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What would change if healthcare listened more deeply to Black breast cancer survivors and built systems around their experiences, expertise, and lives? In this episode, Ricki Fairley, co-founder and CEO of Touch, the Black Breast Cancer Alliance, joins Philip McAdoo to discuss trust, science, and collective action in the fight against Black breast cancer. Drawing on her own journey as a triple-negative breast cancer survivor, Ricki explains why the science of Black breast cancer must be treated differently, how the "purple cape" of accountability shapes Black women's experience of illness, and why doctors, pharma, and health systems must change the language, the data, and the support they offer. She also shares how Touch's navigators, clinical trial matching, and community partnerships help Black women move from fear to informed, confident decision-making. Tune in for a powerful, personal conversation about building trust, changing the science, and turning advocacy into a movement! About Ricki Fairley:Ricki Fairley is co-founder and CEO of Touch, the Black Breast Cancer Alliance, and a triple-negative breast cancer survivor and thriver. She has turned her personal experience, strategic expertise, and sense of purpose into a national movement focused on eradicating Black breast cancer. Ricki has founded and led major initiatives including #BlackDataMatters, the When We Trial Movement, For the Love of My Girls, Touch Cares, and BlackTNBCSanctuary.org, all designed to increase awareness, support Black women and families, advance clinical trial participation, and change outcomes for Black breast cancer survivors. IHI Spotlight: Ashley JacksonIn this episode's IHI Spotlight, Ashley Jackson discusses IHI's Cancer Collective Action Collaborative, a 14-month initiative connecting healthcare organizations, cancer centers, and community-based and advocacy groups to address disparities across the cancer care journey. She shares why moving from awareness to action requires an honest look at gaps in care, committed partnerships, and accountability, and why building trust with communities must come before any collaborative work begins. Things You'll Learn: Black breast cancer is biologically and clinically different, and clinical trials must reflect the burden of disease that Black women actually carry. Trust is difficult to build and easy to lose; a genuine, sustained partnership matters more than one-time sponsorship. Many Black women carry an invisible "purple cape" of caregiving and financial responsibility that doesn't come off during treatment, and health systems often fail to see it. Doctors' limited time with patients and low awareness of the latest trials leave many patients without a real clinical trial conversation. Peer navigators who have lived the experience themselves can provide education, emotional support, and practical resources around the clock. Racial bias in care delivery is real and can directly affect the quality and speed of treatment a patient receives. Meaningful partnership with communities requires listening first and building trust before starting collaborative work. Resources: Connect with and follow Ricki Fairley on LinkedIn. Learn more about Touch, the Black Breast Cancer Alliance.

What would change if health care truly organized itself around what matters most to older adults, patients, families, and caregivers? In this episode, Alice Bonner, a nationally recognized leader in age-friendly care and person-centered systems, joins Dr. Philip McAdoo to discuss ageism, dignity, caregiving, and what it takes to make health care more responsive to older adults. She explains how ageism shows up in everyday assumptions, communication, workflows, physical spaces, and care decisions, and why it must be treated as a health equity issue. Alice also highlights the importance of age-friendly care, the 4Ms framework, listening deeply to older adults, engaging caregivers without bypassing the person receiving care, and making “what matters” visible, documented, and actionable across the system. Tune in for a thoughtful conversation about designing care around dignity, trust, and the real lives of older adults and the people who care for them! About Alice Bonner:Alice Bonner is a nationally recognized leader in age-friendly care, person-centered systems, and efforts to make “what matters” a reliable part of care for older adults, families, and caregivers. Her work focuses on helping health systems address ageism, strengthen dignity and respect in care delivery, and build reliable practices that support older adults across hospitals, nursing homes, clinics, home care, and community settings. IHI Spotlight: Kate DeBartolo In this episode’s IHI Spotlight, Kate DeBartolo highlights practical tools that help older adults prepare for medical appointments and communicate what matters most. She discusses IHI’s My Health Checklist and The Conversation Project, which support care planning around priorities, medications, mind, mobility, and end-of-life wishes. Kate also shares how IHI’s partnership with AARP has expanded these resources through community engagement, translations, caregiver support, and tools for health care teams. Things You’ll Learn: Ageism often begins with assumptions about older adults before getting to know them as individuals. Health systems can unintentionally create inequities when they do not account for hearing, mobility, cognition, language, fear, or the need for more time. Dignity should not be optional in health care; it should be treated as a design requirement. Age-friendly care is built around the 4Ms: what matters, medication, mentation or mind, and mobility. Families and caregivers often hold important information about medications, safety, finances, living conditions, and social support. Asking “what matters” is only the first step; health systems must document, share, and act on the answer. Leaders can make person-centered care real by modeling dignity, listening to frontline teams, and building age-friendly practices into workflows. Resources: Connect with and follow Alice Bonner on LinkedIn. Explore the Institute for Healthcare Improvement’s Age-Friendly Health Systems work. Learn more about IHI’s My Health Checklist. Learn more about The Conversation Project.

