Don Berwick has been working his entire career to improve health care. Now, he may have his best chance yet.
Yesterday, several news sources announced that President Obama would nominate Don Berwick to be the next CMS director. This follows almost 4 years of the agency's lead position being vacant. With the recent passage of the health care bill it's important to have a qualified and respected leader in this position to guide change.
Why is Dr. Berwick qualified to be this person? Crossing the Quality Chasm, a report from the Institute of Medicine describing the medical errors and deaths occurring in American hospitals was authored by Dr. Berwick and others over 10 years ago. This was the first time the quality of American medicine had come under significant scrutiny and it was Dr. Berwick who had the courage to tell all of us we need to do better. Well, Medicare/Medicaid needs to do better, a lot better, and it's going to take a leader with his courage (and knowledge) to take on the status quo and get us redirected toward incenting and delivering much better and lower cost care.Dr. Berwick has that courage and experience.
The priorities at CMS need to change and Don knows this. He is a big supporter of changing systems so as to improve. The systems of reimbursement are clearly broken and need to change. We reward the least efficient lower quality organizations with our present reimbursement system and that must change. We need to have the data. Physicians and other health care workers change when they are confronted with the facts. The facts related to hospital and physician performance must become transparent before change will happen. Finally we have to change how we deliver care.We have shown as others have that there is at least 40% waste in the present delivery system.
At the Health Care Value Leaders Network we have begun to show how waste can be removed. The framework for this change will be published shortly in our book "On the Mend"
How can we help Dr. Berwick succeed assuming the president does nominate him and the senate confirms him? We need to be willing to change the way we are delivering care. We need to engage in experiments in our own institutions and we need to scale our learnings across the industry. We need to be willing to enter into pilots and research studies which are designed to show that lean health care can remove massive waste and lower cost at the same time improving quality.We need to learn a new management system. One that supports the front line workers and ultimately delivers defect free care to our patients. We need to stop bellyaching about not getting paid enough and figure out how to better use the huge resources we already have to decrease the cost of care for the government and our employer customers. We've got a big responsibility as providers to help Don. Let's come together to get it done!
Oh, and by the way, assuming he is nominated, please call your senator and tell them to ratify Don as the next CMS director.
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