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CHS Research News
Vol 19, Issue 3, Fall 2007

Feature Article

Birnbaum speaker: Regions must align for quality and equality in health care

By Rebecca Hughes

While selected programs and projects to improve health care are showing promising results, the United States still has “a health care system where quality is hit or miss.” That was the assessment delivered by Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation (RWJF), at Group Health’s 8th Annual Hilde & Bill Birnbaum Endowed Lecture on November 15. Earlier that day, she participated in a roundtable discussion with Group Health and community leaders on “Transforming Health Care Regionally: Group Health as a Catalyst for Change.”

The RWJF is committed to ensuring that all Americans receive quality health care. Its many programs and projects have included Improving Chronic Illness Care—based on the Chronic Care Model pioneered at the MacColl Institute for Healthcare Innovation at the Group Health Center for Health Studies (CHS). “We have achieved inspiring results, showing that health care can be improved in ways that matter to patients and providers,” Dr. Lavizzo-Mourey said.

However, she said, proven “best practices” are not taking hold and transforming care across the country. The United States still spends twice as much on health care as any other nation, she added, without achieving consistently high quality, especially for patients with chronic diseases and those from certain racial, ethnic, and cultural backgrounds. “The care minority patients receive is often of lower quality than that received by whites,” she said.

Regional Quality Strategy
Accordingly, said Dr. Lavizzo-Mourey, the RWJF is focusing on its Quality/Equality programs, including: creating quality measurements that are more meaningful to patients and providers; standardizing measurement and reporting activities; and communicating these activities transparently.

Also, as part of its Quality/Equality programs, the RWJF is launching a Regional Quality Strategy to bridge the fragmented systems involved in health care, region by region. “This will build on our Aligning Forces project,” said Dr. Lavizzo-Mourey. In that project, the Foundation has worked with coalitions in 14 U.S. communities—including Western Washington through the Puget Sound Health Alliance—to focus on performance reporting, quality improvement by health care providers, and engaging consumers in health care quality.

For the Regional Quality Strategy, the RWJF will choose as many as 20 regions, which might be as large as states and which together will represent the United States at large. In each region, the Strategy will create multiple-stakeholder coalitions, including patients, providers, consumer groups, health plans, businesses, and payors. Their joint goals, she said, will be to provide more equitable and patient-centered care and achieve sustained improvements in health care outcomes for patients by 2015.

Hometown health care
One of the regions that the RWJF is inviting to apply to its Regional Quality Strategy is Dr. Lavizzo-Mourey’s hometown. She was raised in Seattle by two physician parents: pediatrician Blanche Sellers Lavizzo, MD, MPH, the founding medical director of the Odessa Brown Children's Clinic; and surgeon Philip Lavizzo, MD.

Dr. Lavizzo-Mourey hailed Seattle’s “problem-solving approach,” which she linked to engineers at Boeing—and now Microsoft. Seattle’s medical community shares that “can-do” approach, she said, thanks to its world-class training hospitals and Group Health, the Puget Sound Health Alliance, and the Seattle Indian Health Board.

“Seattle’s always had a strong sense that when it comes to health care, we’re all in this together,” she said. “I wish we could bottle that feeling and export it elsewhere.”

The Birnbaum Endowed Lecture
The annual Birnbaum Endowed Lecture was established in 2000 to honor Hilde and Bill Birnbaum’s long-term commitment to Group Health, their active participation in its founding, and their passion for using research to improve patient care. The lecture provides an annual opportunity for nationally prominent leaders and innovative thinkers to address the scientific community and Group Health leadership, staff, providers, and supporters. The Group Health Center for Health Studies and the Group Health Community Foundation sponsor the event with funds from the Birnbaum Endowed Fund.

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