I have lived the past five years with daily focus upon what it takes to improve rehabilitation patient care and provide managers and clinicians with the best tools to accomplish this objective. Five years later I can readily admit that improvement has resulted in better tools, but not necessarily better care. Tools do not define the professionals who use them.
In retrospect, certain clarity has evolved; the value of patient care is not defined by the availability of tools but rather the principle that defining expectations in advance of care delivery maximizes the chance for success. We see this through use of best known practices and how tools are used.
Patient care is a sophisticated complex system; value is not generated by the availability of tools. Rather, the application of tools must continually test and reflect how the system is actually performing to expectations. Value is maximized by identifying problems when and where they occur. Rapid reaction to variance from the expected and the corrective actions taken define excellence in clinical operations. Knowledge gained is the system currency for improvement.
Sustaining excellence results with systematic approaches for designing processes to capture current status of patient care expectations and to identify problems as they occur, to solve problems to build new knowledge and to incorporate systemically what was learned with each patient. Professional administrative and clinical leadership models cultivates these skills by their choice of principles, not tools.