QSHC

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER


[Advanced]
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this link to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Add article to my folders
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Berwick, D M
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Berwick, D M
Topic Collections
Right arrowRelevant Article
Qual Saf Health Care 2003;12:i2
© 2003 BMJ Publishing Group Ltd & Institute for Healthcare Improvement

Improvement, trust, and the healthcare workforce

D M Berwick

Institute for Healthcare Improvement, 375 Longwood Avenue, 4th Floor, Boston, MA 02215, USA

Correspondence to:
D M Berwick
Institute for Healthcare Improvement, 375 Longwood Avenue, 4th Floor, Boston, MA 02215, USA; dberwick{at}ihi.org Although major defects in the performance of healthcare systems are well documented, progress toward remedy remains slow. Accelerating improvement will require large shifts in attitudes toward and strategies for developing the healthcare workforce. At present, prevailing strategies rely largely on outmoded theories of control and standardisation of work. More modern, and much more effective, theories of production seek to harness the imagination and participation of the workforce in reinventing the system. This requires a workforce capable of setting bold aims, measuring progress, finding alternative designs for the work itself, and testing changes rapidly and informatively. It also requires a high degree of trust in many forms, a bias toward teamwork, and a predilection toward shouldering the burden of improvement, rather than blaming external factors. A new healthcare workforce strategy, founded on these principles, will yield much faster improvement than at present.

Keywords: trust; improvement; workforce; Taylorism


Relevant Article

Working differently for better, safer care
F Moss
Qual. Saf. Health Care 2003 12: i1. [Extract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Qual Saf Health CareHome page
L Gunningberg, M F. Dahm, and A Ehrenberg
Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care
Qual. Saf. Health Care, August 1, 2008; 17(4): 281 - 285.
[Abstract] [Full Text] [PDF]

Home page
 Am J Crit CareHome page
C. W. Hatler, D. Mast, J. Corderella, G. Mitchell, K. Howard, J. Aragon, and D. Bedker
Using Evidence and Process Improvement Strategies to Enhance Healthcare Outcomes for the Critically Ill: A Pilot Project
Am. J. Crit. Care., November 1, 2006; 15(6): 549 - 555.
[Abstract] [Full Text] [PDF]

Home page
 Qual Saf Health CareHome page
M Walton
Creating a "no blame" culture: have we got the balance right?
Qual. Saf. Health Care, June 1, 2004; 13(3): 163 - 164.
[Full Text]

Home page
 Qual Saf Health CareHome page
D M Berwick
Improvement, trust, and the healthcare workforce
Qual. Saf. Health Care, December 1, 2003; 12(6): 448 - 452.
[Abstract] [Full Text] [PDF]

Home page
 Qual Saf Health CareHome page
F Moss
Working differently for better, safer care
Qual. Saf. Health Care, December 1, 2003; 12(90001): i1 - 1.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER
Terms and conditions relating to subscriptions purchased online  ¦  Website terms and conditions  ¦  Privacy policy
Copyright © 2003 by the BMJ Publishing Group Ltd.