Although the title of his speech was “How Unnecessary Variation Can Be the Nemesis of Clinical Quality,” Nash didn't dwell on that subject. He did cite a study, however, that noted how only about 18% of what physicians do is based on rock-solid, “Grade A” clinical evidence. The remaining percentage of what physicians do, Nash said, can qualify as what people call “the art of medicine.”
“The people who pay for what we do are not connoisseurs of great art,” Nash said.
Not only are patients in danger, so are healthcare employees, Nash said, citing a study that found healthcare workers suffered more injuries than people who work in construction or agriculture.
What's needed is more systems training in medical schools as well as more education in patient safety and quality improvement, Nash said. He noted with pride that students at his school must demonstrate areas of clinical competency on nonhuman simulation models before they are allowed to touch a patient. If aviation can improve its outcomes though the use of simulated-environment training, so can healthcare, he said.
“Care will never be error-free,” Nash said. “We must strive to make that care harm-free.”
Nash concluded by highlighting the need for institutionalized healthcare leadership training and, stating how—if the right patient receives the right dose of the right medicine at the right time—that patient will have better outcomes and receive more affordable care.
“High-quality care costs less—it has to,” Nash said. “We learned this from every other industry worldwide.”