Yesterday evening, members of the Community Health Improvement Consortium (CHIC) gathered to eat a meal together and discuss the future of a network of people who together had cooperated to improve health care for patients of Whatcom County since 1996. Among its ranks included medical directors of key healthcare organizations, educators, quality improvement professionals, nurses, insurers, doctors in primary, internal and surgical practice. Some of these individuals had been members of this quasi-organization since its inception, others joined the group for the first time. The question at the table: What was the future of the Community Health Improvement Consortium?
It seems the success of this group with its intention for change had been successful. It had been a catalyst to bring resources to the community because of its cooperation and willingness to work together to improve diabetes care, immunizations, smoking cessation and mammography. Now they were at a crossroads- they had attracted an grant from Robert Wood Johnson Foundation called Pursuing Perfection and the intensity of that involvement had consumed key members of this group. Others who could not be intimately involved in the grant implementation, were feeling disconnected and anxious that other efforts to improve and cooperate in the community would not be recognized and nutured in relationship with those involved in the initiative. If they could not radically test the aims and rules outlined in the IOM Crossing the Quality Chasm Report, would they be left out? What would be the future of CHIC or would there be a future????
I witnessed a difficult conversation- one where assumptions were exposed, experiences shared. It was an honest, respectful, open dialogue between all. It was able to occur because of the foundation and relationships created over a number of years.... Six years of shared successes and failures to cooperate above competition to create a healthier community. Options were discussed and explored about a future of healthcare improvement with CHIC or without.
Through listening and questioning, a renewed commitment to CHIC and to each other was forged. There was a recognition that there had been a shift because of the Pursuing Perfection initiative. A recognition that a new vision of CHIC would be required and that only together in continued dialogue would this vision be created. Not all involved in CHIC were able to be there, but enough of a diverse core of influential partners to bring in other community, system-minded people including patients, employers for this next dialogue. It was one of the most critical steps for this community to move toward a sustainable pursuit of perfection.
