If you can’t measure it you can’t manage it – WRONG!?

“If you can’t measure it you can’t manage it.” How many times have we heard this said – and accepted it as a truism? At last week’s IHI International Forum in Glasgow, Don Berwick asserted, with his characteristic mix of eloquence, humility, humor, and passion, that “all measurements are wrong”. In measuring we create a construct that’s a faulty representative of what matters. How many dinners we share is a mere shadow of the quality of a relationship or ultimately of [...]


Is there a simple formula for sustainable quality improvement?

Answer: no! Almost any process in health care can be improved but sustained improvement is much more elusive. Part of the problem is the prevalence of discontinuous and non-integrated quality initiatives attempting to tackle, for example, safety, value, staff satisfaction, and culture change. A recent report from IHI published in NEJM Catalyst (March 6, 2019) argues that what’s missing for sustainability is not care model redesign, incentive payments, IT systems, or policy change but management structure and practice that changes the organisational [...]