I am attending the pre-conference of the Institute for Healthcare Improvement's 20^th annual National Forum on Quality Improvement in Healthcare (and if my oldest son wasn't having a minor health care crisis of his own later this week—not that he really needs his wisdom teeth—I'd stay for the whole thing). It hasn't really gotten going yet but a few things to share:

• This conference began 20 years ago with about 287 participants. Now, 6000 are converging on a hotel so enormous that we have to carry around color-coded maps and get custom-printed instructions on how to find our rooms. Another 10,000 people are watching IHI CEO Don Berwick and his faculty by satellite. For a growing portion of the health care world, quality is not a threatening idea brought in by cost-cutting consultants. Quality is part of their mission.
• The conference is so far-reaching that participants are invited to an hour-long orientation. Questions ranged from "how do I not get lost here" to "How do I get a bailout?" The comment that got the loudest applause was when one participant—I didn't get her name—told everyone that now, with a new administration committed to health care reform, is the time to raise their voice, share their ideas. "Senator Daschle is taking emails," she said.
• The exhibition hall and poster sessions might not be open before I leave but I heard a few advance snippets which show that quality improvement isn't an abstraction, it can translate into care that makes a difference for patients. Groups here from hospitals around the country will show how they cut infection rates, inspired physicians, brought patient satisfaction up to 99 percent—in the ER.

I had a chance to chat with Berwick recently and will share that soon...