The Care Quality Commission chief inspector of general practice has been exploring innovative integrated care solutions in the US
At the beginning of June, together with Maureen Baker, the Chair of the Royal College of General Practitioners, I accompanied the Secretary of State, Jeremy Hunt, to the United States.
We visited Seattle, to see the integrated care organisation called Virginia Mason. The organisation includes what is widely regarded as one of the safest hospitals across the country, if not the world. They also have an excellent primary care service and excellent co-ordination between primary and secondary care.
Virginia Mason has received numerous awards for clinical excellence and medical expertise, but what struck me the most was the focus on the experience of every patient. Every patient, regardless of their condition, was made to feel like they are a priority.
The turnaround at Virginia Mason was due to an avoidable patient death. This triggered their excellent CEO to introduce the Toyota production system into their care delivery. They have a very open and transparent culture which means that near misses and errors are celebrated rather than condemned, and they learn from these errors. They have also developed a very safe and trusting environment for staff and their patients.
We also visited Group Health, also in Seattle, again to look at general practice in action.
Meanwhile, we visited Kaiser Permanente in Washington DC and attended the annual Health Datapalooza event, which focused on using big data for clinical improvement. What struck me whilst visiting these various orgs and attending these events, was that the GPs I encountered felt happy with their roles – they all worked in extended teams, working with nurses, physicians’ assistants, and a new role to me, which was like an extended healthcare assistant.
This medical assistance was neither a nurse or a doctor, but would help the GP by screening emails, helping patients with appointments and when patients appeared at the surgery, would do what we would expect a healthcare assistant to do. In addition, this role took a very hands on approach that maximised the GPs clinical time and included arranging for telephone and email consultations – resulting in a reduction of appointments for the GP and the abolition of waiting time. While one could argue that the US system costs more, there are lessons for us to learn about productivity and patient focused care.
From Seattle, I travelled straight to Liverpool to attend the 2014 NHS Confederation conference. Mike, Andrea and I (our three Chief Inspectors) did a live Q&A with a large audience of NHS managers.
Following this I had a brief stop in England, before travelling back to the US for my annual visit to Harvard.
Lecturing at Harvard University
I am a Member of Faculty at the Harvard Macy Institute, at Harvard University in Boston, helping to lead a course on innovation and leadership in health.
It is one of the most intellectually exciting times of each year for me. Every year for the past 12 years, I have been giving lectures to professionals and students alike and I am very passionate about exploring innovative solutions to some of the issues facing healthcare provision across the world. It’s always really inspiring to see the dedication and determination amongst the healthcare community out there to continuously improve and develop solutions.
Backing Nigeria in the World Cup
My travel stateside didn’t interrupt me keeping an eye on England’s first match in the 2014 World Cup tournament! It is so sad that England were so predictable. And it was strange to be watching all the action from so far away. I’m backing Nigeria all the way as the ones to watch, especially as they are the team that I have been lucky enough to draw in the sweepstakes!
I’m now back in England, back at CQC and things are looking up for recruitment. More from me next week.
This article was originally published on the CQC website.