Tuesday, April 20, 2010

President Obama Nominates Dr. Don Berwick

Don Berwick's Nomination

President Obama has nominated Dr. Donald Berwick president and chief executive of the Institute for Healthcare Improvement to head up Medicare and Medicaid programs. CMS, with a budget in the trillions, it is the largest U.S. healthcare agency and will undergo major changes following the healthcare system Obama recently signed into law.

Medicare and Medicaid are the federal medical programs for elderly and low income Americans and pending senates confirmation, will extend coverage to millions more Americans with Obama’s healthcare plan.

Dr. Berwick, a professor of pediatrics and health policy at Harvard, a leader in patient safety, led the nation in the 100k Lives Campaign which was aimed at giving hospitals and medical professionals the tools to improve outcomes by using proven methods that work.

There is no doubt that patient safety advocate’s, like myself are excited about this nomination. Even with just the nomination, patient safety is on the radar again. Every chance to discuss the importance of safety and quality in healthcare is important. This has started the conversations going again.

But, I do have concerns if Dr. Berwick took this position. Will he be able to keep safety and quality as the center of his work? I am afraid not. He will be taking on a big job and working for the government. If he worked for the government as a Patient Safety Officer I would say he would and could do great things for us. But he won’t. He will have many departments, a huge budget and many people to answer to. He will, in fact have to dilute his work in patient safety to cover other areas.

As I look for my own work in patient safety (yes, I still need a job), I am careful not to forfeit my values. There are diseases and people who don’t have healthcare but does that mean they don’t deserve safe care or quality care? If we ever get to a place that we are glad we have medical care but we don’t need to monitor their work or demand safe, quality care, hospitals will become an even more dangerous place to be.

I am mixed on my excitement on Dr. Berwick’s possible move. I am excited over this recognition for him but I fear if he takes this position, we may have to start looking for another Don Berwick to keep us safe.

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