• MHA Student Courtney Nielsen Shares IHI Experience


Student Perspective

by Courtney Nielsen
Suffolk University MHA Student
January 2009

Within the period of a month, I have had the pleasure of attending both the Institute for Healthcare Improvement’s (IHI) 20th Annual National Forum on Quality Improvement in Healthcare as well as the inaugural events for Barack Obama. To many, an annual conference is no competition to the making of history. While this may be true for the majority of conferences, it is not the case for IHI’s. The reality is that IHI and its conferences are a part of history. They are the face of quality improvement and patient safety and play a fundamental role in the transformation of the delivery of care in the United States.

In the midst of an economic downturn, where unemployment is the highest we have seen in sixteen years and budget cuts are paralyzing organizations, IHI had a record 6,000 people (200 of whom were students) attend its event. Over the course of three days, individuals from a variety of professions and healthcare settings came together with the common purpose to change the delivery of care and the belief that it is possible. The leader in quality and safety, Dr. Don Berwick, opened the conference with a plenary speech that motivated and challenged the audience. Within his plenary he presented a letter to his daughter, a future doctor, on what the health care environment may be in 2028. The letter maps out two very different roads for the next twenty years. The first map portrays a future filled with devoted professionals and hospital leaders who grow frustrated and forlorn. The hope that existed in 2008 had diminished and as a result the chance for real change had evaporated. The scrutiny of medical professionals prevails over trust, and the constant reporting, measurements, goals, targets and scorecards leave people feeling like “gerbils on a wheel, running fast and getting nowhere.”  Rather than trying to work harder to change the system, we let the system represent us.

Luckily, in the second letter, we made the right choices. Dr. Berwick pointed out that “it was hard work but we had courage.” When it appeared that change was not a possibility, we worked faster and harder; “we realized that what we choose we can choose to change.” Therefore, by 2028 we were able to have a highly integrated system, which reduced waste, made patient safety a primary goal, allowed us to look at patients as whole beings rather than fragments, and were able to provide care to everyone irrespective of their race or ability to pay.

Dr. Berwick’s plenary set the tone for the conference. He pushed the audience to answer the question: which map are we going to choose? It was very apparent from the conference that the tools and motivation are there for substantial transformation to occur. Medical professionals and hospital leaders from around the nation and world presented on the progress their institutions had made in patient safety, quality of care, disparities in care and reductions in cost. So now I present the question to my peers, which map are we going to choose?

As a student of healthcare administration and a young professional, there was a lot to take away from the IHI Forum. Professionally, I have been able to apply many of the concepts and tools presented at the conference in my line of work. From the student perspective, I have developed a deeper understanding of students in our roles as emerging leaders. As the leaders of tomorrow, it is our obligation to follow and provide support to those who are leading the way for change. At the same time, we must learn from their mistakes and correct them in the future. As future leaders of healthcare organizations, we need to be equipped to sort through the chaos and guide our organizations as effectively as possible. IHI and its conferences are great resources that can assist us in seeing beyond the confusion and toward our true goal -- to heal and care for individuals.

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