Patient safety and workforce safety are not separate priorities. They are different, but deeply connected outcomes of the same health care system. In this episode, Patricia McGaffigan, Senior Advisor for Safety at the Institute for Healthcare Improvement and President of the Certification Board for Professionals in Patient Safety, explains why health care organizations cannot deliver consistently safe, compassionate care without also protecting and supporting their workforce. She discusses why leaders must move beyond reacting to individual errors, distinguish burnout from moral injury and compassion fatigue, and create systems that encourage people to speak up, report risks, and learn from mistakes. Patricia also shares how boards and senior leaders can make safety a daily purpose rather than a dashboard metric by asking what every major decision will mean for the safety of patients and the workforce. Tune in to learn why patient and workforce safety must be led together, and how health care organizations can build a culture where people are safe to speak up, learn, and thrive. About Patricia McGaffigan: Patricia McGaffigan is Senior Advisor for Safety at the Institute for Healthcare Improvement and President of the Certification Board for Professionals in Patient Safety. She co-chairs the National Steering Committee for Patient Safety and serves as a liaison to IHI’s Lucian Leape Institute, Patient and Workforce Safety and Well-Being Initiative, and Nursing Initiative. A nationally recognized patient-safety leader, Patricia brings experience in clinical practice, teaching, and medical device and technology organizations, with a career focused on improving safety for patients, families, and the health care workforce. Things You’ll Learn: Patient safety and workforce safety are inseparable because patients and care teams experience the same system. Safer systems address the conditions that lead to harm instead of expecting people to be infallible. Workforce well-being is a performance strategy that makes care safer, more compassionate, equitable, and reliable. Burnout, moral injury, and compassion fatigue have different causes and require different responses. Psychological safety, transparency, and accountability must work together for organizations to learn and improve. Workarounds often reveal system problems and should be examined rather than blamed on individual clinicians. Boards and leaders must treat zero preventable harm as a core purpose and weigh the safety impact of every major decision on patients and the workforce. Resources: Connect with and follow Patricia McGaffigan on LinkedIn. Follow the Institute for Healthcare Improvement on LinkedIn and explore the IHI website. Learn more about IHI’s National Action Plan to Advance Patient Safety. For questions, ideas, or guest suggestions, email [email protected].

