Originally Posted by
chasm54
No, in my case the dismissive tone was entirely intentional. Less than full analysis can be useful, certainly. But grossly superficial analysis is not better than nothing, it is worse than nothing, because it has the potential to mislead and to distort behaviour.
If hospitals are required to respond to poorly-set objectives, they will do so. And that will cause them to behave in ways that actually militate against an improved standard of care. I've seen it many times, including - I regret to say - in hospitals for which I was responsible. People start to try to meet the target, even when they know that doing so diverts effort from the real objective. That can have dangerous consequences.
Absolutely true that responding to poor objectives results in poor result. That was true early on in the aviation industry. But, rather than dismissing the methods the focus was on how to improve them. To just dismiss something as not being as good as it can be without offering an alternative is to place a stumbling block in the road of progress.
People do positively respond to clear goals and procedure clearly communicated and enforced. That is a major tool that can be used to improve the safety of the medical industry.
I don't argue for even a moment that the cited study is the end all of hospital evaluation. But, right now it, or its' rough equivalent, is about all we have outside of the inside industry certifications. The person or organization that designs a workable evaluation system that presents useful information to the customers and allows the industry to focus on positive outcomes will not only perform a great service, but will probably make a mint.