A Broken System
Some might conclude from the preceding discussion that health professionals are doing a lousy job. Yet even the greatest critics of American healthcare generally acknowledge that our situation is best described as “very smart people working very hard in a broken system.”
The following section is a timeline showing the origin of quality improvement as a process advocated first within industry. These early lessons successfully showed that most quality problems can be traced to flawed systems, lack of proper training, and perverse incentives. The radical message of the quality movement was to focus on system improvement rather than faulting the individual. The application of these principles to healthcare, and the rise of the patient safety movement, will be discussed.