crystallize the fact that the work I do is ultimately meant
to support patients and the staff that care for them. My work affects the
resources, workflow, and operations of a system that ultimately affects the
care provided. This might be a typical day for a nurse, but for someone focused
on administration, it is not. I was
reminded of the human side of health care. I witnessed — and better
appreciated — the love and care that clinicians provide. I would highly
recommend that non-clinicians spend some time shadowing clinical staff.
I’m young in my career and I’ve still got a lot to learn. I
finished my IHI Open School online modules just last year. I’ve almost
completed my Lean Six Sigma Green Belt and am on my way to my Black Belt.
Process improvement is the path I’ve chosen to improve health care, and I can’t
wait to get better at what I do — for our patients.
Dr. Berwick’s words from that 2011 speech still ring in my
head: “Put the patient first. Every single deed – every single change – should
protect, preserve, and enhance the well-being of the people who need us. That
way – and only that way – we will know waste when we see it."