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Creating a Learning and Improving Health System

Project Description

Healthcare has often relied on independent silos of medical research to drive progress and innovation. However, this approach does not adequately address the complexities and opportunities within the modern healthcare environment. We posit that creating a learning and improving health system that is purpose driven will ultimately lead the next transformation in healthcare. We describe the structure within Johns Hopkins Medicine that established a learning and improving health system. The system is built around a clear and compelling purpose: to help patients thrive; to prevent disease when possible, to cure when we cannot prevent, and to care when we cannot cure. This purpose is driven by research and training and supported by infrastructure based on the concept of a fractal - a structure in nature, such as a fern, containing identical shape and varying size structures.

This framework provides horizontal links for peer learning and vertical links for accountability. It dismantles traditional research and clinical silos, and combines basic and applied research with health system operations. While our learning and improving health system is driven by a patient-oriented purpose, it is supported by a robust model of transparency and accountability modeled after finance. It is strengthened by a broad network of allied entities and initiatives at our institution and organized into focused clinical communities. As a result, our system aligns the goals and strengths of a diverse set of stakeholders including clinicians, patients, researchers, and administrators toward a common goal. We share our journey of developing a learning and improving health system.

Primary Contact: Peter J. Pronovost, M.D., Ph.D.
Institution: Johns Hopkins Medicine

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