No one has ever said no to me" was the quote attributed to the first person profiled in the first installment of Up & Comers 20 years ago. Cocky? Probably. Charismatic? Undoubtedly. It's the proverbial thin line.
The man who led the inaugural class of 1987 alphabetically stands out unequivocally as its leader today. Even 20 years ago, Donald Berwick, then 40, was championing the ideas that would eventually blossom into the Institute for Healthcare Improvement.
In the late '80s, the quality measurement expert, who worked for the Harvard Community Health Plan, an HMO based in Brookline, Mass., started pairing up hospital chief executive officers with leaders from other industries to try to glean how their quality best practices could be applied to healthcare. One of the hospital CEOs who was involved in the project, known as the National Demonstration Project on Quality Improvement in Health Care, was Maureen Bisognano.
At the time, she was CEO at the Massachusetts Respiratory Hospital in Brain-tree, Mass. Her hospital was paired up with Florida Power & Light Co. in Miami. "From what little happened that year, I think he has built a global system that is connecting people and their improvement efforts, and spreading evidence-based medicine around the world," says Bisognano, who is now the executive vice president and chief operating officer at the Cambridge, Mass.-based IHI.
Since 1991, Berwick has served as co-founder, president and CEO at the IHI, a not-for-profit organization dedicated to worldwide healthcare quality-improvement efforts. Berwick has helped the healthcare industry embrace quality improvement as a science. Under his leadership, the IHI—with 100 employees, 250 faculty members and a budget of just under $40 million—has spearheaded several national quality improvement efforts. Topping that list is the 100,000 Lives Campaign, which began in December 2004. The IHI estimates the program saved roughly 122,000 lives—although some dispute the figures—at more than 3,000 participating hospitals through rapid response, evidence-based care and intervention to prevent infection and ventilator-associated pneumonia.
But why stop there? In December 2006, the IHI set out to avoid 5 million potential patient injuries over the next two years, building on its earlier project. The campaign, called the 5 Million Lives Campaign, aims to prevent pressure ulcers and harm from high-alert medications, reduce surgical complications and methicillin-resistant Staphylococcus aureus infections, and promote evidence-based care for congestive heart failure.
An elected member of the Institute of Medicine, Berwick, 61, served as a member of the IOM committee that in 1999 published the landmark report To Err is Human. That report, perhaps more than any other, helped galvanize the industry with the jarring statistic that 44,000 to 98,000 Americans die in hospitals annually as a result of medical errors. In addition to advocating the application of quality techniques from other industries to healthcare and making patient safety a high-profile priority in the U.S., Berwick's work with the U.K.'s National Health Service led to his being awarded an honorary knighthood by Queen Elizabeth II in 2005.
"He feels that in many cases the processes developed in hospitals and even between healthcare organizations are ill-designed and don't serve the patient well," Bisognano says. "He is driven by a passion for improving care so the patient gets the right care every time." And who could say no to a knight?
CLASS OF 1988