Sunday, January 25, 2009

Kitap Önerisi - Better

Better: Tıp sektöründe başarıya ve sürekli daha iyiye nasıl ulaşılabileceğine dair fikirler ve örnekler sunuyor Atul Gawande. Sanıldığının aksine çözümün ağırlıklı olarak yeni tedavi yöntemlerinin keşfi ile değil, mevcut bilgi ve deneyimin paylaşılmasında ve hastalara doğru biçimde uygulanması ile sağlanabileceğini iddia ediyor. Bu da ayrıntılara özen göstermek, istatistik tutumak ve her gün birşeyi biraz daha iyi yapmaya çalışmakla olur. Daha önce Complications kitabını okumuş ve beğenmiştim. Hepimizi eninde sonunda hayati olarak etkileyen tıbbı anlamak ve herşeyi daha iyi yapmak isteyenlere tavsiye ederim.

Altını çizdiğim bölümler:
[p.3] What does it take to be good at something in which failure is so easy, so effortless?

[p.9] Ingenuity is often misunderstood. It is not a matter of superior intelligence but of character. It demands more than anything a willingness to recognize failure, to not paper over the cracks, and to change.

[p.21] ... success requires making a hundred small steps go right - one after the other, no slipups, no goofs, everyone pitching in.

[p.29] People underestimate the importance of diligence as a virtue.

[p.64] We do little tracking... Ask a typical American hospital what its death and complications rates for surgery were during the last six months and it cannot tell you.

[p.87] The average doctor in a high-risk practice like surgery or obstetrics is sued about once every six years.

[p.98] ... everybody at some time in his life is negligent, whether he's a physician, an auto mechanic, or an accountant. Negligence occurs and that's why you have insurance.

[p.102] ... people often call an attorney just to to get help in finding out what happened ... the one argument that persuaded many doctors to be more forthright about mistakes is that doing so might patients less likely to sue.

[p.107] Ninety-eight percent of American families that are hurt by medical errors don't sue. They are unable to find lawyers who think they would make good plaintiffs, or they are simply too daunted. Of those who sue - about fifty-five thousand a year - most will lose. In the end, fewer than one in a hundred deserving families receive any money. The rest get nothing: no help, not even an apology. And only the worst is brought out in all of us.

[p.126] In 2005, the United States spent ... $7110 per person [on health care]

[p.174] For thousands of years, childbirth was the most common cause of death for young women and infants.

[p.198] We have no score for how the mother does [after birth], beyond asking whether she lived or not - no measure to prod us to improve the results for her, too.

[p.206] After an ordinary hernia operation, for example, the chances a patient will have a recurrent hernia are one in ten with surgeons at the unhappy end of the spectrum, one in twenty with those in the middle majority, and under one in five hundred with an elite handful... for a given patient, there are wide, meaningful differences

[p.207] Baseball teams have win-loss records. Businesses have quarterly earnings reports. What about doctors?

[p.208] What one really wants to know is how we perform in typical circumstances ... For patients with pneumonia, how often does my hospital get them the correct antibiotic, and on the whole how do they do? How do our results compare with those of other hospitals?

[p.214] ... openness would drive improvement, if simply through embarrassment.

[p.223] Warwick's combination of focus, aggressiveness, and inventiveness is what makes him extraordinary.

[p.232] So the question we got talking about was: What is more likely to save his life - investment in laboratory science or in efforts to improve how existing medical care performs?

[p.244] There was much the surgeons [in India] had no control over: the overwhelming flow of patients, the poverty, the lack of supplies. But where they had control - their skills for example - these doctors sought betterment.

[p.246] Arriving at meaningful solutions is an inevitably slow and difficult process. Nonetheless, what I saw was better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes willingness to try.

Konuyla ilgili videolar:

Daha fazla video için bkz IHI Open School

mp3: Mor ve Ötesi - Cambaz

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