Institute for Healthcare Improvement leader tells a story: A nurse, a patient, and a dog

Ethyl and her dog/Courtesy photo

The Cambridge-based Institute for Healthcare Improvement is holding its annual conference in Florida this week, and President Maureen Bisognano spoke this morning about how creating change in the health care industry will require its leaders to become storytellers.

Among the stories she told was one that I heard her share recently and was struck by:

At Gundersen-Lutheran Health System in La Crosse, Wis., the sickest of their population are enrolled in an extraordinary care coordination program. Led by nurses and social workers, the program guides those most in need across all dimensions of health and sick care. Free of charge for everyone who’s eligible, and funded by the hospital, the patients are guided to the best care and the results are remarkable. They get care where and when they need it, eliminating avoidable hospitalizations and emphasizing preventive care. For those in the program, health care costs have been reduced by $18,000 per patient, over two years. The data are great, but the stories are even better.


When I visited Gundersen Lutheran just a few weeks ago, I met the care coordination team, including Deb. … She told me about a patient whose picture she keeps on her desk. Ethyl is 94 years old, has lost her husband and has no family. She was losing weight and was completely dependent on home care. One day, Deb asked Ethyl, “What do you want?’’ Ethyl said, “I want a dog.’’ The nurse’s first reaction was, “I’m the nurse. I don’t do dogs,’’ but after more conversation over the next few weeks, the care coordination nurse stopped by the pound and picked up a dog. Ethyl went from being chair-bound and completely dependent, to walking 125 feet and playing the violin for the other patients in the hospital’s lobby. And look at the dog, and her joy, and her health.

At IHI we hear stories of excellent care every day, but we long to hear more stories about patients who are cared for comprehensively, as people. By focusing on outcomes, we are putting the patient at the center of care design, and by transferring control to our patients, we are easing the burden of treatment, improving outcomes, reducing costs, and restoring the freedom many of them have lost.


Read another of Bisognano’s stories here, and find out more about the forum on the IHI website.

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