New Course Provides Refreshing Perspective on Care Delivery

Health care consumes one dollar out of every seven in the US economy, but it remains disappointing in terms of availability and quality of care. It is no surprise that it is central in media coverage and political debate.

Despite all the attention, little headway is made because of a powerful but false assumption: That whatever good is gained must be traded off for something else in return. The reasoning goes that more or better care must be more expensive, so we must chose between getting more or saving money. In other words, we cannot get more, but pay less.

This premise – and the resulting conclusions – is mistaken. In fact, it is possible to provide better care to more people at less per unit and total cost. Accomplishing this requires applying a more sophisticated approach to managing the delivery of care.

The newest course in the IHI Open School, “Achieving Breakthrough Quality, Access, and Affordability,” demonstrates how this more dependable, reliable approach works. By the completion of the course, students will come to understand that:

· The delivery of care is a far more complex undertaking than in years past because the contributions of many more people – spanning many more specialties and disciplines –have to be coordinated and integrated.

· The complexity of systems creates vulnerabilities that weren’t significant in simpler systems. Given the number of contributors involved and the strong interdependencies among their work, small aberrations – that might have had minimal effect – can gel to cause major harm.

· Certain behaviors, if avoided, and other behaviors, if embraced, both protect against these failures and also contribute to success.

As a result of these lessons, the best of both worlds is enjoyed: The full benefit of complexity is appreciated, diagnoses and treatments incorporate what is best known across multiple disciplines, AND the systems that harness all these contributions are reliable and responsive.

- The course is authored by Steven Spear, DBA, MS, MS, Senior Lecturer at the MIT Sloan School of Management, Senior Fellow at the Institute for Healthcare Improvement, and author of a number of influential articles on operational excellence in general and healthcare excellence, and author of the award winning book, The High Velocity Edge.