8 years later, Still Pursuing Perfection?
Organizational Change Takes Patience; Grant Funding May Be Essential, Too.
This posting started off as a grateful reaction to Gwen Darling’s blog post. But it grew. She was blogging on the
I went to and read the WSJ and ECRI links she provided. In the process, I saw ECRI’s tag line: “The Discipline of Science. The Integrity of Independence.”
Then I pondered, which of these 10 hazards can be
fixed with HCI technology? Yes, that’s laughably sincere framing of a big problem, but perhaps a reasonable starting point for anyone trained, in part, as a technologist. So, “Misleading displays” jumps out. The focus was medical devices, including medication pumps and vital sign monitors.
Fast forward. Readers of HCI are keenly focused on work needed for the real, system-level fixes, some percentage of which benefit from technology enablement:
- change management
- human-computer interactions
- risk management
- organizational behavior
- workflow redesign
- productivity improvement
- organizational culture
(see yesterday’s post,
AMIA’s Meryl Bloomrosen slide click here)
Not a New Problem – It's
Systems, not individuals, not working harder, and not about blame
Almost a decade ago, I was invited to help healthcare provider organizations pursuing an interesting grant:
What if health care delivery in the United States aimed to be perfect? What would it look like? We now have some preliminary answers, thanks to a project known as Pursuing Perfection (PP) — funded by The Robert Wood Johnson Foundation and led by the Institute for Healthcare Improvement (IHI).
The work of Pursuing Perfection, which began in 2001, is anchored by a shared desire to totally transform health care delivery. There are 13 participants in the US and Europe, and their efforts, taken as a whole, offer some of the best evidence yet that fundamental improvement in patient care is possible across and within a wide range of health systems. Most important of all, the Pursuing Perfection sites have learned that the pursuit of perfection, or aiming high, raises the bar on health care performance and leads to clinical and operational results once considered out of reach.
Pursuing Perfection challenges its grantees to set new, higher standards for the delivery of healthcare services and then to
share their methods for achieving this goal with providers across the country. The grant sponsors call this sharing component “
transparency” since it requires that grantees expose the details of their journey —
the good and the bad — outlining the lessons learned along the way as well as their formulas for success. (emphasis mine)
So what happened with Pursuing Perfection and the Grant Recipients?
Good news: Lots of impressive results in safety, mortality and costs. The primary source, RWJ and IHI,
My favorite resource has been the related