Don Berwick, President and CEO of the Insitute for Healthcare Improvement, and MIT Professor Steven Spear coauthored an editorial in the Boston Globe last week called “A new design for healthcare delivery,” which focuses on the fact that more coverage does not have to mean more cost — if it comes with an ongoing commitment to process improvement and redesign.

Their thoughts are valuable and the article is worth a read. Don and his colleagues have been on the leading edge of a movement in health care reform for more than a decade, with a mission to improve quality and safety — but within the boundaries of what we already know.

I first learned about their work about ten years ago — when I was still working for then-Massachusetts Governor Bill Weld. I attended a meeting hosted by the Institute for Healthcare Improvement (IHI) in Boston. At the time, I knew little about the Institute, other than it was founded by a Harvard-trained pediatrician (Don Berwick), who’d gained some notoriety as a researcher and writer on health care quality and safety. It was a cozy gathering — maybe 75 to 100 people in all — but the national distribution of the audience was pretty amazing, and the people who were there were almost all “C level” type folks from hospitals, health plans and physicians organizations.

The discussion that day was all about process — something I’d never heard anyone in health care discuss at any great length before — and focused primarily on hand-offs — into and out of the hospital, across shifts within the hospital, and from one department to another within the hospital setting.

As the conversation went on, I realized, probably for the first time, that there was tremendous opportunity to improve care delivery by focusing on the minutiae of care delivery processes. Like most people, I thought health care improvements were generally associated with advancements in scientific knowledge — so-called basic research — but this conference turned this world view on its head — arguing that huge gains in care delivery could be had by simply doing what we already knew how to do better.

Since then, IHI has engaged thousands of organizations around the country — and across the globe — in their endeavors. They’ve launched numerous campaigns to improve care, safety and cost-effectiveness, and done most of them by focusing not on how much new money is needed to “reform” health care, but on how much more can be done in all three areas with the money that’s already on the table.

Over 7,000 people will gather in a couple of weeks to attend the IHI’s annual National Forum on Quality Improvement in Health Care Forum — which is the single largest gathering of health care professionals with an interest in better, safer care, using the IHI’s process improvement approach. Let’s wish them all luck. As the population ages, and the technology that’s available to serve illness and manage disease gets more and more sophisticated, the operating models and the processes that support them will need all the IHI can bring — and then some — to ensure that health care gets better, safer and more cost-effective along the way.

Posted by Charlie Baker in Health Care Costs