Perhaps this study should be re-titled "Effect of Academia taking an
interest in General Practice, with regular pep-talks", and subtitled
"Subliminal messaging re: managing Hospital Admission Rates" ?
It is interesting that this effect did not depend on the putative
interventions; there was no measurable difference in effect on
cholesterol or BP process measures, yet hospital admissions declined.
That's benefit enough, you might think.. until you ask " What happened to
patient well-being, morbidity and mortality ? "
Perhaps people who needed hospital admission didn't get it ??
One could focus further study on CHD morbidity. Such advice and keen
interest as was shown in this study , also pertains under the QOF
incentive scheme. Yet Des Spence is unimpressed with any outcomes
change.. Perhaps this is a new "Toyota Way" ? Give me academic
"personalised interest" anytime ( and some away-days !), instead of
blanket overburden with muda, mura, and muri ?
References
Grimshaw et al. "Effect of clinical guidelines on medical practice: a
systematic review of rigorous evaluations."
The Lancet, Volume 342, Issue 8883, Pages 1317-1322
Parsons HM: What caused the Hawthorne effect? A scientific detective
story.
Adm Soc 1978, 10:259-283. Publisher Full Text
Des Spence: Dr Doom
BMJ 2009;339:b4663, doi: 10.1136/bmj.b4663 (Published 12 November 2009)
Jeffrey Liker (2003), The Toyota Way: 14 Management Principles from
the World's Greatest Manufacturer, First edition, McGraw-Hill, ISBN 0-07-
139231-9.
Rapid Response:
Hawthorne Effect
Perhaps this study should be re-titled "Effect of Academia taking an
interest in General Practice, with regular pep-talks", and subtitled
"Subliminal messaging re: managing Hospital Admission Rates" ?
It is interesting that this effect did not depend on the putative
interventions; there was no measurable difference in effect on
cholesterol or BP process measures, yet hospital admissions declined.
That's benefit enough, you might think.. until you ask " What happened to
patient well-being, morbidity and mortality ? "
Perhaps people who needed hospital admission didn't get it ??
One could focus further study on CHD morbidity. Such advice and keen
interest as was shown in this study , also pertains under the QOF
incentive scheme. Yet Des Spence is unimpressed with any outcomes
change.. Perhaps this is a new "Toyota Way" ? Give me academic
"personalised interest" anytime ( and some away-days !), instead of
blanket overburden with muda, mura, and muri ?
References
Grimshaw et al. "Effect of clinical guidelines on medical practice: a
systematic review of rigorous evaluations."
The Lancet, Volume 342, Issue 8883, Pages 1317-1322
Parsons HM: What caused the Hawthorne effect? A scientific detective
story.
Adm Soc 1978, 10:259-283. Publisher Full Text
Des Spence: Dr Doom
BMJ 2009;339:b4663, doi: 10.1136/bmj.b4663 (Published 12 November 2009)
Jeffrey Liker (2003), The Toyota Way: 14 Management Principles from
the World's Greatest Manufacturer, First edition, McGraw-Hill, ISBN 0-07-
139231-9.
Competing interests:
None declared
Competing interests: No competing interests