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MEDICINE AND PUBLIC ISSUES

Quality Comes Home

Donald M. Berwick, MD

15 November 1996 | Volume 125 Issue 10 | Pages 839-843

Without a clear focus on the needs and experiences of individual patients, much of the financial and structural reorganization now rampant in health care will be unlikely to yield improvements that matter to the patients we serve. As we change the system of care, five principles can help guide our investment of energy: 1) Focus on integrating experiences, not just structures; 2) learn to use measurement for improvement, not measurement for judgment; 3) develop better ways to learn from each other, not just to discover "best practices"; 4) reduce total costs, not just local costs; and 5) compete against disease, not against each other.

Author and Article Information

From the Institute for Healthcare Improvement, Boston, Massachusetts. For the current author address, see end of text.
Requests for Reprints: Donald M. Berwick, MD, Institute for Healthcare Improvement, 135 Francis Street, Boston, MA 02215.

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