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November 19, 1997

IHI Views Collaboration vs Competition in Quality

JAMA. 1997;278(19):1560. doi:10.1001/jama.1997.03550190024013

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THIS ISN'T a trick question: If surgery is scheduled for 9 AM, what does that mean?

Should the patient simply arrive in the operating room at the appointed hour, or should the incision be made at 9 AM? "One reason surgery doesn't start on time is that no one agrees on what the start time is," said Donald M. Berwick, MD, president, chief executive officer, and cofounder of the Institute for Healthcare Improvement (IHI) in Boston, Mass.

Such miscommunication that results in delays for patients and physicians is among a dozen or so topics that IHI has targeted in its 2-year-old Breakthrough Series. The series is a set of formal collaborations that IHI sponsors to bring up to 40 health care organizations together "to put knowledge into action" on a single health care improvement issue, Berwick said.

Whether the series has addressed reduction in waiting times, high cesarean delivery rates