Richard Bohmer is a persuasive proponent of the view that “patient care, once the domain of the individual practitioner, is becoming the domain of the care delivery organization.” He argues that, as a result of this historic change, the organization of care in an “institutional context” is an “increasingly important determinant” of its effectiveness and efficiency (p 216) . Appropriate “design principles” for “two key operating systems” should be the basis of the reorganization of care: one system for delivering care known to be effective from research that meets international standards; the other for “creating new knowledge about which care to deliver in the future and how to better deliver it” through continuous experimentation and learning within organizations (p 218).
Fox DM. Designing Care: Aligning the Nature and Management of Health Care. JAMA. 2010;303(9):886-887. doi:10.1001/jama.2010.245