Doing “Good in the World” and Improving Health Care





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Sep 17, 2019
by Mirabelle Morah
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Doing “Good in the World” and Improving Health Care

President Emeritus at the Institute for Healthcare Improvement, Donald Berwick, reflects on his Salzburg experiences and the power of patients’ voices Don Berwick during the Salzburg Global program on Moving Measurement into Action: Designing Global Principles for Measuring Patient Safety

In 1998, Donald Berwick attended Salzburg Global Seminar to take part in a program exploring the issues related to the patient-health provider relationship. Four years later, he returned to co-chair a program concerned with making medical facilities safer places for work and care. It’s perhaps no surprise Berwick is back in Salzburg for a third time—on this occasion, for Moving Measurement into Action: Designing Global Principles for Measuring Patient Safety.

“Many of the people who were there in 2001 are still leaders in the movement,” said Berwick. “So I have enormous respect for what happens here. I had high expectations, and they were met.”

Earlier this month, Berwick, president emeritus and senior fellow at the Institute for Healthcare Improvement, was one of many experts from around the world who convened in Salzburg to tackle the issue of patient safety. It is a global health priority and the demand for improvement is growing. Given his interest in the topic and previous experiences in Salzburg, Berwick has been able to watch how patient safety has evolved.

“In 2001, the topic of patient safety was not well known. We didn't understand how many errors there were in health care. We hadn't forged relationships between researchers on error from outside health care and inside health care. We hadn't thought about leadership activities that are necessary. It was all beginning, and it was a wonderful launch, an initiation of what I think was a real maturation of sciences of patient safety,” Berwick said.

“Today, 18 years later, you can see how mature the field has become. We know so much more about how patients are injured in care. We know a lot about effective approaches. We understand now how crucial the role of leadership is. We have governments and multilateral agencies interested in the policy level approach to improving the safety of patients and maybe most importantly of all, the importance of the voice of the patient has matured.”

For Berwick, a major takeaway from this year’s program is how deeply he and other health experts have come to understand the crucial role of giving patients much more power than they’ve ever had before, “really devolving power to patients and helping them participate in the creation of safer care.”

A pediatrician by background, Berwick is a former administrator of the Centers for Medicare and Medicaid Services. He has also served on the on the faculty of the Harvard Medical School and Harvard School of Public Health, and on the staffs of Boston's Children's Hospital Medical Center, Massachusetts General Hospital, and the Brigham and Women's Hospital. “What inspires me is the good hearts of the people that I see here and elsewhere,” said Berwick.

There are many achievements in Berwick’s biography. Among those include his appointment in 2005 as an Honorary Knight Commander by Queen Elizabeth II in recognition of his work with the British National Health Service. Meanwhile, he has found time to author or co-author more than 160 scientific articles and six books.

“The people in health care, by and large, they want to help people, they want to do good in the world,” said Berwick. “Their commitment, their generosity, and their spirit; it constantly gives me energy. And then many of them like many of the fellows here at this meeting, are working very hard on changes… I just want to make it happen everywhere.”

Reflecting on his experience in Salzburg in 2001, Berwick said the program, Patient Safety and Medical Error, “became one of the turning point events globally in attention to patient safety.” It’s clear Berwick associates fond memories with Schloss Leopoldskron.

“I just want to say what a gift the Salzburg Global Seminar is,” Berwick said. “What is created here is a meeting place, an intersection for people who wouldn't otherwise meet each other for many, many roles, places on earth, many cultural backgrounds, and the generativity. The richness of these intersections, it's evident to me, it's made evident each time I come.

“So how much you can learn from people who are from different backgrounds, have different experiences is extraordinary. And I don't think in the planet we have enough places for that kind of intersection, especially in a setting that actually gives you the time and the headspace to experience it. So I leave here enormously grateful, for this is a global resource.”

The Salzburg Global Seminar program, Moving Measurement into Action: Designing Global Principles for Measuring Patient Safety, is part of the Health and Health Care Innovation multi-year series. The program is being held in partnership with the Institute for Healthcare Improvement. This program has been supported by the Gordon and Betty Moore Foundation.