“Fragmentation is the most toxic agent I can think of in a system of care trying to help people through the journeys that are their lives and illnesses.” - Donald M. Berwick, MD, MPP; Past President and CEO, Institute for Healthcare Improvement; Former Administrator,Centres for Medicare and Medicaid Services in Boston.
In this one quote Berwick summed up everything that was a motivator for me to enter the leadership arena as a physician. Berwick went on to posit that almost every form of defect eroding the quality and sustainability of care – problems of safety, reliability, patient centeredness, timeliness, efficiency and equity – has its roots deeply embedded in failures of cooperation.
At the end of February, the provincial government introduced legislation that would require chain restaurants with 20 or more locations to post calorie counts on their menus.
In doing so, the government heeded the call of health experts who were concerned about the rates of obesity. This seems to be a simple straight forward intervention; tell people how many calories are in the foods that they are ordering and they will make better decisions. The problem is that most of us are not simple or straight forward folk. Our decisions are influenced by many things and many of the factors that influence our decisions in the moment are out of direct control or our awareness. That may be why the results of studies examining these types of interventions are quite mixed. When asked why support an intervention that is not clearly effective, my colleagues in the obesity field respond with two arguments.
It may be April, but I am still reflecting on our 3rd Annual Research Day last month.
The theme of this year’s event was ‘Recovery’ and it was highlighted by powerful keynote presentations from Dr. Mike Slade and Laura Burke, while attendees were asked to re-evaluate the delivery of mental health care.
Since then, I have been trying to tie together presentations from the point of view of professionals delivering care and patients receiving service.