What is public trust in nurses worth if it does not lead to voice, protection, and authority? In this episode, Dr. Ernest J. Grant, Clinical Associate Professor and Vice Dean for Diversity, Equity, and Inclusion at the Duke University School of Nursing, reflects on a nursing career shaped by bedside care, burn prevention, public policy, and national leadership. He shares how nursing found him, what decades of caring for burn patients taught him about dignity and presence, and why prevention became an extension of bedside care rather than a departure from it. Dr. Grant also discusses volunteering after the September 11 attacks, leading the American Nurses Association during COVID-19, and using nurses' firsthand experiences to advocate for safer working conditions and stronger public-health responses. Looking ahead, he explains why nurses need a meaningful seat at the table, how AI should support rather than replace human care, and why healthcare leaders must mentor the next generation and create safer ways for nurses to speak up. Tune in to hear why honoring nurses requires more than praise; it requires systems that recognize their expertise, protect their courage, and give them the authority to lead. About Dr. Ernest J. Grant Ernest J. Grant, PhD, RN, FADLN, FAAN, is a Clinical Associate Professor and Vice Dean for Diversity, Equity, and Inclusion at the Duke University School of Nursing. He is the immediate past president of the American Nurses Association, the nation's largest nurses' organization representing the interests of 5.3 million registered nurses. He was the first man elected president in the organization's 130-year history. Dr. Grant has more than 30 years of nursing experience and is internationally recognized for his expertise in burn care and fire safety. He also serves as adjunct faculty at the University of North Carolina at Chapel Hill School of Nursing. His work has included bedside care, professional education, injury prevention, public policy, workforce advocacy, and national nursing leadership. In 2002, President George W. Bush presented Dr. Grant with a Nurse of the Year Award for his work caring for burn victims from the World Trade Center site. He was inducted as a Fellow of the American Academy of Nursing in 2011 and designated an Academy Living Legend in 2026, its highest honorary recognition. He earned his BSN from North Carolina Central University and his MSN and PhD from the University of North Carolina at Greensboro. He has also received honorary doctoral degrees from the University of Wisconsin and Thomas Jefferson University. Things You'll Learn Nursing can become a calling through direct experience, mentorship, and the realization that nurses can influence care far beyond a single role or credential. During major crises, leaders need to listen closely to frontline workers, translate their experiences into action, and advocate for the equipment, information, and protection they need. Calling nurses heroes is not enough if healthcare systems fail to protect them from unsafe staffing, inadequate resources, violence, and exclusion from decision-making. Public trust should translate into a meaningful nursing voice in strategy, policy, technology, resource allocation, and the design of patient care. AI can support clinical work, but it cannot replace the human touch, individualized judgment, or active listening that help patients feel heard. Leadership does not require a formal title; nurses can lead through advocacy, committee participation, professional organizations, and efforts to improve policies and practice. Healthcare leaders can turn trust into lasting authority by mentoring future leaders, sharing decision-making context, and building thoughtful succession plans. Resources Connect with and follow Dr. Ernest J. Grant on LinkedIn. Visit the Duke University School of Nursing website.

What can four decades of HIV/AIDS response teach public health about preparing for the next crisis? In this episode, Dr. Eugene McCray, a physician, epidemiologist, and longtime public health leader, reflects on the lessons HIV/AIDS has taught about trust, stigma, data, prevention, equity, and community engagement. He explains how community advocacy helped accelerate surveillance, drug development, education, and access to care, and why effective interventions mean little if they do not reach the people who need them most. Dr. McCray also explores the importance of transparent communication, timely, locally relevant data, and the creation of safe environments where communities and public health teams can share concerns and solutions. Looking ahead, he argues that future public health responses must be community-centered, evidence-based, prevention-focused, and willing to take accountability when systems get things wrong. Tune in to hear why the lessons of HIV/AIDS are not simply history, but a blueprint for building more resilient public health systems. IHI Spotlight: The episode's spotlight connects the conversation to healthcare improvement, safety, equity, and public health learning. The central lesson is that public health needs memory: science and data must remain connected to people, prevention tools must be paired with systems that deliver them equitably, and community partnership must be treated as a condition for effectiveness rather than a courtesy. About Dr. Eugene McCray: Dr. Eugene McCray is a physician, epidemiologist, and public health leader whose career has contributed to the HIV/AIDS response in the United States and globally. His work has included HIV surveillance, prevention, healthcare-worker safety, global HIV programs, and leadership of the CDC's domestic HIV program. In this conversation, he draws on decades of experience to explore what public health can learn from HIV/AIDS about trust, community engagement, data, prevention, equity, and accountability. Things You’ll Learn: Community-led advocacy helped accelerate the HIV/AIDS response by strengthening surveillance, speeding drug development, and building trust with affected populations. Stigma and discrimination can undermine public health by discouraging people from testing, seeking care, and accessing services. Transparent communication is essential when science is uncertain, especially when leaders clearly distinguish what is known from what is not yet known. Public health leaders need to listen to communities and create environments where staff and community members feel safe sharing concerns, assumptions, and solutions. Data is most powerful when it is timely, local, actionable, and used to identify populations being left behind rather than to assign blame. Effective prevention tools such as PrEP cannot reduce inequities unless public health systems tailor delivery to the communities that need them and involve those communities in designing interventions. Meaningful community engagement should extend across research, implementation, evaluation, and the feedback loop that uses data to improve programs. Future public health crises will require systems that integrate trust, prevention, and accountability, take responsibility for mistakes, and build stronger community-centered partnerships. Resources: Connect with and follow Dr. Eugene McCray on LinkedIn.

