We write a lot about quality improvement in medicine. Paul Levy in his Running a Hospital blog has a nice concrete example demonstrating how simple some of the fixes can be. In this case, a nurse couldn't find a pulse oximeter (a handy-dandy little device that monitors oxygen saturation in the blood at the bedside without having to draw blood and send it to the lab). The solution didn't involve a high-priced team of consultants—just a conversation among nurses and managers, and some help from a carpenter and electrician. The oximeters are being moved to a more convenient storage spot. Nurses won't have to waste time searching for them. Patients can be monitored better. The end.
Obviously fixing everything wrong with American health care requires more than an electrician or a carpenter. But we like these examples because they support what a lot of experts are telling us about health care. Our problem isn't just figuring out how to cover everybody, it's what kind of system we cover them in. If we want coverage, we also need quality and efficiency. Little steps contributing to a culture of change can help us get there.
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