Inspection doesn’t work.

by reestheskin on 28/04/2015

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This is an impressive talk by Don Berwick. A lot of it will be old hat to those who know about the history of improvement ‘science’ and how, as in so much economics, what passes as common sense, really makes no sense at all. But all I can see are the parallels with how we think about inspection — as in testing— of medical students. What he and others have pointed out for years, is that inspection doesn’t work. But please, lets not call it science: rationality yes, empirical observations, yes. But not all that is a sound basis for action is science. Concentrating on the failures is only a part of making things better.

I like his list of myths. He is talking primarily about health care, but as he admits, at another level, he is talking about learning and learning systems. That is why I cannot read them, and not think about medical education.

Myths to abandon

  1. Incentives will save us.
  2. Skin in the game will save us.
  3. Measurement will save us.
  4. Accountability will save us.
  5. Standards will save us.
  6. Markets will save us.
  7. Technology will save us.
  8. Heath care will save us.