Berwick Names 11 Monsters Facing Hospital Industry

Cheryl Clark, for HealthLeaders Media , July 29, 2013

Former acting head of the Centers for Medicare & Medicaid Services, Don Berwick, MD, acknowledges healthcare providers have come a long way in the last few decades, but it's "by no means enough."


Donald Berwick, MD

"And the wild things roared their terrible roars and gnashed their terrible teeth and rolled their terrible eyes and showed their terrible claws."

Where the Wild Things Are by Maurice Sendak

Like this line from Maurice Sendak's celebrated children's book, America's hospitals face some terrible monsters, 11 of them to be exact, said Don Berwick, MD, former acting administrator of the Centers for Medicare & Medicaid Services.

"We're scared of the truth, the next wave of what we have to do to transform healthcare. And it crosses some scary landscape. It's stuff we don't want to think about and don't want to talk about," he told some 1,400 executives assembled for the American Hospital Association's Leadership Summit in San Diego last week.

That "stuff" involves grasping the extent of the industry's greed, ignorance, excess, overutilization, and waste, Berwick admonished.

Now a senior fellow of the Institute for Healthcare Improvement, which he founded in the late 1980s, and a candidate for Massachusetts governor, Berwick said he's seen a lot of changes in the industry in the last several years and congratulated hospitals and providers for making tough choices.

"Thirty years ago, we didn't know patient safety was a problem. We thought healthcare infections came with the territory. Patient-centered care was the name of a focus group and most doctors would laugh at a 'checklist' and say it's cookbook medicine.

See Also: Berwick: Zapping Overtreatment, Costs Takes 'Courage'

"We've come a long way," he said. "Central line infections are down in intensive care units 53% between 2002 and 2009… and patient-centered care is now front and center (with)…hospitals opening their doors and taking away visiting 'hours.' They're putting patients on their boards, and are now saving thousands of lives" with efforts to prevent sepsis.

But it's "by no means enough," he said. America's hospitals must first slay its monsters, and that will not be easy.

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7 comments on "Berwick Names 11 Monsters Facing Hospital Industry"

Peggy Gonder (8/5/2013 at 5:26 PM)
Berwick's best suggestions are the last 2: increased focus on prevention and keeping people out of the hospital, to improve health and reduce the cost of healthcare. "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."

Laup Nepm (8/1/2013 at 5:09 PM)
The Real Monsters of Facing Medicine: Christine Cassel MD, Margaret Nora MD, Richard Baron MD, Eric Holmboe MD, Robert Wachter MD, Humayun Chaudry DO, The American Board of Medical Specialites (ABMS), the American Board of Internal Medicine (ABIM), the Federation of State Medical Boards (FSMB), Maintenance of Certification (MOC), Maintenance of Licensure (MOL), Ezekiel Emanuel and the entire Insurance Industry.

Bill Baar (7/30/2013 at 4:19 PM)
Berwick made a fortune as a consultant (Guys who tell you a million solutions but can't fix a thing themselves). It's time he took the money he's taken from the Healthcare Industry and retire. He's really gotten tiresome.




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