Why Have We Struggled So Hard to Improve Healthcare Quality?

There are many incredible efforts under way to drive needed change throughout the healthcare system. I love what Christensen and Hwang have proposed in Innovator’s Prescription. I have much respect for what Berwick and colleagues have done for years under the banner of the Institute for Healthcare Improvement.

There are many incredible efforts under way to drive needed change throughout the healthcare system. I love what Christensen and Hwang have proposed in Innovator’s Prescription. I have much respect for what Berwick and colleagues have done for years under the banner of the Institute for Healthcare Improvement. I have followed the countless pilot projects that demonstrate the short-term impact of the patient-centered medical home. I have read everything published on the rapid-learning healthcare system. And, I believe that there is a huge upside to PPACA/Obamacare. But I don’t think any of these ambitious efforts is going to have the impact we need…because they each have failed to effectively leverage the critical element that either makes or breaks complex transformations. This is perhaps the classic example of good being the enemy of great…

For us to ensure a ‘great’ healthcare system, the type of healthcare system that we commonly see glimpses of in small pockets throughout the nation, and the type of healthcare systems that our parents and grandparents deserve, we must change the way we think about implementation. In reality, none of these broad campaigns and policy changes will be effective without this new framework — none of initiatives will be effective without what I have come to call: SocialQI.

For us to accelerate healthcare quality improvement such that our friends and family receive safe, timely, effective, efficient, equitable, and patient-centered care; we must direct our unwavering energies at the intersection of two emerging fields of science: the science of social networks and the science of behavior change – and you would be hard pressed to find these fields weaved within any of the respected models described above.

Think about it (and if you are so inclined, look for it), despite the mass appeal or funding that each of broadly established models above may have garnered, 1) they each require information to flow more effectively than it does today (science of social networks) and 2) they each require millions of individuals to make more informed/logical choices (science of behavior change). Said another way, a) they each require collective action (science of social networks) and b) they each require millions of connected individuals to think differently (science of behavior change).

Our challenge is to seed the idea of SocialQI within the house of medicine and to tell the story in ways that appeals to those charged with driving change – and perhaps this is our most critical challenge, those who embrace the framework understand the importance of listening to the edges of the social graph for new ideas and models for change; but those without the vision have no ability to see what could be…often until it is too late.

If you have ideas of how to best leverage the SocialQI model or to share it with your institutional or organizational leadership send me a note…the more people thinking about making these changes the better…and I am always looking for other’s driven to help me ‘walk-the-walk.’