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March 2, 2011

The Need for Systems Integration in Health Care

Author Affiliations

Author Affiliations: Departments of Anesthesiology and Critical Care Medicine, Surgery, and Health Policy Management (Dr Pronovost), Johns Hopkins University School of Medicine, and Johns Hopkins Quality and Safety Research Group (Mr Mathews), Baltimore, Maryland.

JAMA. 2011;305(9):934-935. doi:10.1001/jama.2011.237

Progress in patient safety and quality has been slow, despite increasing recognition of risk across the health care system. Efforts to reduce harm to patients or to improve quality of care often focus on a single, local intervention or a collection of local interventions, usually seeking to improve a single care process. Although valuable, this approach is incremental, resulting in modest, though needed, improvements. Most quality improvement efforts miss a larger opportunity to improve and redesign the fabric of health care. It appears that a systems-integration approach that incorporates the fundamental building blocks of health care, from equipment and technology to clinical insight and workflow processes, is needed to take the next major leap in improving quality and safety. More specifically, a systems integrator in health care, the equivalent of Boeing in aviation, is needed to make significant progress.

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