Implementing the ‘How’ That Is Right for You

By Jay Want, MD, Executive Director, Peterson Center on Healthcare

Throughout 2018, we have featured several posts authored by the leadership of the Six Foundations Collaborative that supports the Playbook. In honor of the second anniversary of the Playbook’s launch, Jay Want, MD, reflects on the philosophy behind the Playbook and shares his vision for its use.

Although most young people don’t remember it, there was a time when information was scarce, and knowledge was relatively static. What students learned in school held special value as a rare commodity. Moreover, this knowledge was likely to be true twenty years later—retaining its value over the course of one’s career. Market advantage, then, was gained by building knowledge and experience that was held by only a few, and then “selling” that knowledge at whatever price the market would bear. Whole professions—medicine, law, architecture—were based on this principle.

In today’s digital age, the paradigm has shifted. More information than ever is available—eroding the unique power of specialization and making expertise both easier to achieve and more dynamic over time.  

Are there lessons contained in this transformation that we can apply to health care performance? 

It is becoming clearer every day that the most important skill is not jealously guarding small drips of knowledge, but the ability to sort and synthesize a rushing firehose of data. When knowledge was scarce, the challenge was to find an elusive answer, perhaps in a dusty law book or an obscure medical journal. But when knowledge is plentiful, as it is now, the true test is sifting through a torrent of information to find what’s useful in your circumstance and can be applicable in your own setting.

That’s what the Better Care Playbook is about. 

There are two ways you could approach the Playbook:

  1. Search through the existing models and pick one; try to do everything the originator did irrespective of the inevitable differences between their local context and yours, hoping you get the same results; or
  2. Start with your community and your problems, and then shop through the models/learnings/innovations to assemble mechanisms that might work, likely from several different sources.

I strongly recommend the second approach. One thing we’ve learned here at the Peterson Center on Healthcare is that the first approach is often undermined by the factors that models don’t consider—payer structure, government supports for optimizing the social determinants of health, purchaser environment, and so on. It’s your world, and none of us in philanthropy are ever going to understand it a tenth as well as you do. 

What we can do is try to knit together the community of people with good intentions and grace in their hearts, to do better for the people we all strive to serve. While that sounds noble, the reality, as we all know, is that redesigning care for people with complex needs is stubbornly difficult work. Best intentions often collide with inertia, misunderstanding, and even willful neglect. It will always be painful when the world doesn’t respond in the way you’d hoped; but in the presence of community, we are reminded of the reservoir of goodness that is so common. We are inspired by peers who can see what can be, and not simply what is now. 

To create such a community, we at the Six Foundations Collaborative believe the Playbook is, while not sufficient on its own, a crucial step in the right direction. By bringing you not just knowledge but also access to expertise, we hope that we can all learn together faster than we would apart. The uncomfortable truth is that the flood of knowledge that characterizes the twenty-first century accelerates both good and bad trends. It can help us achieve great things but has the potential to create chaos and confusion as well. We are all challenged to learn fast enough to stay ahead. 

I encourage you to explore the Playbook, to see all the wonderful work you and your peers are doing. And then take your new knowledge back to improve the care for those who need it most.