Paul
Borawski offers examples of the good and the bad of 2011 in his recent post
. His use of the word
"quality" highlights the abstract nature of that word--something the
world is no longer willing to accept.
You have to be more specific and tell us what you mean by
"quality" before we're willing to agree with you that "quality
works" or that it has a rightful place in society. What good is it? What has it done for me lately? The Institute
of Medicine assessed the impact of their publications, "To Err is
Human" and " Crossing the Chasm." These two works sharply criticized the US healthcare system
for its many failings and prescribed broad approaches for improvement. Ten years later, nothing has
happened. Various quality
initiatives in healthcare have essentially failed to address either the
incidence of errors or the cost of the services provided. One can point to
various initiatives or projects that have demonstrated small improvements, but
nothing has spurred the industry to emulate these successes everywhere. The reason for this general failure is
pretty clear--money. It's not that
there isn't money to implement change, but that there is no financial incentive
to do so. There is no financial
incentive for improvement.
Following
that negative note, what were the discrete disappointments of 2011? Paul cites the discontinuance of
funding for the Baldrige award.
ASQ has a financial interest in the Award, and it's always disappointing
to lose a client, so he’s hardly an impartial observer. Beyond that, Baldrige was a concept
that came and went. Applications
have diminished in the last several years, and the whole system has degenerated
into a commercial enterprise, with consultants and writers to enhance your
application and improve your chance of success. The original concept of identifying a few examples of
excellence for others to model has become a competition. The ideas and criteria are still valid
and still provide an excellent guide to excellence in any industry. We just don't need shining examples any
more.
Don Berwick/s departure from CMS should
be on most people's list of disappointments. A victim of Republican ideology, he brought credibility and
stature to the position. Not
everyone agreed with all of his ideas, but then, not everyone agrees with me
either. I hope that's OK.
Paul
cites the high point of his year as going to a meeting in China. Maybe that's a sad commentary on the
real absence of anything good.
