… thinking and leading the health system with your colleagues to deliver the safest, best quality, patient experience you can.” McDonnell started at Duke last summer … health upstream? How can we improve outcomes? If you don't ask, if you don't find out what's behind the condition, it's very difficult to really impact the … health upstream? How can we improve outcomes? If you don't ask, if you don't find out what's behind the condition, it's very difficult to really impact the …