In article <[log in to unmask]>, Adrian
Midgley <[log in to unmask]> writes
>THere is a serious point to this which is that if we want to have
>things that matter measured rather than things that don't matter but
>are easy to measure and administrators feel they can understand then
>there is nobody else qualified to actually sort out what the things
>are, and how to record them or assess them or genrally deal with them.
Agreed. We need a new paradigm. One that moves away from monocausal
events, but we are often our own worst enemies. Easy example -
complained the gov didn't come clean about rationing then Dobbo _did_
and so we complained about that! Sometimes we can't see the wood for the
trees. All we had to do was back him up and only then enter into the
argument about what is and is not rationed. We know that patient
satisfaction as a measure of clinical quality is nonsense but which
medical fool advised him to institute the survey?
I wrote a lot more here but have deleted it. I cannot answer your
question at this stage but APPLAUD your point. A start would be not to
publish 'me-too' papers but actively seek out new ideas even though
they're not 'RCT' or reviews. While we only move the goal posts with
most medicine, we have to ask what we really want for outcome. We go on
ad nauseam about patient centredness then only publish reductionist
findings. One thing that we do need is this atmosphere of blame
removing, so that mistakes can be examined and rectified rather than
punished. <delete, delete>
Regards
George
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