By Dr. Adam Hoverman - OHSU Preventative Medicine Resident

Attending the Institute for Healthcare Improvement's (IHI) Annual Forum this year I was astonished by the surprising revelations that occurred for me in the several conversations that I had early in the week with the esteemed “Blue Shirts”. Consisting of both a wide range of international volunteers and IHI staff, the Blue Shirts are the veritable glue and stalwart navigators for the 5000+ attendees of the conference. I took every opportunity possible to speak with them in the early moments of the forum as they were collectively preparing, encouraging each other, and bracing for the event tsunami ahead. By doing so, I learned more about the heart of IHI, the spirit of improvement on the most quotidian and daily of scales, and the vigorous commitment to shifting the balance of power in all aspects of an organization and beyond.

First, Karen, was a lovely volunteer who had previously worked in Public Health with director of the NW Region, bordering Cumbria in the UK. Cumbria, she taught me, was an English non-metropolitan county that came into existence in 1974 after the passage of the Local Government Act of 1972. While with the local public health agency she focused on reducing teenage pregnancy, tobacco cessation, and increasing vaccination rates in the region. Her passion was both providing “safe sex” education and services once women in the community were pregnant. Most of all, she shared with me, she did not want them to feel outcast or alone. Many had applied from her organization to attend the Annual Forum and she was the one who was chosen to do so. Following a one day orientation, she said of being a blue shirt, “It made sense sooner than I had thought”; “I felt included in the team” and “I was happy that I was able to contribute.”

Then there was Kush, an IHI Staff working as a Blue Shirt at the Forum this year. He shared with me insights from IHI's inner sanctum in Cambridge, MA where he offered a physical description of the layout of the offices. Being from the East Coast myself, I particularly appreciated when he shared with me that “I don’t get that East Coast feeling at IHI. We’re all on one floor. Walls have been taken down. You can see from end to end from one side. We sit by region. No one has an office.” The spirit of transparency, openness, and inclusion that I have always gleaned from reading and listening to Don Berwick, Paul Batalden, and others was clearly demonstrated in Kush’s further description of the offices when he shared with me that “All conference rooms have glass walls. It's very visible who’s meeting. Even our chief of staff sits with the rest. They take one of the seats with us. It’s a great feel. A simple thing and it follows through in how we all act.” Lastly, the inspiration that is evident in the behavior and accountability among the staff of IHI, also turns out to be evident in the art placed throughout the office, “It’s visible on our walls”, Kush said, “All there for us to read and remember daily. Mindfulness. Transparency. Compassion. Boundlessness.”

In all, from Dr. Berwick’s invigorating keynote on Shifting the Balance of Power to the myriad daily interactions with fellow attendees, colleagues, peers, and mentors, my time at the IHI Annual Forum this year was absolutely humbling and rose far above any expectation of what an improvement conference might hold. I encourage you who are reading this to attend next year, present a storyboard even, and if so inspired, consider joining me in volunteering as a Blue Shirt. Few things exceed the value of learning while doing, and in the end it is the improving while doing that matters most of all.

Please consider learning more, and participating in the IHI Open School and local PSU-OHSU IHI Open School Chapter. Further information can be found here:

Institute for Healthcare Improvement (IHI) Open School

PSU-OHSU IHI Open School Chapter