This lecture explores the background and evidence behind the need for the “Triple Aim” in health care: better care for individuals, better health for populations, and lower per capita costs. It explains why those results are way out of reach for health care as currently designed and operated, and what are the dire consequences of failing to change. It develops the needed principles for redesign, and presents example of success from around the world for each of those principles.
Levels of burnout among physicians and nurses may be at an all-time high in the US and in many other nations. This lecture explores the reasons for burnout and conflict in the health care system. It traces the roots to two co-existing and unsatisfactory foundational cultures: the culture of professional dominance (“Era One”) and the culture of measurement and accountability (“Era Two”). It explains the deep flaws in both those world views, and recommends a new and more effective approach to the “Triple Aim” (better care for individuals, better health for populations, and lower per capita costs) – “Era Three.” It describes detailed components of Era Three, and implications for the behaviors, training, and self-image of physicians, nurses, other health professionals, leaders, and patients and families.
This talk explores the need for major redesign of health care delivery – long overdue. Drawing on the so-called “Radical Redesign Principles” for a new health care system from the Institute for Healthcare Improvement’s Leadership Alliance, Dr. Berwick will explain especially the first of those principles: “Change the Balance of Power,” with specific illustrations of how patients, families, and communities can take over their own care and better pursue their own health. This gives new and fresher meaning to the much-used phrase, “patient-centered care,” and offers doctors, nurses, and other health professionals a new and positive image of themselves as healers, “co-producing care” with those they serve. It also offers a glimpse of some of the truly disruptive care delivery system innovations now well on their way.
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