Berwick Pushes for Quality

Prior to taking over as administrator of the Centers for Medicare & Medicaid Services (CMS) two months ago, Donald Berwick's name was fairly synonymous with the word "quality." The list of accomplishments for the founder, past president and CEO of the Institute for Healthcare Improvement have made him an international figure when it comes to examining the delivery of quality care. So the next big question is: what emphasis on quality improvement is he bringing to his new job?

Berwick made his first public speech this week to attendees at America's Health Insurance Plans (AHIP's) Medicare and Medicaid conference in Washington. Threaded throughout the talk—beyond examining the implementation of the Affordable Care Act—were references to quality and healthcare that will likely be highlighted during his term.

He said that "as we say in the world of quality improvement, 'Every system is perfectly designed to achieve exactly the results it gets.' If we want new results—and we do—we need a new system. All improvement is change." Here are some of those changes he is proposing.

The Triple Aim. To get started on his journey, Berwick referred to the roadmap that he would like to see "healthcare rally around"—"The Triple Aim"—which he first wrote about two years ago on how to improve care in the United States. The Triple Aim, he noted, refers to three goals at once:

• Better care for individuals, as described by all six dimensions of quality in the 2001 Institute of Medicine report on Crossing the Quality Chasm: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.