Improvement, strongtruststrong, and the healthcare workforce - Forum News.pdfVIP

i2 Improvement, trust, and the healthcare workforce D M Berwick . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Qual Saf Health Care 2003; 12(Suppl 1):i2–i6 Although major defects in the performance of healthcare Yet the range among centres is 7.4–60.0%. systems are well documented, progress toward remedy Nationally, the average FEV1 (a measure of lung function) is 73.5% of the predicted normal value. remains slow. Accelerating improvement will require large Yet individual centres range from an average of shifts in attitudes toward and strategies for developing the 70.1–104.4% for children aged 6–13, and from healthcare workforce. At present, prevailing strategies rely 40.0–85.8% for adults aged 18–30.3 Recent analyses of large United States data- largely on outmoded theories of control and bases by Professor Brian Jarman suggest that standardisation of work. More modern, and much more case mix adjusted standardised mortality rates in effective, theories of production seek to harness the American hospitals (on a scale where 100 represents th