A career that created ‘the conscience of healthcare’
Many observers would cite Dr. Don Berwick’s promotion of the Triple Aim—now embraced by virtually every healthcare leader—as the highlight of his career.
Others would point to his role, as administrator of the Centers for Medicare and Medicaid Services, in implementing the Affordable Care Act. Some would credit his leadership of the Institute for Healthcare Improvement, which he co-founded.
Berwick, president emeritus and senior fellow at the IHI, chooses something else. “Of all of the specific projects or programs that I got to participate in, the one that I feel proudest of and most delighted with was the 100,000 Lives Campaign,” he said.
“Don has been characterized as the conscience of healthcare in the United States,
and I think that characterization is 100% true.”
Dr. Kedar Mate, president and CEO of the
Institute for Healthcare Improvement
Present Serves as chair of the National Academy of Medicine Board on Health Care Services
2019 Elected member of the American Academy of Arts and Sciences
2016 Elected member of the American Philosophical Society
1997 Elected member of the Institute of Medicine/National Academy of Medicine
2002-07 Served two terms on the Institute of Medicine Council
2005 Appointed Honorary Knight Commander of the British Empire by Queen Elizabeth II in honor of his work with the British National Health Service
Career in review
2012-present President emeritus and senior fellow, Institute for Healthcare Improvement
2012-14 Candidate for the Democratic Party’s nomination for governor of Massachusetts
2010-11 Administrator, Centers for Medicare and Medicaid Services
1991-2010 President and CEO, Institute for Healthcare Improvement
1987-91 Principal investigator, National Demonstration Project on Quality Improvement in Health Care
1980-89 Various positions, including vice president for quality-of-care measurement, Harvard Community Health Plan
1975-96 Pediatrician, Children’s Hospital Medical Center
Since 1972 Various academic appointments at Harvard, including clinical professor of pediatrics and healthcare policy, Harvard Medical School, and professor of health policy and management, Harvard School of Public Health. Currently, a lecturer in the Department of Healthcare Policy
Harvard Medical School, 1972
Public policy, John F. Kennedy School of Government, Harvard University, 1972
Social relations, Harvard College, 1968
The IHI initiative, launched in December 2004, mobilized more than 3,000 hospitals to focus on patient safety sufficiently that they could extend or save 100,000 lives during an 18-month period, proving that deaths by central line infections, adverse drug events and other common hazards in care are not inevitable.
“I don’t think I’ve ever seen such an outpouring of support and enthusiasm and authentic engagement,” he said. “It was very moving and it was all volunteered. There was no financial incentive—they did it because they felt it was important to do.”
For this and his many other contributions to healthcare, Berwick is being inducted into Modern Healthcare’s Health Care Hall of Fame.
Berwick showed how industrial engineering, manufacturing science, reliability science, and systems thinking could be applied to healthcare to make health systems more reliable, high-performing, person-centered, higher-quality and safer, said Dr. Kedar Mate, IHI’s president and CEO. But that’s only part of his legacy.
“Don has been characterized as the conscience of healthcare in the United States, and I think that characterization is 100% true,” he said. “He represents a bulwark against injustice, and he’s out there always picking the right side of the fight.”
Berwick has inspired people around the world to make healthcare safer and more affordable, Dr. Gary Kaplan, a former IHI board chair, said in an email.
“However, Don’s influence goes far beyond healthcare as he challenges all of us to create a more sustainable, equitable and caring world,” said Kaplan, former CEO of Virginia Mason Franciscan Health in Seattle. “His passion for the underserved and less fortunate continues to show that each of us can make a difference in our communities and far beyond.”
Trained as a pediatrician, Berwick led the IHI as its CEO for 19 years, leaving in 2010 when President Barack Obama appointed him to the top post at CMS, where he served for 17 months. He has practiced at Boston’s Children’s Hospital, Massachusetts General Hospital and Brigham and Women’s Hospital. He taught at Harvard Medical School and Harvard School of Public Health. He has chaired the National Advisory Council of the Agency for Healthcare Research and Quality, and served as vice chair of the U.S. Preventive Services Task Force.
In 2008, Berwick and his colleagues created the IHI Open School as the first formal online curriculum for students and health professionals to learn about improvement science, quality and safety. Over a million people in more than 100 countries have enrolled in the virtual classes.
Berwick had been working on quality improvement for decades when he was appointed to serve on the Institute of Medicine committee that issued “To Err Is Human: Building a Safer Health System” in 1999 and “Crossing the Quality Chasm: A New Health System for the 21st Century” in 2001. Ever since, he has maintained focus on their findings and recommendations, publishing periodic assessments of the halting progress.
“The biggest frustration I have is that in the terrain of healthcare, which is very complex and shifting and urgent, it’s really hard to maintain the constancy of purpose and the authentic focus of boards of trustees, executives, and even senior clinical leaders on continuous improvement of care,” he said.
The failure to make continuous improvement a strategic imperative is directly related to the constant distraction of focusing on financial success. “The basic theory that I have been taught—that the best route to financial sustainability is the continuous improvement of care processes—has not yet taken root in the healthcare industry,” Berwick said. “There’s an unfortunate separation between financial stewardship and improvement of care. And we need to address that.”
2022 Hall of Fame judges
President and CEO
American College of Healthcare Executives
Publisher, Modern Healthcare
Retired president and CEO
President and CEO
President and CEO
That tough-love perspective does not alienate the many healthcare leaders who have flocked to the annual IHI National Forums for the past 33 years. Kaplan, internationally recognized as a pioneer in healthcare improvement himself, recounts “the anticipation and excitement I have felt annually as I’ve waited for his annual IHI National Forum address.”
“Each one is a tour de force of passion, vulnerability, challenge and inspiration to create a better world for everyone,” he said.
Berwick’s presence on a podium is matched by his presence one-on-one. Mate recalls a time, early in his career at IHI, in which he accompanied Berwick on a trip to the United Kingdom, where he was to deliver a master class in quality to a student group. They were scheduled for a long train ride, and Mate intended to seize the chance to ask him a long list of questions.
Instead, the entire trip was devoted to Berwick’s stories of family—he and his wife Ann, an environmental lawyer, have four children and eight grandchildren—and questions about Mate’s family, his vacations and his hopes for the future. “All he wanted to do was learn about me and figure out what mattered to me,” Mate said. “That is Don’s radical humanness—his deep connection to everyone he is with.”
Lola Butcher is freelance writer based in Springfield, Missouri.