The safety and quality agenda could smother genuine innovationBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h561 (Published 20 February 2015) Cite this as: BMJ 2015;350:h561
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This is a timely and well considered reminder that slavish adherence to returning everything to the "norm" is a practice that stifles innovation, creativity and even the motivation to work toward measurable improvement. It has the potential, in effect, to dumb down a highly dynamic, almost infinitely variable entity - a health service, and render it unresponsive to the collective intelligence of its most valuable asset - its workforce.
In this jurisdiction, NSW, Australia, a web-based portal has been established to allow clinicians to compare institutional performance, to a highly refined level, across all facilities. The expectation is that those demonstrably "behind" will actively seek, perhaps from peer hospitals, "guidance" on how to move toward the top of a league table built completely on the submission of unscrutinised data.
At its arguably most harmful level, the existence of the "portal" has been seized upon by Health Service overseers to now set benchmarks for clinical "engagement". That is, clinicians do not engage with managers to assess performance, set agendas for change and reform, and do this collaboratively, but rather engage with technology - in the form of their PC, to be challenged by observations of how they might compare to their peers. Or, indeed, not!
Whether peers are truly "performing" will always remain moot. Whether innovation is promoted and genuine engagement with "people" is fostered, remains to be seen.
In the meantime we wait to be granted access to the "portal". It would appear that this particular clinically focused initiative is yet to be supported by adequate innovation in information technology.
Competing interests: No competing interests