Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, has hand-selected one of our most-listened-to and impactful conversations from the archives to highlight once again. Dr. Philip introduces this essential dialogue with Professor Charles Vincent, reflecting on why its core message, moving past basic compliance toward true, real-time healthcare improvement, is so vital to where the podcast is headed next. Summary: Blame rarely makes care safer, but understanding the system usually does. In this episode, Professor Charles Vincent, a clinical psychologist and leading patient safety researcher, explains how harm often emerges from a chain of small breakdowns, not from a single “bad” decision, and why the better question is “what in the system allowed this to happen?” He unpacks how the fixation on individual error can miss deeper contributors, such as fatigue, poor supervision, weak monitoring, clunky equipment design, noise, distraction, and communication that is not truly heard. You will hear why disrespectful behavior and hierarchy are safety risks, how simple routines like surgical safety checklists can change whether people speak up, and why healthcare struggles to name the trade-off between pushing volume and protecting safety. Tune in and learn how a systems lens, respectful teamwork, and real trade-offs can make care safer. About Prof. Charles Vincent: Charles Vincent is a Professor of Psychology at the University of Oxford and a longtime researcher focused on patient safety across a wide range of healthcare settings. He studies how and why errors and patient harm happen, what actually works to improve safety, and how safety events affect patients, families, and healthcare staff. More recently, his work has zeroed in on how risk is managed when teams are under pressure, where small breakdowns can quickly compound in complex systems. Before Oxford, he spent over a decade at Imperial College London as Professor of Clinical Safety Research and later served as Emeritus Professor. His academic background spans psychology and clinical psychology, including a PhD in Psychology, which shapes his practical, systems-based approach to safety and risk management. Things You’ll Learn: Most serious harm in healthcare results from interconnected system conditions, such as missed monitoring, delays, and weak supervision, rather than a single individual error. A focus on blame fosters defensiveness and inhibits organizational learning, whereas a systems perspective examines factors such as fatigue, workflow, tools, environment, and teamwork that shape human performance. Disrespect and rigid hierarchy pose safety hazards by suppressing speaking up, whereas high-performing teams normalize open communication across roles. Safety routines, including surgical checklists, create social permission to voice concerns, but when senior clinicians dismiss them, psychological safety deteriorates. The tension between productivity and safety is often unacknowledged in healthcare, even though increasing volume and evolving care complexity, such as expanded home-based care, can heighten systemic risk. Resources: Connect with and follow Prof. Charles Vincent on LinkedIn. Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, has hand-selected one of our most-listened-to and impactful conversations from the archives to highlight once again. Dr. Philip introduces this essential dialogue with Dr. Vivek Garg, reflecting on why its core message, moving past basic compliance toward true, real-time healthcare improvement, is so vital to where the podcast is headed next. Summary: Quality measurement matters only if it helps patients and clinicians deliver better care in real time, not just prove compliance after the fact. In this episode, Vivek Garg, President and CEO of NCQA, reflects on how growing up with an immigrant physician father, living with his mother’s undiagnosed bipolar disorder, and training in internal medicine shaped his commitment to patient-centered improvement. He explains why he pursued “edge-case” primary care roles at innovative organizations and how those experiences led him to focus on quality, value-based care, and complex populations. Vivek also clarifies NCQA’s role in convening standards, accrediting health plans and practices, and validating performance through audits and support. He critiques today’s bloated measurement ecosystem and argues for digital, interoperable, clinically meaningful metrics that reduce burden and truly improve care delivery. Tune in and learn how quality standards can evolve from checklists into a continuous improvement engine that patients can actually feel! Resources: Connect with and follow Vivek Garg on LinkedIn. Learn more about the National Committee for Quality Assurance (NCQA) on their LinkedIn and website. Learn more about your ad choices. Visit megaphone.fm/adchoices

