lunes, 14 de marzo de 2016

Era 3 for medicine and health care

Era 3 for medicine and health care
Berwick DM
Journal of the American Medical Association. 2016 [epub]. DOI

In this Viewpoint piece Don Berwick describes medicine as undergoing “an epic collision of 2 eras with incompatible beliefs” before positing a new era, era 3. While “Era 1 is the era of professional dominance. Era 2 is the era of accountability and market theory” he argues that “It is time for era 3—guided by updated beliefs that reject both the protectionism of era 1 and the reductionism of era 2.” His era 3 requires nine important changes:
1. Reduce Mandatory Measurement
2. Stop Complex Individual Incentives
3. Shift the Business Strategy From Revenue to Quality
4. Give Up Professional Prerogative When It Hurts the Whole
5. Use Improvement Science
6. Ensure Complete Transparency
7. Protect Civility
8. Hear the Voices of the People Served
9. Reject Greed.