Healthcare can’t ask communities to trust systems that haven’t earned their trust. In this episode, Harold Phillips, the CEO of NMAC (formerly the National Minority AIDS Council), discusses what HIV reveals about stigma, trust, racial justice, and the communities still being left behind by healthcare. Drawing on his lived experience with HIV and decades of public health leadership, Phillips explores why healthcare must treat the whole person rather than simply the diagnosis. He explains how stigma, misinformation, and mistrust can keep people from accessing care even when effective treatments and prevention tools are available. Phillips also examines the difference between outreach and genuine community partnership, emphasizing the importance of listening to communities and using their lived experiences to shape healthcare systems and policy. Tune in to hear Harold Phillips share what healthcare leaders can learn from communities that have historically been left behind, and how those lessons can help build more equitable, trustworthy systems. IHI Spotlight - Sylvia Trent-Adams: This episode’s IHI Spotlight features Sylvia Trent-Adams, President and CEO at the Institute of Healthcare Improvement, who talks about the lessons HIV has taught her about dignity, trust, equity, and person-centered care. Drawing on her experience as a nurse caring for soldiers living with or affected by HIV, she emphasizes that treating a diagnosis and truly seeing a person are not the same thing. She also discusses why healthcare organizations must listen to marginalized communities and act on what they hear, making equity an essential part of quality and safety rather than a separate initiative. About Harold Phillips: Harold J. Phillips is a nationally recognized HIV policy leader and public health strategist with over 30 years of experience advancing equity, access, and innovation in the fight against HIV/AIDS. In 2025, he was appointed CEO of NMAC, where he leads eNorts to center racial justice and community leadership in the national response to HIV. Previously, Phillips served as Director of the White House Office of National AIDS Policy (2021–2024), overseeing the implementation of the National HIV/AIDS Strategy and shaping federal policy to accelerate progress toward ending the epidemic. He also held senior roles at the Health Resources and Services Administration’s HIV/AIDS Bureau, where he managed key programs including Ryan White, AIDS Education and Training Centers, and PEPFAR-funded initiatives. As a Black gay man living with HIV, Phillips brings lived experience and visionary leadership to his work. His career has been defined by a commitment to uplifting marginalized voices, modernizing HIV policy, and building sustainable systems of care. Things You’ll Learn: HIV continues to reveal how stigma, misinformation, and mistrust can create barriers to healthcare access. Treating the whole person requires healthcare systems to address the social and personal circumstances that shape health outcomes. Lived experience should inform healthcare policy, system design, and shared decision-making. Genuine community partnership requires ongoing listening, responsiveness, and action, not one-time outreach or consultation. Healthcare organizations can build trust by listening to communities, adapting their services, and creating systems that center historically marginalized populations. Resources: Connect with and follow Harold Phillips on LinkedIn. Follow NMAC on LinkedIn and explore their website!

