One of the events in my calendar that I have missed only once in the past 5 years – IHI Forum. London once again was the setting for over 3,000 healthcare leaders and practitioners from around the world and whilst in retrospect I’d say that day 2 was the real winner for me, there were some standouts on Day 1 that should be shared.

Lord Ara Darzi, Professor of Surgery, Institute of Cancer Research, Imperial College, London, and, Don Berwick, President Emeritus and Senior Fellow, Institute for Healthcare Improvement both emphasised strongly a focus on relationships, partnerships and teamwork between clinicians and patients to get optimal quality outcomes.

Don Berwick told the packed audience that “Patients need to be trusted to govern their own care.” They also need to be involved in clinician training so that clinicians learn early and throughout their training to put patients at the centre of care and can get feedback on the experience of patients where treatment may not have been optimal or possible and where there may have been a lack of relationship. “Getting technical skills is only one part of the quality equation.” Understanding the patient experience will foster empathy, build listening skills and get better outcomes.

In my view when clinicians have a level of humility the chances of them investing the time to listen increases and participation in decision making increases – Kevin Hardy

The emphasis across day 1 was on learning to build and create a partnership between the health professional and the patient. I have to say that the language confuses me as I still hear the word patient expressed as an unequal relationship. In my view when clinicians have a level of humility the chances of them investing the time to listen increases and participation in decision making increases – you can read HGI’s review of Humble Inquiry by Edgar Schein. It’s a book for all healthcare leaders, not just clinicians on the art of questions vs telling.

The cost of ‘money first’

With the pressure that exists in health systems to deliver care in the right place at the right time and first time and to control finances there is a tension about what comes first. Under pressure it seems money first and then there is a risk that quality and safety will get parked and that increased regulatory frameworks will stifle innovation. The risk is that we will see an increase in pressuring healthcare professionals and managers, making them disillusioned about care and the priority to maintain quality but manage cost more fiercely. We all know of systems right now where morale is low, disillusionment high and those who are skilled at their job look elsewhere to other states or even other countries to get greater career satisfaction – that’s at best, at worst the consequences can be unnecessary deaths.