The Institute for Healthcare Improvement's (IHI) National Forum on Quality Improvement in Health Care is the premier meeting place for people committed to the mission of improving healthcare. This annual event draws more than 5,500 healthcare leaders from around the world as on‐site participants and thousands more via satellite broadcast. The 2007 conference was aptly titled “The Energy of Many.” Donald Berwick, IHI president and CEO, gave the opening keynote address. Admitting that his talk was going to differ somewhat from his typical presentations, he referred to the philosopher Martin Buber's concept of “I—It” (being detached) and “I—Thou” (looking at whole beings). Berwick examined the role of evidence and the importance of context in promoting improvement. The way ahead, he says, requires both. Evidence‐based care is the gold standard in medicine today, and the best evidence is gained through randomized clinical trials in which all variation is removed. This is important when one is considering the efficacy of methotrexate for leukemia or beta blockers for heart failure. But what about assessing the value of more complex interventions, such as rapid response teams, chronic disease management programs, or improvement collaboratives? Removing variation also means ignoring context, and when ideas
Journal for Healthcare Quality – Wolters Kluwer Health
Published: May 6, 2008
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