Health Systems Solutions

In October, Legacy members convened in the home of Legacy Member Joanne Kagle for a reception and discussion with Dr. Atul Gawande, MD, MPH on health systems innovation and his cutting edge work with Ariadne Labs in creating scalable health care solutions.

Atul covered a lot of ground during the evening, but here are the key takeaways we noted from his conversation with us:

  • Atul’s Lab, Ariadne Labs, follows the “Ariadne Arc” to design simple solutions to close the health care delivery gap; rapid cycle pilot and test with more people, institutions, systems; and then spread and implement proven solutions at large scale
    • Applying science to follow-through discoveries the same way we previously applied science to biological discoveries
    • Capturing positive deviants on the bell curve of health care delivery to bring that success to scale
    • Current focus areas of Birth, Surgery, End of Life
    • Safe Surgical checklist used in estimated 100 million of 300 million surgeries globally; Ten innovations in the pipeline
  • Challenges:
    • Built our health care system in the 1950s around clinical autonomy, the clinician as “solo craftsman”, but now siloed autonomy is part of the problem:  poor coordination, difficult to manage growing complexity
    • Use different approaches to culture change: 20% of surgeons and teams think the checklist approach is a waste of time, BUT 95% of them would want the checklist used if they were having surgery
    • Health insurance is tied to work, but the least healthy are the least employable. How do we tackle this in the gig economy?
  • Impact:
    • Team communication component has been key to success of Safe Surgical Checklist
    • 22% reduction in post-surgical deaths after statewide implementation in South Carolina
    • Ariadne Labs has both domestic and international focus; Design and test often starts domestically, while spread and scale embraces global implementation in low, middle and high resource countries

Resources that were mentioned: