Intended for healthcare professionals

Letters Hospitals and bottling factories

Improving quality of care

BMJ 2009; 339 doi: (Published 14 September 2009) Cite this as: BMJ 2009;339:b3625
  1. D Julian De Silva, Darzi fellow1,
  2. Ara W Darzi, professor of surgery2
  1. 1Oculoplastics Department, Moorfields Eye Hospital, London EC1V 2PD
  2. 2Division of Surgery, Oncology, Reproductive Biology and Aesthetics, Imperial College Healthcare NHS Trust, St Mary’s Hospital, London W2 1NY
  1. drdjdesilva{at}

    Morton and Cornwell highlight the flaws of management tools in relation to the unpredictability of patients’ response.1 Most patients want to establish a diagnosis (such as for abdominal pain or blurred vision), which makes some of the lean management and six sigma tools difficult to apply because diagnosis needs the intuitive …

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