Continuous Improvement as an Ideal in Health Care

Donald M. Berwick(Harvard University)
New England Journal of Medicine
January 5, 1989
Cited by 1,729

Abstract

Imagine two assembly lines, monitored by two foremen.Foreman 1 walks the line, watching carefully. "I can see you all," he warns. "I have the means to measure your work, and I will do so. I will find those among you who are unprepared or unwilling to do your jobs, and when I do there will be consequences. There are many workers available for these jobs, and you can be replaced."Foreman 2 walks a different line, and he too watches. "I am here to help you if I can," he says. "We are in this together for the long . . .


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