What if the key to leading change isn't having all the answers, but knowing how to listen? In this episode, Sue Hassmiller, a nationally recognized nurse leader, leadership coach, and health care strategist, talks about the human side of leading teams through change and what it takes to build trust, psychological safety, and true ownership. She explains why deep listening and genuine relationships are more effective than simply telling people what to do. She also explores the difference between compliance and ownership, and how leaders can help teams take greater responsibility for improvement by connecting change to their values and giving them a voice. Finally, Sue shares how coaching, curiosity, and self-awareness can help leaders overcome judgment and better understand why teams may feel stuck, resistant, or exhausted. Tune in to learn how leaders can listen differently, build stronger connections, and create the conditions for meaningful, lasting change in health care! IHI Spotlight - Jesse McCall: In this IHI Spotlight, Jesse McCall, Senior Director at IHI, explains that sustainable healthcare improvement depends as much on people and culture as it does on technical methods. He emphasizes connecting frontline staff to a shared purpose, creating psychologically safe environments where people can speak up and test new ideas, and ensuring leaders close feedback loops so employees become partners in change rather than recipients of it. About Sue Hassmiller: Sue Hassmiller, PhD, RN, FAAN, is an executive and leadership coach for nurse executives and health care leaders. Across a distinguished career spanning frontline public health, nursing academia, high-level government policy, and 25 years leading national initiatives at the Robert Wood Johnson Foundation, she has dedicated her life to transforming health care systems from the inside out. An elected member of the National Academy of Medicine, recipient of the Florence Nightingale Medal, and recognized as a Living Legend by the American Academy of Nursing, Sue combines multi-sector expertise with certified coaching to help health care leaders navigate complex relationships, drive health equity, and champion compassionate care. She is also the author of Resetting: An Unplanned Journey of Love, Loss, and Living Again, which explores healing and the vital human element in modern health care. Things You’ll Learn: Deep listening is essential for understanding how people experience and respond to change. Leaders build ownership by listening to their teams, acknowledging their perspectives, and connecting change to shared values. Psychological safety enables teams to contribute ideas, innovate, and perform at their best. Effective behavior change requires leaders to change their own behaviors by becoming more curious, self-aware, and less judgmental. Leaders can better support stuck or exhausted teams by asking questions and seeking to understand the underlying causes instead of making assumptions. Resources: Connect with and follow Sue Hassmiller on LinkedIn.

What would health care look like if nurses had the power to shape the systems they work in? In this episode, Dr. Beverly Malone, President and CEO of the National League for Nursing, discusses why nurses must be recognized not simply as health care workers, but as healers, leaders, educators, and system shapers. She explains how nursing's unique combination of scientific expertise, empathy, advocacy, and whole-person care gives nurses a critical perspective on what patients and health care systems need. Dr. Malone calls on health care organizations to invest in nurses by providing career pathways, supporting well-being, fostering inclusion, and ensuring meaningful participation in decision-making, arguing that the future of health care depends on listening to and empowering the nurses already at the center of care. Tune in for an inspiring conversation about the power nurses already hold, and what health care systems can do to listen to, support, and empower them to lead!  About Dr. Beverly Malone: Dr. Beverly Malone is President and CEO of the National League for Nursing. A nurse, educator, clinician, and global health care leader, she has held senior leadership roles in the United States and the United Kingdom, including serving as Federal Deputy Assistant Secretary for Health under President Bill Clinton and as General Secretary of the Royal College of Nursing in the UK. Her work has focused on nursing education, leadership, diversity and equity, evidence-based practice, and advancing nurses' roles in shaping health care systems. Things You’ll Learn: Nurses are healers whose work combines science, skill, empathy, trust, and hope. Nurses exercise leadership every day by coordinating complex systems around patient care. Health care organizations must replace gratitude alone with meaningful structural support for nurses. Nurses need a seat at decision-making tables because their frontline perspective can reveal what systems miss. Nursing education and clinical practice must collaborate to prepare and support nurses throughout their careers. Cultures of belonging and well-being are essential to retaining nurses and delivering quality care. Empowered nurses can help lead health care toward prevention, health promotion, and more coordinated care. Resources: Connect with and follow Dr. Beverly Malone on LinkedIn. Follow the National League for Nursing on LinkedIn and explore their website!

