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Enigma by Fahmi Bhs
“When you are courting a nice girl an hour seems like a second. When you sit on a red-hot cinder a second seems like an hour. That's relativity.”
Albert Einstein
The only way we can rescue American healthcare is to improve it: better care, better health, lower cost. Donald Berwick
Why ISTEW?
Institute of Medicine Report 2001
“Quality problems are everywhere.”
Hospital blunders 'kill 90,000 patients'Rebecca Smith, Medical Editor, Daily Telegraph 29.11.07
• 1 in 10 patients
unintentionally
harmed
• 50% avoided if
lessons from previous
events had been
learned
• £2 billion a year in
extra bed days alone
Department of Health, National Audit Office. A Safer Place for
Patients: Learning to improve patient safety. HC 456 Session 2005-2006
http://www.nao.org.uk.
17 years to apply 14% of research knowledge to patient care!
Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yrbk of Med Informatics 2000; 65-70
“Quality Improvement”
The combined and unceasing efforts of everyone –health care professionals, patients and their
families, researchers, payers, planners, administrators, educators – to make changes that
will lead to
better patient outcome, better system performance, and better professional
development.
Batalden P, Davidoff F. Qual. Saf. Health Care 2007;16;2-3
Two jobs to do!
• All healthcare professionals
• Deliver the best possible care you can
• Constantly try to improve the care you delver and the experience for patients and their carers
Don Berwick, Former CEO
Institute for Healthcare Improvement,
USA
https://uws.ac.uk/improvementscience
Heart & Minds
‘If you want to build a ship do not gather men together and assign tasks. Instead teach them the longing for the wide endless sea.’
(Saint Exupery, Little Prince)
IOM’s six “Aims for Improvement”
“The car design process begins with a design concept.” – Dacia lean manufacturing team, Romania
Creating a culture of Lean is to create an insatiable appetite for
improvement