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TRANSCRIPT
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A Report from XanaduDonald M. Berwick, MD, MPP
26th Annual National Forum on Quality Improvement in Health Care
December 10, 2014
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Marco Polo
Don Polo
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Gorge Sanchez
Campaign Activities605 days of campaigning
208 fundraising events74 campaign strategy meetings
219 meetings with stakeholders and political figures
95 town caucuses
20-30 hours of fundraising phone calls every week
30,000 car miles visiting 185 towns and cities
5 parades
24 labor union breakfasts
52 radio and TV interviews
23 debates
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SSYI
SSYI Workshop
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Jackie and SSYI Get Results
39% reduction in
homicides attributed to youth violence in
Massachusetts.
No shooting deaths
among SSYI clients
since 2012.
SSYI Wall of Success
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SSYI Deaths
UTEC
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UTEC
Gregg Croteau
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UTEC Recidivism Results
Gary Slutkin
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HOW TOSTOP EPIDEMICS
1. Interrupt transmission1. Interrupt transmission1. Interrupt transmission1. Interrupt transmission
2. Change behavior2. Change behavior2. Change behavior2. Change behavior
3. Change norms3. Change norms3. Change norms3. Change norms
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Results – Logan Square Cure Violence
CURE VIOLENCE
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DOJ - INDEPENDENT EVALUATION
↓ 41 – 73% shootings and killings (overall effect seen)
↓ 16 – 34% shootings and killings (directly attributable)
↓ 100% retaliation murders in 5 of 8 communities
85 – 97% helped to jobs, school, out of gang
Demonstrated effective to reduce shootings and killings
Issues List: PartialJobs
Economic DevelopmentEducation
Poverty
EnvironmentEnergy
Health Care
LGBT RightsTransportation
Casinos
Affordable Housing
HomelessnessReproductive Rights
Gun Violence
Immigration
Criminal Justice
Veterans AffairsFisheries
Arts and Culture
Tax PolicyVoting Rights
Early Childhood Education
Infrastructure Gender Equity
Local Aid
Social Justice
Alternative EnergyCoastal Flooding
Standardized Testing
Smart Growth
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IHI Triple Aim
Triple Aim in a Community
and community health
and health for the individual and economic vitality
for the community
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Naromie
“Bring all the agencies together (both statutory and private sector), and bring a method.” – Derek Feeley
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Just Mercy and The New Jim Crow
Massachusetts Incarceration Rate
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LB
Massachusetts Budget FY 2001-15
Source: Massachusetts Budget and Policy Center
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$2,000,000,000
$4,000,000,000
$6,000,000,000
$8,000,000,000
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$12,000,000,000
$14,000,000,000
$16,000,000,000
$18,000,000,000
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15
Fiscal Year
Education
Environment & Recreation
Health Care
Human Services
Infrastructure, Housing &
Economic Development
Law & Public Safety
Local Aid
Other
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-60%-60%
Percent Change in Massachusetts Spending
FY 2001-15
Looking Back: What We Could Have Saved if We Had Matched the Next Highest Country (Switzerland)
Note: Per capita spending amounts adjusted for differences in cost of living, total U.S. savings adjusted for inflation. Source: D. Squires, The Road Not Taken: The Cost of 30 Years of Unsustainable Health Spending Growth in the United States, (New York: The Commonwealth Fund Blog, March 2013).
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Gorge and Jadiel
Baystate Medical Center
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Comparing Investments
“You’re either part of the solution or
you’re part of the problem.” – Eldridge
Cleaver
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Three Big Steps
1. Costs down. Really… I mean, REALLY!
15%
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66% started using substances
before age 20
29% experienced homelessness
60% struggle w/ mental health
50% have been in jail, prison
or arrested
50% are socially isolated
None have regular employment
Nearly all report difficulty
getting needed health care
Growing Up66% experienced ABUSE
(physical, emotional or sexual – often starting before age 6)
40% lived w/ adult substance users
23% were separated from their birth parents
50% struggled in school
Only 40% graduated
from high school
Adulthood
Who Are Medicaid “High Utilizers?”Replacing “What’s wrong with them” with “What happened to them…”
Lived-Experience interviews tell us that. . . .
Health Share / CareOregon
Health Resilience Program
How do we support building trust, safety, a sense of control, partnership?
What Is Possible?
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Three Big Steps
1. Costs down. Really… I mean, REALLY!
2. Broaden our engagement
Make the Problem Bigger
“Whenever I run into a problem I can’t solve, I always make it bigger. I can never solve it by trying to make it smaller, but if I make it big enough, I can begin to see the outlines of a solution.” – Dwight Eisenhower
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“The opposite of poverty is not wealth… the opposite of poverty is justice.” – Bryan Stevenson
To Do List
Join 100 Million Healthier Lives Initiative.Join IHI’s Leadership Alliance.
Students enroll in I-CAN. Join and be active in the Healthier Hospitals Initiative.Break through on energy and environmental responsibility. – Call Jeff Thompson, CEO of Gunderson Health System.
Personal cell: 608-397-5158. Say hi for me.
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Three Big Steps
1. Get costs under control
2. Broaden our engagement
3. Vote
No society can legitimately
call itself civilised if a sick person is denied medical aid
because of lack of means…
– Aneurin “Nye” Bevan, father of the UK National
Health Service
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Something is profoundly wrong with the way we live today.For thirty years we have made a virtue out of the pursuit of
material self-interest: indeed, this very pursuit now constituteswhatever remains of our sense of collective purpose. We know
what things cost but have no idea what they are worth. We no
longer ask of a judicial ruling or a legislative act: Is it good? Is itfair? Is it just? Is it right? Will it help bring about a better society
or a better world? Those used to be the political questions,even if they invited no easy answers. We must learn once
again to pose them.
--Tony Judt, Ill Fares the Land, 2010
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Minnesota Toward Zero Deaths
Gorge Sanchez
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Don’s Twitter Question of the Session
Tweet your answer
using the National Forum hashtag:
#IHI26Forum
How can
health care
help reduce
youth violence
in the
community?
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