Healthcare improvement is never just about systems, measures, policies, or processes; it is fundamentally about people. In this special transition episode, Dr. Philip McAdoo introduces himself as the new host of Turn on the Lights, a podcast by the Institute for Healthcare Improvement (IHI). He honors the foundational work of previous hosts Don and Kate while laying out an expansive vision for the podcast’s next chapter. To bridge where the show has been with where it is going, Philip announces a summer series re-broadcasting the five most popular episodes from the past year. These episodes cover critical subjects like patient-centered quality, the systemic roots of patient safety, Medicaid access, inclusivity in healthcare measurement, and the financial complexities behind rising premiums. Looking ahead, Philip shares his commitment to widening the podcast's frame by treating stories as evidence, balancing data with human dignity, and bringing frontline workers, patients, and marginalized communities directly to the table. About Philip McAdoo Dr. Philip Dorian McAdoo is an organizational strategist, educator, author, advocate, and storyteller. He serves as Director of Internal Equity & Workplace Well-Being at the Institute for Healthcare Improvement, where he helps strengthen the cultures, practices, and conditions that allow people and systems to improve. As host of Turn on the Lights, Philip brings a human-centered lens to conversations about trust, dignity, leadership, and building better healthcare systems. Resources: Connect with and follow host Philip McAdoo on LinkedIn Learn more about the Institute for Healthcare Improvement (IHI) by visiting their LinkedIn and website. Learn more about your ad choices. Visit megaphone.fm/adchoices

What happens after 150 conversations about the future of health care? In this episode, co-hosts Dr. Don Berwick, Former Administrator and CMS President Emeritus at IHI, and Dr. Kedar Mate, Founder & CMO of Qualified Health-genAI for Healthcare and Former CEO of IHI, look back on more than 150 conversations exploring health care reform, patient advocacy, medical debt, AI, and global health systems. They discuss how the podcast evolved into a platform for making complex health care topics more understandable through candid conversations and personal storytelling. The hosts also announce a transition as the podcast continues under the Institute for Healthcare Improvement, with new leadership, while they prepare their next collaborative project. Looking ahead, they share their excitement about diving deeper into subjects like artificial intelligence, international health care comparisons, and investigative-style series shaped by listener feedback. Tune in to hear Don Berwick and Kedar Mate reflect on what they learned, what surprised them most, and where the conversation about health care innovation, AI, and reform goes next! Resources: Connect with and follow Dr. Don Berwick on LinkedIn or reach out via email! Connect with and follow Dr. Kedar Mate on LinkedIn or reach out via email! Follow IHI on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

Health care should not be designed around fragments of a person’s life. It should be built around the whole person, with data, intelligence, and ownership working together. In this episode, Nasim Afsar, author of Intelligent Health and former Chief Health Officer at Oracle Health, joins Don Berwick and Kedar Mate to discuss how technology can transform healthcare from reactive and fragmented to personalized and proactive. Drawing on her experience as a hospitalist, quality leader, health system COO, and health tech executive, Dr. Afsar explains why healthcare systems often fail when they prioritize institutional needs over patient realities. She shares the story of Elena, a patient labeled “noncompliant” whose challenges were actually tied to homelessness, insurance loss, and a care plan disconnected from her daily life. Dr. Afsar also outlines the three pillars of Intelligent Health: integrating clinical and social data, applying intelligence to generate foresight and insights, and creating systems driven by consumers themselves. Tune in and learn how intelligent health can give people more agency, more personalized support, and a better chance at living healthier lives. Resources: Connect with and follow Dr. Nasim Afsar on LinkedIn. Learn more about her book, Intelligent Health, here! Explore Nasim’s website. Learn more about your ad choices. Visit megaphone.fm/adchoices

Health insurance policy is complicated, but the consequences are deeply human. In this episode of Turn on the Lights, Professor Jonathan Gruber, Ford Professor of Economics and Chair of the Economics Department at MIT, joins Don Berwick and Kedar Mate to explore the history, structure, and future of health reform in the United States. Drawing on his work shaping Massachusetts health reform and the Affordable Care Act, Gruber explains the three-legged stool of reform: ending insurance discrimination, requiring broad participation, and making coverage affordable through subsidies. He also reflects on the political battles behind the ACA, the importance of Medicaid expansion, and the growing risks to health care coverage today. The conversation concludes with cautious optimism about biomedical innovation alongside serious concerns about affordability, rising costs, and the need for a more seamless health care system. Tune in to hear why health reform is not just about policy design, but about whether people can get care when they need it. Resources Follow MIT on LinkedIn and explore the website.  Learn more about Professor Jonathan Gruber:https://economics.mit.edu/people/faculty/jonathan-gruber Learn more about your ad choices. Visit megaphone.fm/adchoices