What does health care truly need now, and who is already showing us the way forward? The newest season of Turn On The Lights centers on one defining question: What does health care need now? Host Philip McAdoo speaks with experts and changemakers about workforce well-being, public health, HIV prevention, aging, technology, AI, cybersecurity, patient advocacy, and health equity. Rather than focusing solely on problems, each conversation highlights practical strategies, innovative thinking, and the leaders driving meaningful improvement across the health care system. Together, these stories reinforce that better care begins with trust, safety, dignity, and a willingness to listen. If you're passionate about improving health care through leadership, innovation, equity, and human-centered care, this season offers inspiring conversations you won't want to miss. About Dr. Philip McAdoo: Dr. Philip Dorian McAdoo is an organizational strategist, educator, author, advocate, and storyteller whose work focuses on trust, culture, workplace well-being, belonging, and systems change. He serves as Director of Internal Equity & Workplace Well-Being at the Institute for Healthcare Improvement, where he supports leaders and teams in strengthening the human and organizational conditions that make improvement possible. Philip’s career spans health care, education, environmental justice, consulting, policy advocacy, philanthropy, and the arts. He holds a doctorate in Educational Leadership from the University of Pennsylvania, where his research explored the identities and experiences of openly gay educators. He is the author of Independent Queers and Every Child Deserves…, and he has spoken and led work across national convenings focused on leadership, culture, equity, and institutional change. As host of Turn on the Lights, Philip brings a human-centered and systems-focused lens to conversations about what health care needs now and how better systems can be built. Things You’ll Learn: Health care improvement starts with supporting the workforce caring for patients every day. Equity requires addressing the communities that continue to be left behind. Public health lessons from HIV remain highly relevant today. Person-centered care should be designed around what matters most to patients. Technology should strengthen trust, not simply automate processes. AI, cybersecurity, and digital transformation require strong leadership and governance. Patient advocacy remains essential for reducing disparities. Meaningful improvement begins by listening to patients, caregivers, and communities. Resources: Connect with and follow Dr. Philip McAdoo on LinkedIn and visit his website! Follow the Institute for Healthcare Improvement on LinkedIn and explore their website!

Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, has selected one of our most impactful and widely listened-to conversations from the archives to revisit. He introduces this timely discussion with Chris Van Gorder, which explores how cost shifting, regulatory mandates, and Medicare Advantage risk transfer are pushing healthcare toward structural unaffordability. Summary: Leading a major health system today means juggling patient-first ethics with a financing model that keeps tightening the screws. In this episode, Chris Van Gorder, President and Chief Executive Officer of Scripps Health, explains why health care is becoming structurally unaffordable amid soaring premiums, uncompensated emergency care, and rising input costs. He describes how hospitals have become the default safety net as county systems disappear, while underpayment by Medicare and Medicaid forces cost shifting onto employers and commercially insured patients. Van Gorder also highlights California’s seismic rebuilding mandates, which create massive capital pressure without matching reimbursement. He critiques managed care, value-based care, and Medicare Advantage for pushing risk onto providers through prior authorization and denials, recounting Scripps’ difficult decision to exit several Medicare Advantage contracts after heavy losses and the downstream impact on patients. Tune in and learn how payment design, intermediaries, and regulation shape what hospitals can sustain and what patients can access. About Chris Van Gorder: Chris Van Gorder, MPA, FACHE, is the President and Chief Executive Officer of Scripps Health in San Diego, where he has led the organization since 2000 after serving as its Chief of Healthcare Operations and COO. A veteran healthcare executive with decades of experience across California hospital systems, he previously held CEO and senior leadership roles at Long Beach Memorial Medical Center, Anaheim Memorial Medical Center, and Little Company of Mary Hospital. Beyond health system leadership, he has served on multiple boards, including Prolacta Bioscience and previously Abiomed and Z-Medica, and he has been active in national and civic service as a commissioner for the U.S. National Commission for UNESCO. He also brings an uncommon public-safety background, including reserve service with the San Diego Sheriff’s Department and long-running involvement with California’s Emergency Medical Services Authority, earning a Distinguished Service Medal. An educator and author, he teaches at USC and wrote The Front-Line Leader (2014). Things You’ll Learn: Healthcare executives are dealing with an unprecedented volume of simultaneous operational, financial, and workforce demands, raising the stakes of everyday decisions.  Affordability isn’t just a household problem; it’s a system design problem that forces hospitals to cover the growing cost of unpaid care.  Cost shifting is not a theory; it is the mechanism that pushes public underpayment onto commercial premiums.  Regulatory and capital mandates can dramatically raise costs without generating new revenue, especially in California.  Medicare Advantage often adds friction through narrow networks, prior authorization, and payment disputes, while shifting risk downhill. Walking away from bad contracts can stabilize a system financially, but it creates real disruption for patients and exposes policy gaps in switching coverage. Resources: Connect with and follow Chris Van Gorder on LinkedIn. Follow Scripps Health on LinkedIn and explore their website!

Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, is revisiting some of the most impactful conversations from the archives. For this episode, he selected a standout discussion with Dr. Michelle Schreiber and Brenna Rabel, exploring how quality measures are developed, adopted, and implemented across Medicare and Medicaid programs. Summary: How do we decide what “good care” looks like, and who gets to choose the scorecard? In this episode of Turn on the Lights, Kedar Mate speaks with Dr. Michelle Schreiber of the Centers for Medicare & Medicaid Services and Brenna Rabel of Battelle about how quality measures are developed, adopted, and applied across Medicare and Medicaid programs. They explore why measurement is essential for accountability, patient choice, and improvement, while also acknowledging its vulnerability to politics, feasibility constraints, and “teaching to the test.” Using diabetes and sepsis as examples, they explain how performance cutoffs are established, why “all-or-none” measures often face resistance, and what makes complex measures difficult to report and score. The conversation also addresses efforts to reduce reporting burden, including CMS’s shift from broader MIPS reporting toward MIPS Value Pathways and the expansion of digital quality measurement through FHIR-enabled eCQMs. They conclude with a forward-looking discussion on how artificial intelligence could reduce manual chart abstraction and advance quality measurement, particularly as patient-reported outcomes play a larger role in shaping the future of value-based care. Tune in to hear how measures shape what health systems prioritize, what gets improved, and what “value” could look like in the future. Resources: Connect with and follow Dr. Michelle Schreiber on LinkedIn. Follow CMS on LinkedIn and explore their website! Connect with and follow Brenna Rabel on LinkedIn. Follow Battelle on LinkedIn and explore their website!

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 brings back to attention this conversation with Dr. Ben Sommers on how Medicaid work requirements and reduced ACA subsidies are driving coverage losses through administrative barriers, with far-reaching consequences for patient health and the stability of safety-net hospitals and communities. Summary: Millions of Americans could lose health coverage in the coming years, and the consequences may be more profound than most people realize. In this episode, Dr. Ben Sommers, the Huntley Quelch Professor of Health Care Economics at the Harvard T.H. Chan School of Public Health, and professor of medicine at Harvard Medical School and Brigham & Women’s Hospital, talks about how new federal policies, including Medicaid work requirements and the rollback of Affordable Care Act subsidies, are reshaping access to health insurance in the U.S. Drawing on extensive research, he explains why these changes are expected to increase uninsured rates without meaningfully boosting employment. Dr. Sommers also shares evidence from prior state experiments showing that administrative red tape, not a lack of willingness to work, drives coverage loss. He outlines the ripple effects on patient health, safety-net providers, and hospitals, especially in rural and underserved communities. Tune in to understand what these policy shifts mean for patients, providers, and the future of the U.S. health care system. Things You’ll Learn: New federal policies could result in more than 15 million Americans losing health insurance over the next decade. Medicaid work requirements do not meaningfully increase employment but do lead to significant coverage losses due to administrative barriers. Evidence from Arkansas shows that most people who lost Medicaid coverage were eligible and already working or exempt, but were tripped up by reporting requirements. Losing health insurance is associated with worse health outcomes, delayed care, increased financial strain, and higher rates of preventable death. Expanding health coverage increases overall system spending, but it delivers substantial benefits in terms of health, stability, and longevity for individuals and families. Reduced Medicaid funding and rising uninsured rates will place a severe strain on safety-net hospitals and providers, especially in rural and underserved areas. Changes to ACA marketplace subsidies and Medicaid rules will affect patients, providers, and communities in phases, with political and health system consequences unfolding over several years. Resources: Follow the Harvard T.H. Chan School of Public Health on LinkedIn and explore their website! Learn more about the One, Big, Beautiful Bill here!

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.

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.

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 Kadar 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.