Can System Analysis Bring About All Necessary Improvements?
Although quality improvement theory tells us that most problems are caused by the system and not by the individuals working within the system, occasionally process improvements alone are not the answer. The standards of the Joint Commission on Accreditation of Healthcare Organizations address this situation by saying that when an individual’s activities are deficient and support systems are unable, or will not be able, to improve the individual’s activities, changes are considered in the individual’s role, responsibility, and/or status, that are designed to improve processes and patient outcomes. Therefore the medical staff peer review system must always be prepared to address significant problems exhibited by individual doctors which are not correctable by process or system improvements. Fortunately, these situations are rare. Ideally, the medical staff’s peer review mechanism concentrates on fixing the “bad” systems in affect the quality of care provided by all physicians. 1998 Brown
