The greatest danger in times of turbulence is not the turbulence – it is to act with yesterday’s logic - Peter Drucker

The Berwick Report: Subtle, Eloquent and Powerful

The Berwick Report was published this week. It distils the lessons learned and specifies the changes needed in the wake of the Frances Inquiry into the Mid Staffordshire tragedy. 

I'm familiar with Don Berwick's writing and I've heard him speak. A giant in the world of healthcare quality improvement, he has inspired me to see the world differently. I hoped that his voice would not have lost any of its impact and I was not disappointed. The Frances report was a landmark publication for NHS England with implications for the rest of the UK but the Berwick Report is one for the NHS of Great Britain. It has important messages for all.

Reading the social media sites, it's apparent that the Berwick Report has had a mixed reception with various groups feeling that the recommendations just don't go far enough. Everyone has a perspective borne of their experience and I respect their view.  However, I urge the critics to look deeper. 

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An Intrinsic Desire to Improve

An intrinsic desire to improve

I'm getting ready to do the BUPA 10k run on Sunday (14th July) around Holyrood in Edinburgh. This will be the second of four 10ks that I will be doing over the summer.  The first was part of the Edinburgh Marathon Festival in May and the third will be the 'Mind your Head' Charity run in Shetland in August (in support of mental health services).   A route around Loch Ness will complete the 10k quartet in September.  So a summer of personal challenge lies ahead.  

There's something special about running though that makes you want to continually improve.  It's not about being in competition with others; it's more about challenging yourself to do better.  In order to improve you need to measure your performance and I have an app on my iPhone for this.  Monitoring my own stats has got me thinking about the rancour that measuring performance has been generating in the NHS in recent months.

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The Dance of the Blind Reflex

Flicking through some literature on quality improvement recently I came across a quote from quality expert Harold F Dodge - "you cannot inspect quality into a product". The simple central message made me pause. It has a particular potency in the context of the recent high profile quality of care concerns in the NHS. So much energy has revolved around what the inspectors and regulators are doing that it seems we are missing the point about how to improve quality.  

My thoughts turned to Joseph Juran's Quality Trilogy which still has currency today.  The trilogy holds that, in complex social systems, three elements need to be brought together for improvements to be realised - quality planning, quality control and quality improvement. When working well, and in synergy, they can stimulate a dynamic energy to drive improvement. 

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Guest — Fraser Mitchell
I like the Dodge quote. Having had some training on Lean approaches to quality improvement I am aware that checking/audit work is... Read More
Wednesday, 07 August 2013 11:02
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