Crossing the quality chasm in neonatal-perinatal medicine

The "Quality Chasm" exists in neonatal intensive care. Despite years of clinical research in neonatology, therapies continue to be underused, overused, or misused. A key concept in crossing the quality chasm is system redesign. The unpredictability of human factors and the dynamic complexi...

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Bibliographic Details
Published inClinics in perinatology Vol. 37; no. 1; p. 1
Main Author Ellsbury, Dan L
Format Journal Article
LanguageEnglish
Published United States 01.03.2010
Subjects
Evidence-Based Medicine
Humans
Infant, Newborn
Intensive Care, Neonatal - organization & administration
Intensive Care, Neonatal - standards
Neonatology - organization & administration
Neonatology - standards
Perinatology - organization & administration
Perinatology - standards
Quality Assurance, Health Care
Systems Integration
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Summary:The "Quality Chasm" exists in neonatal intensive care. Despite years of clinical research in neonatology, therapies continue to be underused, overused, or misused. A key concept in crossing the quality chasm is system redesign. The unpredictability of human factors and the dynamic complexity of the neonatal ICU are not amenable to rigid reductionist control and redesign. Change is best accomplished in this complex adaptive system by use of simple rules: (1) general direction pointing, (2) prohibitions, (3) resource or permission providing. These rules create conditions for purposeful self-organizing behavior, allowing widespread natural experimentation, all focused on generating the desired outcome.
ISSN:1557-9840
DOI:10.1016/j.clp.2010.01.001