QUALITY: Improving health care from within, by Eric Novack

Eric Novack sees hope in the IHI’s 100K lives program which announced impressive results this week, and being Eric, he thinks that there’s a political message in there too. There’ll be more on his show this Sunday.
The Institute for Health Improvement’s ‘100,000 Lives Campaign’ (www.ihi.org) just released the results for the first 18 months:  participation of over 3000 hospitals and an estimated 122,000 lives saved.
In a word, astounding.
What is more astounding is HOW they did it.  First, the ‘they’ are the organizers of the program and the THOUSANDS OF DOCTORS, PHARMACISTS, AND NURSES who implemented some simple changes in hospitals all over the country.
Did they focus on hundreds of best practices and brow-beat institutions into submission?
Did they threaten to not compensate anyone for trying to provide care?
Did they threaten lawsuits?
No, No, No.
The 100,000 lives campaign focused on 6 simple steps that are essentially universally accepted to be good practices to get the right care, at the right time, in the right place, and to reduce infections along the way.
With success breeding more success, more hospitals are continuing to sign up for the programs and looking to expand their involvement in the program further.
Most remarkably absent, however, was new federal legislation and government regulation.  May I repeat: no federal bureaucracy was and is required to make improvements to our healthcare system.
This, no doubt, is like fingernails on the blackboard for many denizens of The Health Care Blog-osphere.
I was fortunate to interview Alexi Nazem, National field coordinator for the IHI’s 100,000 Lives Campaign for my show this weekend.  You definitely want to find time at 3pm west coast time this Sunday to tune in at www.ericnovack.com to hear the whole interview- and to better understand both the IOM ‘To Err is Human’ report and get an insider’s view of patient safety efforts.

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Maggie Mahar

Eric, Re “Improving Healthcare From Within,” I agree that IHI is doing a great job. Don Berwick (head of IHI) is right when he says that health care reform will not come about by “someone buying right” (i.e. the consumer can’t lift quality) but through health care professionals pulling together to reduce waste and errors. But at this point, they’re badly demoralized.–they need leadership. Just today, a physician in New York told me that the head of nursing at one of the large hosptials here recently confided to him that at this point, she’s “ashamed” to be part of the… Read more »


You’re correct to a point, but what you’re forgetting is marketing. Medicaid plans aren’t allowed to market, period, so there are no costs associated with advertising and whatnot, and that could account for a fair chunk of the difference.
That said, you’re right that there is some admin advantage Medicaid enjoys, since it doesn’t have to submit folks to the underwriting process (you pass the means test, you’re in!), and what’s covered or not covered is laid out pretty clearly. Medicaid plans have finally got religion about maintaining a formulary, too, thank goodness.


Eric, your post about the 3% myth was quite thought provoking, but I think I have an rebuttal to your argument which can be summed up in one word, Medicaid. Correct me if I’m wrong, but I believe that Medicaid’s administrative costs are something like 4-6%. While that is not as good as 3% that still leaves a substantial savings if compared to the 15% to 25% of private insurers. I don’t believe that alone is a good enough reason to switch to single payer, but it does mean that’s one aspect of potential savings if there was a switch.