Don Berwick: Candidate and Dr. Quality

August 30, 2013 in Medical Technology

By Martha Bebinger, WBUR

Dr. Donald Berwick might be running for Governor of Massachusetts, but he’s still got a foothold in his former life. 

Berwick, most recently known as the acting chief of the Centers for Medicare and Medicaid, had a long record as the leading authority on health care quality, including being founder and CEO of the Institute for Healthcare Improvement. And it was more in that capacity that the British Prime Minister David Cameron asked Berwick for his recommendations for improving safety and restoring confidence after higher-than-expected death rates at one hospital rocked the country.

[See also: Donald Berwick to run for Mass. governor.]

The result? Berwick’s “Letter to the people of England” explained his call for continuous learning without blame as the fastest route to improved quality within the National Health Service. The NHS needs national safe-staffing formulas that can be applied, with discretion, Berwick said, to avoid the dangers of understaffing at British hospitals. Berwick spoke, by phone, to a group of reporters about the health care and political lessons his work in the UK offers for Massachusetts.

Here are edited excerpts of that call.  

Q: How do you think this report relates to people in Massachusetts. What do they take away from it?

A: Well…this report is not part of the campaign; I had agreed to do it prior to the announcement. But this is about large system change, I mean, here you have a system with 1.4 million employees. That’s the size of the NHS spending 100 billion pounds [approx. $160 billion]. So it’s a very relevant experience. I obviously was dealing with very senior leaders in a politicized environment, which of course as governor I would be doing constantly and helping build consensus. 

Q: You know that your work in the UK was thrown back at you as a critique in Washington. I wonder how you read the climate in Massachusetts for drawing lessons from work, like what you’ve done in this report?

A: Well, first the critique in Washington always felt to me, more or less hogwash. It was more demagogic than informed. I did work  [his work goes back to the mid-90s, he was Knighted in 2005] with the NHS, I’m proud to have done that, it’s a good system with flaws. They brought me there because of their flaws and what they wanted is to continually improve. It is not the case that you can take a system from one country, or from one state, let alone the country, and just import it to another one, so that was pretty much fabricated, the idea that somehow I had a plot with the NHS. I’m proud of that work.

I think Massachusetts is a state that has a history of learning and growth and development and one of the ways you do that is by reaching out and learning what others are doing. We don’t have a Mid Staffordshire problem of that exact type here in Massachusetts.

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