10. Create Authentic Prevention "Hospitals cure disease but they do not prevent it. And they can not prevent it," because they aren't set up to do that today. "Prevention doesn't have any cathedrals. The result is continuing misallocation of effort.
"And if the Martians came here to visit, they would call this insane. We let bad things happen and then [hospitals] fix them. Well, why don't we stop them from happening? Simply put, we just haven't built the institutional structure for prevention."
11. Creating Transition Models Berwick referred to Alaska's Southcentral Foundation "Nuka System of Care," a project that won the Baldridge award for its success in emptying hospitals and decreasing the need for specialty care, as a care transition model monster that is scaring hospitals.
"It reduced hospital bed days for the population by 53%. Specialty visits fell 65%. These are the highest quality scores I've ever seen. And the highest patient satisfaction and staff satisfaction in history.
"And if we had results like NUKA's at a national scale, it would totally solve the U.S. government's healthcare problem without harming a single patient."
But, Berwick continued, "I'm this excited doctor who just got back from Nuka, and I rush into my CEO's office in my hospital and say, I have an idea, we can reduce our admissions by 53%..."
The AHA audience interrupted him with a long laugh.
"The fact that we all laugh is the problem. Wouldn't you want a healthcare system that makes itself as unnecessary as possible?"