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Your Daily Posterous Spaces Update November 27th, 2011 Berwick to

Leave · Another Blow to Health

Reform?<http://ptmanagerblog.com/berwick-to-leave-another-blow-to-health-refor>

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Another Blow to Health Reform?

November 26, 2011 in

Medicare<http://healthcare-economist.com/category/medicaidmedicare/medicare-medi\

caidmedicare/>|

No

comments<http://healthcare-economist.com/2011/11/26/another-blow-to-health-refor\

m/#respond>

The head of the Centers for Medicare and Medicaid Services (CMS), Don

Berwick, announced he would step down from his post on

Wednesday<http://www.nytimes.com/2011/11/24/health/policy/dr-donald-m-berwick-re\

signs-as-head-of-medicare-and-medicaid.html?_r=1>.

Berwick was a temporary 18 month appointment who Obama hoped would stay on

longer. The San Francisco Chronicle

reports<http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/23/MNVL1M3J4S.D\

TL>

“*The point man for carrying out President Obama’s health care law will be

stepping down after Republicans succeeded in blocking his confirmation by

the Senate, the White House announced Wednesday.*”

Don Berwick aimed to improve healthcare quality in Medicare. Many

individuals, however, have tried to improve the quality of care provided to

Medicare enrollees. Why would might Berwick’s efforts have been any more

successful than his predecessors?

McDonough<http://www.boston.com/lifestyle/health/health_stew/2011/11/post.html>o\

f

Health Stew notes that Berwick has a legacy of promoting quality

improvement across a variety of healthcare organizations.

“*In 1989, Berwick wrote a seminal article for the *New England Journal of

Medicine* called “Continuous Improvement as an Ideal in Health

Care<http://www.nejm.org/doi/full/10.1056/NEJM198901053200110>,”

and set off an intellectual revolution in American, and eventually, global

medicine. Prior to Berwick, “quality” had been linked with the word

“assurance” with the cavalier and false assumption that quality already

existed, and all that was needed was adequate policing to root out “bad

apples.” Every hospital was required to have a “quality assurance”

department that looked out for quality; everybody else just did their jobs.*

*More than anyone, Berwick changed the word from “assurance” to

“improvement” with new assumptions: quality must be an essential part of

everyone’s job; no matter how good or how bad you think you and your

organization are, every day, you have multiple opportunities to improve;

and the key to quality improvement (QI) is the elimination of errors and

waste, along with the empowerment of workers. Berwick did more than just

establish an idea, he created an organization, the Institute for Healthcare

Improvement (IHI), to advance and actualize it. Under his leadership, IHI

has become the worldwide home for QI through training, teaching, learning,

collaborating, advocating, and more.*”

Berwick also ran into trouble for using the ‘r’ word. Specifically, in an

interview with a biotechnology journal in

2009<http://www.nytimes.com/2011/11/24/health/policy/dr-donald-m-berwick-resigns\

-as-head-of-medicare-and-medicaid.html?_r=1>,

he said, “The decision is not whether or not we will ration care — the

decision is whether we will ration with our eyes open.”

*Tags:* Berwick <http://healthcare-economist.com/tag/berwick/>,

CMS<http://healthcare-economist.com/tag/cms/>,

Medicare <http://healthcare-economist.com/tag/medicare/>,

Tavenner<http://healthcare-economist.com/tag/tavenner/>

via

healthcare-economist.com<http://healthcare-economist.com/2011/11/26/another-blow\

-to-health-reform/>

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