Complexity: a simple approach to quality. Are we there yet?

doi:10.1136/bmj.b1812

Published 6 May 2009, doi:10.1136/bmj.b1812
Cite this as: BMJ 2009;338:b1812

Letters

Quality in primary health care

Complexity: a simple approach to quality. Are we there yet?

The first 150 words of the full text of this article appear below.

"When I use a word, it means just what I choose it to mean—neithermore nor less." So Lewis Carroll’s Humpty Dumpty understoodthe words he used. Today’s word is "quality," and Heathand colleagues’ specific vagueness of the "way forward"to measure quality in primary care suggests we won’t beable agree what we mean for many years.¹

"If you don’t know where you are going, any road willget you there," said the Cheshire Cat. Quality is not a destination:it’s a journey of aspiration and achievement rather thancompletion. It will always mean different things to differentpeople at different times.

The problem with the quality journey is that, although we mayknow what route we think we need to take, we don’t knowwhere we are going, or when we are going to get there. Guideslike the English NHS quality and outcome framework (QOF) are. . . [Full text of this article]

Terry Kemple, general practitioner¹

¹ Horfield Health Centre, Bristol BS7 9RR

tk@elpmek.demon.co.uk

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