Don Berwick and Maureen Bisognano lived and breathed different sides of the healthcare industry before starting the Institute for Healthcare Improvement (IHI) – a $60 million not-for-profit organization with 150 employees across more than 70 countries that drives results in health and healthcare improvement worldwide.

What most people don’t know is that Don and Maureen hatched the idea for IHI while working together – Don as a research and quality guide physician and pediatrician, and Maureen as a nurse and hospital CEO. They would discuss each other’s work problems in-depth from very different perspectives, but in a way that helped facilitate actionable improvements.

In the mid-1980s, Don, Maureen, and a larger group started meeting people from outside healthcare who understood how to improve things systematically, without having to rely on incentives. They began teaching people around them what they were learning from different industries, and quickly understood that it’s unfair to send a “changed” person back to an unchanged organization. It became quickly apparent to them that it would take a new breed of leaders, as well as people on the front lines, to create long-term change in healthcare.

IHI was born with an aggressive goal, literally written on the back of an envelope. Don and Maureen set out to solve six problems in US healthcare, and engaged 2,000 hospitals and saved 100,000 lives. With the guidance of their children who fortunately had political campaign experience, they started their own campaign to change healthcare. Originally supported by the John. A. Hartford Foundation, the IHI became a reality in 1991 – and the rest is history.

In this episode of Healthcare is Hard: A Podcast for Insiders, Don and Maureen draw upon their extensive industry experience to cover a number of pressing topics with host Keith Figlioli, including:

• Achieving the “Triple Aim” in Healthcare – the Triple Aim is the trifecta of achieving better care for individuals, better health outcomes, and lower per capita costs. Don and Maureen saw this happening in other industries and in healthcare markets across the world. They talk about how they took this aim and created a leadership alliance within IHI where 40 organizations came together with a common goal of achieving the Triple Aim.
•  Healthcare’s Defects in Areas that Other Industries Don’t Tolerate – among these areas are safety issues, effectiveness, reliability, patient focus, coordination, waste and delay, and most importantly, equity. Don and Maureen discuss how they understood that people were aware of this in the mid-1980s, but no one had a way to deal with it directly at the time.
•  The Will for Change in Healthcare – who needs this inspiration and how can the will for change be built? As Maureen explains, painting the story of a patient can help build such inspiration, especially for senior-level executives who may be a little further removed. It doesn’t matter whether it’s a good or bad story; it’s about providing a background for these ideas to grow.
• The Next Big Things in Healthcare – telemedicine, telehealth, global budgeting, and healthcare for millennials are just some of the innovations Don and Maureen are excited about. 

To hear Don Berwick and Maureen Bisognano talk about these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.