Dr. Donald Berwick (bio), founder of the Institute for Healthcare Improvement, has reportedly named by President Obama to head Centers for Medicare & Medicaid Services (CMS), the organization that administers programs including Medicare and Medicaid (“Berwick to be US healthcare nominee“).
I don't know what Berwick's politics are, having only met him briefly one time — but I do think it's a great move to have someone in that role who is not just an MD, but someone who also recognizes the role of process in healthcare quality. Dr. Berwick has been a proponent of Lean in healthcare for many years, as a piece of the healthcare quality improvement and cost reduction puzzle. Here is an article from BusinessWeek, with a video, with Dr. Berwick (something I shared on my blog previously). You can also click the “Berwick” link at the bottom of the post for more.
You can also read about Dr. Berwick and his advocacy for Lean and improvement methods from other industries in the book The Best Practice: How the New Quality Movement is Transforming Medicine. Dr. Berwick mentioned Lean many times in his keynote at the IHI national Forum back in December.
I think it's a very positive sign for the future of U.S. healthcare to have someone in such a powerful position who understands process improvement and Lean — not just for the sake of the “lean healthcare” world — but for all of us as patients and family members. Lean is such a powerful method for reducing costs the right way — through quality improvement. I have more hope that the future of U.S. healthcare cost control will be a better path than what would be cooked up by those who confuse price controls with real cost reduction.
So back to the politics of the nomination — I've always thought of IHI being pretty apolitical — focusing on improving healthcare quality is a pretty non-partisan issue and I don't recall IHI ever having a political agenda. The Wikipedia page about Berwick calls IHI a “liberal not-for-profit organization helping to lead the improvement of health care throughout the world.” Liberal? An assumption because of an east coast background and time studying at Harvard?
This blog post (“Report: Donald Berwick tapped for top post at CMS“) has some highlights about his policy ideas and areas of focus. More patient involvement, better quality, fewer preventable errors, better information systems = liberal?
Here is a good HealthAffairs Blog post that summarizes some of his ideas on quality and patient-centered care (“CMS Nominee Berwick On Empowering Patients And Improving Quality“). The Disease Management Care blog has a political analysis that says the Obama Administration may be hoping for a fight with Republicans over Dr. Berwick's nomination (“A Raw Political Analysis of the Nomination of Donald Berwick to Lead CMS”). Here is an interview with Dr. Berwick from last November.
Back to the issues of quality improvement, here are a few videos of Dr. Berwick:
1) On patient-centered care and the lack of dignity that can occur in addition to preventable errors:
2) Dr. Berwick on checklists and quality improvement (addressing some students)
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