Logical incentives, matched with emotional appeals and strict guidance, proved to be a lethal combination that inspired behavioral change among Dr. Berwick’s audiences. Initial participants were experiencing improvements in patient safety and care that were too dramatic to ignore, and other doctors began to take note. Change was finally happening!

Eighteen months after the introduction of the IHI’s proposal, or maybe “challenge” is the more appropriate term, the institute revealed that approximately 122,300 avoidable deaths had been prevented. Dr. Berwick and his team forever changed patient standards of care and safety in hospitals and other healthcare institutions.

Similar to the challenges now faced by hospitals today, change did not and will not come easily. With the new ACA initiatives in place, we are well on our way to seeing change in the current healthcare system, but it’s a long road to seeing widespread improvements. The new legislation has provided a purpose (to improve patient safety and quality of care), logical appeals (monetary incentive), and guidance (Medicare’s VBP Program’s 12 clinical measures).  But, maybe, the government and Accountable Care Organizations should read up on the elephant and rider metaphor and take a page from Dr. Berwick’s strategy to realize that for effective change to occur, more concrete goals need to be implemented, emotional aspects considered and addressed, and assisted guidance be offered to healthcare’s already overburdened resources and professionals.

If 76 people were able to do it in 2006, what’s stopping us today?

Read Part 1 for background on the Affordable Care Act and Dr. Berwick and Part 2 for background on the issues facing Dr. Berwick and how he devised methods to overcome the obstacles to affect dramatic change.