AI may be the breakthrough that finally helps a deeply strained health care system do what clinicians and patients have needed all along. In this episode, Dr. Bob Wachter, Professor and Chair of the Department of Medicine at UCSF, examines why artificial intelligence marks a pivotal shift in health care and what it means for clinicians, patients, and care delivery. He draws on past transformations, like hospital medicine and electronic records, to explain why AI stands apart as a fundamentally different force. The conversation highlights where AI is already adding value, including medical scribes, chart summarization, and clinical decision support. Dr. Wachter also explores key risks, including trust, bias, deskilling, security, and conflicts of interest, while considering how AI may redefine the physician’s role, medical education, and the doctor-patient relationship. Tune in to hear why AI may be one of health care’s greatest opportunities and one of its most important tests. Resources: Connect with and follow Dr. Bob Wachter on LinkedIn. Get a copy of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future here. Learn more about your ad choices. Visit megaphone.fm/adchoices

Public health is easiest to overlook when it is doing its job well, and hardest to defend when uncertainty is unavoidable. In this episode, Dr. Rochelle Walensky, former CDC Director and infectious disease physician, reflects on the leadership challenges, pressure, and public scrutiny she faced during the height of the COVID-19 pandemic. She discusses the difficulty of communicating evolving science in real time, preparing for congressional hearings, and rebuilding morale within an agency under intense strain. Dr. Walensky also highlights lesser-known public health efforts, including the CDC’s work to prevent measles spread during the Afghan evacuation. She shares her perspective on the agency’s current challenges and emphasizes the importance of relationships, workforce trust, modern data systems, and her ongoing work with the Vaccine Integrity Project. Tune in to hear why rebuilding trust in public health will require not only better systems, but better storytelling. Resources Follow Dr. Rochelle Walensky on LinkedIn. Explore the CDC’s role in public health preparedness and response here. Read about the Vaccine Integrity Project here.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Why does public health so often get neglected until a crisis makes its value impossible to ignore? In this episode, Dr. Tom Frieden, President and CEO of Resolve to Save Lives, former CDC Director, and former New York City Health Commissioner, reflects on a career spent trying to close the gap between what we know saves lives and what we actually do. He shares how his father’s example shaped his commitment to evidence-based medicine and public service, and he explains the framework behind his new book, The Formula for Better Health, see, believe, create. The conversation explores major public health wins, such as reducing smoking in New York City, the challenges of leading the CDC, the damage to public health infrastructure today, and why prevention, primary care, and global health remain essential to a safer, healthier future. Tune in to hear why better public health depends not only on science, but also on courage, communication, and the will to act. Resources: Connect with Dr. Tom Frieden on LinkedIn. Follow Resolve to Save Lives on LinkedIn and visit the website here.  Learn more about The Formula for Better Health: How to Save Millions of Lives--Including Your Own here. Learn more about your ad choices. Visit megaphone.fm/adchoices

What if one of the biggest barriers in health care is not access to treatment, but access to your own data? In this episode, Hugo Campos, patient advocate, creative strategist, and participant ambassador, shares how his diagnosis with hypertrophic cardiomyopathy led him to advocate for patient agency and access to personal health data. After receiving an implantable cardioverter defibrillator, he discovered that data from his own body was shared with clinicians and manufacturers, but not with him. This realization sparked his work in data liberation and his challenge to traditional health care models. He explores how withholding data undermines trust, how patient communities drive change, and how AI can support patients by helping them ask better questions. Tune in to hear why better health care starts with giving people more visibility, more voice, and more control over their own lives. Resources: Connect with and follow Hugo Campos on LinkedIn. Visit AI Patients at aipatients.org. Read the National Academy of Medicine commentary on critical AI health literacy and patient empowerment here. Learn more about Turn on the Lights here. Learn more about your ad choices. Visit megaphone.fm/adchoices