A Study Group of Thought Leaders
Dr. Berwick: There were a number of us working together from different parts of the country and different parts of the world. I met W. Edwards Deming, PhD, one of the great minds of the century on improvement, along with Dr. Joe Juran and a number of Japanese leaders. We studied together. We formed a little study group, and we studied modern approaches to improvement.
I brought that back to the Harvard Community Health Plan, where I worked. We began some experiments and then started a national demonstration project in the late 1980s, with 21 hospitals. We worked with them, trying to make something better using these then-new quality-improvement techniques from outside healthcare.
And it worked. It was unbelievable. It was so exciting. They were addressing problems that had been chronic for decades with just a little bit of help from people who understood quality. We brought in experts from other industries; a lot of them made breakthroughs.
We worked with outpatient clinics and a rehab hospital, but for the most part, we worked with mainly hospitals of different sizes. They would pick a problem: One hospital worked on infant transport, one worked on discharge smoothness, one worked on billing procedures, and one worked on infections. We got the people from IBM or Bell Laboratories or Corning Glassworks, superior experts in quality, to work with the hospitals, and they started to make breakthroughs. It was really exciting.
Dr. Topol: It was terrific how you brought in these other disciplines to get into the medical sphere. Then you decided that you were going to be a founder of this new institute, right? The Institute for Healthcare Improvement (IHI)?
Dr. Berwick: This demonstration project had been funded by the John A. Hartford Foundation of Philanthropy, and they liked what they saw. So they came to me and asked whether we would be willing to start a nonprofit organization to advance quality in healthcare in the nation. We thought about it and decided to do it. I said I would help set it up for the first 6 months while we looked for a CEO, and I ended up becoming the founding CEO for the first 22 years.