Courage was a key theme at this year’s annual Institute for Healthcare Improvement (IHI) Forum as speakers urged attendees to oppose the quality and access compromises likely to come amid recent policymaking and economic pressures.
The conference on healthcare quality improvement was held in Anaheim, California, and saw about 2,400 attendees. Courage showed up in keynotes and in sessions and is one of the IHI’s core values. The IHI is a global nonprofit advising health systems on how to improve their outcomes at scale. In a Tuesday fireside chat, Sylvia Trent-Adams, Ph.D., president and CEO of the organization, urged the audience of healthcare professionals to lean into “intentional collaboration” in these challenging times.
“Big things can be done. You just have to have the courage to do them,” Trent-Adams told the room.
In the fireside chat, led by IHI President Emerita and Senior Fellow Maureen Bisognano, Trent-Adams spoke about her concern for the state of global health. She called on a “glocal” approach to public health: thinking globally, acting locally. For the IHI, this means convening communities and letting them take the charge in leading health systems improvement. It also means giving patients a voice to be heard and to affect policy change.
“Navigating the future will demand intentional collaboration, leaders working deliberately across roles, departments and systems to share power, strengthen capability and solve problems close to work,” Trent-Adams said.
In a press-only session before her fireside chat, Trent-Adams acknowledged the volatile political and economic state of the U.S. She noted that high provider burnout, providers aging out of the system and rural access barriers pose threats to adequately caring for a quickly aging population.
Focusing on public health and prevention would help relieve some strain on the system, Trent-Adams told reporters. She cited Healthy NYC, a city-led initiative, as a powerful example of data-driven public health work in action that is already seeing success. The initiative, announced in 2023, aimed to increase life expectancy for New Yorkers by addressing the root causes of chronic disease such as social drivers. Its stated goal at the time was to raise the life expectancy from 82.6 years to 83 years by 2030. It has already surpassed that goal, 2024 data show, with citywide life expectancy now at 83.2 years.
Trent-Adams stepped into the roles of president and CEO this summer after Kedar Mate, M.D., departed. Mate is now in the private sector, building out Qualified Health, a generative artificial intelligence company helping centralize the evaluation and governance of AI tools for organizations. Mate attended this year’s conference, presenting in several sessions on the potential of gen AI and AI integration at healthcare organizations.
Courage showed up in other ways at the conference. Donald Berwick, M.D., IHI co-founder, president emeritus and senior fellow, spoke at a session that considered the case for the next generation of quality leadership.
Recapping the interactive session for reporters, Berwick said participants broke out into various groups, based on theme, to share challenges and best practices with their peers. The most popular themes included kindness and courage. Specifically, the courage group considered how to take a public stance on important health issues at a time of constant politicization. The group, Berwick said, varied in their responses according to their organizations’ tolerance level for risk.
In his closing keynote at the conference Wednesday, Berwick summed it up: “Quality has now become political." More healthcare leaders must recognize that money will follow quality, he added, and that there is no room for greed: “We’ve got to remember: No healing, no mission.” This echoed Mate’s own keynote at the 2024 conference, where he called out the rise of toxic individualism and stressed that social capital is foundational to quality improvement work.
Berwick called the Trump administration’s slew of healthcare policies “vicious,” citing cuts to Medicaid, USAID, the National Institutes of Health, the Centers for Disease Control and Prevention, the safety net and sustainability efforts as deeply problematic. During the pandemic, COVID-19 was the germ healthcare professionals were focused on eradicating. “The germ today is policies that are inhumane and murderous, and I personally believe that we have to stand up,” Berwick said as the room filled with applause.
He recommended several steps attendees can take, including not staying silent and leading by example in de-prioritizing price and profit. He also encouraged them to lobby Congress to change coding rules, strengthen antitrust enforcement, expand price transparency and accelerate global budgets for populations.
“Is it safe? No, it’s not safe,” Berwick concluded. “This is a time of risk when you stand up for what is right, and we need to.”