2009 Silverman Symposium
2009 Silverman Symposium
The 2009 Silverman Symposium was held on March 31, 2009, on the campus of Beth Israel Deaconess Medical Center in Boston. The Symposium's Opening Grand Rounds presentation was given by Steve J. Spear, Senior Fellow at the Institute for Healthcare Improvement, and senior lecturer at MIT.
Telling all-too-familiar stories of patients who had been harmed, and in some cases killed, by medical delivery systems that prevented doctors, nurses and other clinicians from doing the right thing, Spear spoke of the dramatic and important discoveries that come to those institutions with a culture that allows staff to call-out problems that can be investigated to root cause and solved so that changes can be implemented across departments and system-wide.
When it comes to making positive and lasting improvements in health care, the secret is to be “relentless” in the pursuit of finding and solving problems, Stephen J. Spear told a packed audience Tuesday morning during his special Grand Rounds presentation. "The characteristic behavior of high performance organizations, in health care or otherwise, is that they are relentless – absolutely, positively, irrepressibly relentless about seeing problems,” said Spear. “That’s because if they can’t see the problems they can’t solve the problems. And if they can’t solve the problems they can’t learn. And, finally, if they can’t learn they can’t get any better.”
The inability to ask tough questions, to be open and transparent about problems with employees and the public at large; to be blame-free in getting to the root of either a single medical error or the investigation of a system-wide failure, is what leaves health care in America stuck in a false compromise about trade-offs, said Spear. Then it’s either “more care at more cost” or “less care at less cost.”
“It’s not just the hugely positive impact on patients who are going to be able to walk out of this hospital receiving the highest potential of what you offer,” said Spear. “It’s not just the service you are doing for yourselves that’s important. We as a society need you to set the example and say that the argument about trade-offs is false, it’s wrong and we can do much better. We can do much better for many more people and at much less cost.”
This year's Symposium also featured our Celebration of Quality and Safety at Work: A Poster Session of BIDMC Performance Improvement Projects. The two-hour event in the West campus Clinical Center lobby served as a public celebration of the many improvement efforts underway at BIDMC. The Session provided guests, staff, and presenters with the opportunity to view and discuss individual projects and learn how teams of physicians, nurses, clinical and non-clinical staff throughout BIDMC are changing BIDMC for the better. In addition to projects that span a variety of dimensions within the Institute of Medicine, this year’s posters illustrated new efforts underway in the area of employee safety, said Kathleen Murray, Director, Process Improvement.
“The quality of the posters and the quality of the projects is beyond anything I expected,’ said Lois Silverman, Chair, Board of Directors. The Silverman Institute for Health Care Quality and Safety was founded by Silverman and her late husband, Norman, both advocates of engaging BIDMC staff members at all levels in providing excellence in health care.
Steven Spear was also impressed by the scope and breadth of the process improvement projects presented in the poster session. “I was just speaking with two nurses about how all of this runs counter to the historic nursing culture,” said Spear. “They’re taught that when they run into problems – don’t complain, don’t whine, just get the job done. It’s clear from these projects that this culture is starting to change here at BIDMC.”
Last Updated: April 1, 2009
