Why Don Berwick is almost right: how public health quality improvement operates within complex systems.

摘要

Don Berwick, through his work at the Institute for Healthcare Improvement (MI), and others have demonstrated the value of quality improvement (QI) approaches for achieving better clinical outcomes in the health care sector. Similar efforts have been under way in public health for the past decade. Several national and state initiatives have advanced the practice of quality improvement and performance management in public health and laid a strong foundation for the field. Examples include the Turning Point Performance Management Excellence Collaborative, the National Public Health Performance Standards Program, the Multi-State Learning Collaborative, and quality improvement programs in the Departments of Health in Florida and Washington. In addition, there are numerous successful examples in local health departments across the country. Each of these endeavors has contributed to the advancement of the science under-girding quality improvement. Through this learning, it has become apparent that although health care models have proven to be a source of great inspiration for public health, there is not always a perfect translation from one discipline to another.