Berwick Pushes for Quality

Janice Simmons, for HealthLeaders Media , September 16, 2010
  • Better health for populations in relation to the upstream causes of ill health, such as poor nutrition, physical inactivity, substance abuse, and unwise behavioral choices, violence, and economic disparities.
  • Reducing per capita costs by eliminating waste.

For the last item, Berwick specified—in light of previous comments that have come under scrutiny—that this meant "not by withholding from us or our neighbors any care that helps them— specifically not by harming a hair on any patient's head."

Acute care. One of his "strategic priority" areas is to make "the quality of care in hospitals and outpatient clinical settings better—much better—everywhere and for everyone," Berwick said. 

One of the top areas that he is focusing on: safety. He noted that the IOM's report on patient safety—To Err Is Human—is now over 10 years old. "We still lack the firm national commitment to make the safest care the standard care everywhere—no matter where an American patient goes," he said.

He called for a "rededication to safe care," with an aim for "a major and immediate reduction in medical injuries to patients in hospitals.

Integrated care. Substantial and prompt progress is needed toward better-integrated care—"care that makes sense to patients and families, so that they don't feel lost and forgotten and confused as they make their way through our complex systems," Berwick said. "We owe them journeys—not fragments."

Fragmented, disorganized care is still relatively common in today's healthcare system, he noted. It's where patients have to tell their name and address and story again and again to everyone you see, and where no one seems to talk to each other and records are forgotten or unavailable.

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