For content related to management

An Obsession with Metrics

Submitted by PeterElias on Sat, 02/16/2019 - 17:59

I precipitated a recent online discussion about healthcare’s obsession with measurement (quality metrics is the current buzz phrase) when I quoted two aphorisms that highlight some problems with metrics and targets:

Goodhart's Law: "When a measure becomes a target, it ceases to be a good measure,"

Campbell's Law: "The more a metric is used, the more likely it is to "corrupt the process it is intended to monitor."

One comment rubbed me the wrong way because it implied that measurement reduces harm:

Inertia

Submitted by PeterElias on Thu, 02/08/2018 - 06:00

The problem with bureaucracy is reluctance to respond to change. Its motto is 'Ready, aim, aim, aim, aim …'  It just can't pull the trigger! 

(Anonymous)

 

status quo

Building boats and EHRs

Submitted by PeterElias on Mon, 03/06/2017 - 06:00

Imagine that you want a boat. You tell someone to build or buy you a boat, and tell them to send you a bill. What would you get? A kayak? A windsurfer? A boat for waterskiing? A sailboat. A party boat? A cruise ship? A submarine? A battleship or destroyer? You probably would not get what you want. Very likely you would end up with something expensive - that you cannot use.

Before you build or buy a boat, you need a defined goal and a process:

Why bother

Submitted by PeterElias on Sun, 03/08/2015 - 06:00

A professional colleague and I were discussing (bemoaning) how hard it is to do quality primary care. She asked why I bothered to keep pushing for change in the face of so much institutional resistance and evidence that it was pointless. I told her, what we put up with is what we end up with.

In return, I asked her why she didn't push back and demand change if she is so unhappy about the way things are?  

Her response: "Well, I watch you, and I can see that it is pointless."