Medical errors both in the U.S. and worldwide occur at alarming rates. In the U.S. medical errors were the third leading cause of death. Southwick experienced the consequences of preventable medical errors firsthand. As a physician and a professor, he researched and wrote about the causes and solutions for medical errors over the years. Southwick also launched pilot programs applying different quality improvement frameworks from other fields to medicine. Although the results were positive, he encountered resistance from many physicians. To build more skills, Southwick became an Advanced Leadership Fellow in 2010 and a Senior Advanced Leadership Fellow in 2011. He used his time at Harvard to develop solutions that would address the root causes of medical errors. The complexities in healthcare and the entrenched cultural norms presented strong barriers to creating change. The case explores Southwick's efforts in getting medical professionals to work collaboratively, communicate effectively, and create a new sustainable culture that improves healthcare outcomes. Southwick's experience raises the question of how one person can best make a difference in a large, complex, entrenched system.
Years before Harvard University Professor Howard Koh was appointed by President Barack Obama as the 14th U.S. Assistant Secretary for Health (2009-2014) for the U.S. Department of Health and Human Services (HHS), where he went on to address a vast portfolio of health challenges, he played a leading role in two highly impactful coalition-based public health campaigns focused on tobacco control and organ donation. The tobacco tax and organ donation campaigns illustrate how public health advocates can effectively build and rally coalitions of diverse groups around a results-focused health mission. They underscore the perseverance and other leadership traits that public health leaders like Koh harness to push through innovative strategies in the face of powerful entrenched groups committed to preserving the status quo. And while the campaigns also demonstrate the difficulties of sustaining public health initiatives due to changing political and economic circumstances, leaders like Koh must surmount disappointments to find new ways to continue the mission over the course of a long career.
Center for Health Communication at the Harvard T.H. Chan School of Public Health Director Jay Winsten spearheaded a national mass media campaign, the Harvard Alcohol Project, also known as the Designated Driver Campaign, to rapidly diffuse the "designated driver" into the American lexicon and culture. The campaign broke new ground in the process, most notably by harnessing on an unprecedented scale the Hollywood entertainment community's power to disseminate messages and facilitate social learning. Writers incorporated the campaign's designated driver message into the scripts of more than 160 prime-time television episodes during four television seasons. The campaign persuaded large numbers of Americans to adopt the practice of choosing a designated driver-i.e., a member of a social group who agrees to stay sober in order to safely drive others in the group who have been drinking alcohol. The campaign provided a model for a generation of advocates seeking to mobilize the power of Hollywood to advance social causes, and convinced funding organizations that media advocacy campaigns were worth supporting.