Word: berwick
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...given the right drugs at the right time, making sure everyone knows which side of your brain to operate on--can cause the biggest problems. "A patient with anything but the simplest needs is traversing a very complicated system across many handoffs and locations and players," says Dr. Donald Berwick, a pediatrician and president of the Institute for Healthcare Improvement. "And as the machine gets more complicated, there are more ways it can break...
...enough watchful waiting and re-examination anymore, partly because patience literally doesn't pay. "The areas in the U.S. with the highest rates of use of hospital beds, intensive-care units, specialist consultations and invasive testing don't have the best quality of care and outcomes," says Berwick. "In fact, they often have the worst. It would be a great advance in both quality and cost if somehow the American public came to understand that 'more care' is not by any means always 'better care,' and that new technologies and hospital stays can sometimes harm more than they help...
...doctors walk around with their pockets stuffed with 3-by-5 cards on which they write patient information; when they sign off for the day they read from the card to the doctor coming on duty. "My pizza parlor is more thoroughly computerized than most of health care," says Berwick. It's easy to see the advantage of giving everyone easy access to a patient's history and test results. But getting there can be painful. Enter a hospital when it is in the process of introducing more computers, they say, and you can hear the sound of nurses growling...
...agree, is a sentinel--someone to take notice, be an advocate, ask questions. Now that the family doctor has been squeezed out of that role, someone else has to step in. But even a doctor--family member may not be able to counter the complexity of the system. Dr. Berwick of the Institute for Healthcare Improvement tells the story of his wife Ann's experience when she developed symptoms of a rare spinal-cord problem at a leading hospital. His concern was not just how she was treated; it was that so little of what happened to her was unusual...
According to a press release by the British Consulate-General, Berwick will receive the honor in a ceremony later this year...