If President Barack Obama officially nominates Donald Berwick, 63, to lead the CMS as expected, some are wondering what that choice would mean for the future of the Institute for Healthcare Improvement.
... but if he leaves
Quality executives expect little change at IHI
Berwick, president, CEO and co-founder of the Cambridge, Mass.-based not-for-profit organization, is arguably one of the most prominent leaders in the quality-improvement and patient-safety movement. Under his direction, the IHI spearheaded the widely publicized 100,000 Lives Campaign and the 5 Million Lives Campaign, two initiatives aimed at curbing the number of preventable deaths from medical harm.
Michael Cruz, vice president of quality and safety at 573-bed OSF St. Francis Medical Center, Peoria, Ill., credits the IHI with helping the hospital improve its processes and aid other organizations. OSF St. Francis participated in the 5 Million Lives Campaign as a mentor site for pressure ulcers and provided guidance to hospitals trying to achieve better results.
Cruz said he thought that Berwick's nomination would significantly affect the IHI and that the organization would inevitably feel the loss. Still, he said, there are other talented people onboard and it will likely continue to be a valuable resource.
Others echoed that sentiment.
“Dr. Berwick is the poet laureate of the quality and patient-safety movement, and he is an inspiration to all of us,” said Leah Binder, CEO of the Leapfrog Group, a healthcare quality organization formed by large employers. “I imagine he is very instrumental to their success, but having said that, he is also a good manager, and good managers make sure there are people there to take the lead when they leave.”
Brian Koll, medical director for infection control and chief of epidemiology at 1,051-bed Beth Israel Medical Center, New York, said: “The IHI is not just about Dr. Berwick, it's about the program, and it will continue as people move on.”
Koll also predicted patient-safety advocates such as Peter Pronovost, director of the Quality & Safety Research Group at Johns Hopkins University, Baltimore, and Lucian Leape, chairman of the Lucian Leape Institute at the National Patient Safety Foundation, Boston, will continue to push the movement forward.
The IHI's recent improvement initiatives have made it even more accessible to providers, Koll said. Beth Israel Medical Center served as a mentor site for three initiatives during the 5 Million Lives Campaign—central-line infections, methicillin-resistant Staphyloccus areus and catheter-associated urinary-tract infections—and is also working with the IHI on its Improvement Map, a free and open online resource that allows hospitals to access specialized tools and best practices developed by mentor sites during the campaign.
In addition to the Improvement Map, the IHI's current projects include the How Do They Do That? initiative, which shares the lessons learned from 10 models of low-cost, high-quality care, and the IHI Open School, a free, online educational community dedicated to healthcare improvement.
The IHI's programs have not been universally praised. The 100,000 Lives Campaign took some flak in 2006 over its method of accounting for the number of lives saved by hospitals in the program.
The IHI has been doing well financially and reported $40.2 million in net operating revenue and a $4.5 million increase in net assets from operations in the year ended April 30, 2009, according to audited financial statements on its Web site. The organization did report a net realized and unrealized loss of $13.9 million from its investments, which were valued at $44.2 million in that period.
Berwick's 2007 total compensation was $764,333, according to the most recent available Internal Revenue Service Form 990.
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