THE BEST PRACTICE

A cheerleading look at how some healthcare professionals are trying to improve quality by changing the way doctors and hospitals handle patients.

An alarmingly high number of people die because of medical error each year, writes Kenney (Rescue Men, 2007, etc.), but a group of reformers are trying to change that. The author focuses on what is known as the “new quality movement,” which examines hospital systems, examining everything from the way waiting rooms are laid out to the simple but often fatal errors doctors and nurses make in overadministering medicine. Kenney spends a lot of time with the bureaucrats he considers visionaries, who are working to shore up the system. A lot of what they try to implement—doing away with top-down management, rigorous attention to detail—comes from other sectors of the economy, such as Japanese automotive industries; the appeal of the book broadens at these points to engage readers interested in issues other than healthcare. In general, however, reading about hospital policies and procedures is as tedious as it sounds. The text acquires emotional weight when Kenney profiles patients who have suffered tragedies due to medical error and families forced to deal with senseless deaths that could have been avoided. But the author, who works as a consultant for Blue Cross Blue Shield, too often puts aside his journalistic skepticism in favor of unadulterated cheerleading for the new quality cause. At those times, the book reads like a slick sales job that overwhelms the reader with “evidence” but leaves critical questions unanswered. The issue most egregiously brushed aside is the question of how political forces prop up an obviously inadequate healthcare industry.

Strictly for the already converted.