Donald Berwick: Curing the Healthcare System

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IHI analyzes the data to identify the method that has the biggest impact on patient outcomes and publishes the results for free on its Web site for any hospital to adopt.

To further spread its findings, IHI launched the 5 Million Lives Campaign, which 4,000 hospitals joined, meaning that they adopted at least one of the 12 goals and promised to report the results. Even after the campaign ends next month, any hospital can still adopt the goals. Dr. Berwick thinks many probably will, because the goals—and the specific recommendations to reach them—save lives and prevent harm, and they often cut costs.

For instance, patients on a ventilator are susceptible to an often-deadly pneumonia. Every case adds an estimated $40,000 to the cost of a typical hospital stay. One of the four IHI-recommended approaches to preventing the infection is to ensure that a patient's head is elevated at least 30 degrees.

To prevent the head from falling below that, IHI suggested drawing a line on the wall beneath which the bed shouldn't drop and instructing nurses, housekeepers, family members, and anyone else to alert the nurse if the line became visible. It's simple but effective, and it's the same story for the other 11 goals. "Each complication, if not prevented, would have resulted in thousands of dollars of extra care, medication, and prolonged hospitalization," says Louise Liang, the senior vice-president of quality and clinical systems support at Kaiser Foundation Health Plan & Hospitals.

"A Personal Hero"

Dr. Berwick, a former pediatrician, has won myriad awards for his work, but when it comes to measuring his impact, the proof is in the data. Dominican Hospital in Santa Cruz, Calif., reduced the rate of hospital-acquired infections to near-zero after adopting IHI's methods. At Missouri Baptist Hospital in St Louis, the April 2004 introduction of an IHI-tested innovation led to 31 fewer cardiac arrests than the previous year. And Albany Memorial Hospital reduced its mortality rate by 15% in 2006. Hundreds of doctors and nurses and health-care administrators deserve credit for these achievements, but Dr. Berwick's role in developing, testing, and spreading these innovations is unparalleled.

"Dr. Berwick is the single most influential worldwide leader and driver of health-care process, practice, and clinical outcome improvement," says Dominican Vice-President Lee Vanderpool, "He's a personal hero of mine."

Jessie Scanlon is the senior writer for Innovation & Design at BusinessWeek, where she covers the intersection of design and business.

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