The 10 Best Rehabilitation Centers to Watch in 2019 The 10 Best Rehabilitation Centers to Watch in 201 | Page 39

What gets measured gets improved. The complexity that arises in healthcare leads to
an enormous list of metrics all which claim to improve health care: Beds per 1000,
doctors per 1000, cost of an inpatient stay for each procedure, toilets per family, nets
in mosquito-friendly regions, lab tests per person, out-of-pocket spend, Healthcare
spend as a percent of GDP, infant mortality rates, and maternal mortality rates.
Metrics
The 910 bed Bokaro General Hospital (BGH) run by SAIL has one of the best
neonatal care facilities in Asia, but has one of the worst records for neonatal deaths.
Just 10 minutes away is the Sadar Government hospital that had the best record for
neonatal deaths: ZERO. The entire result can be attributed to the well-meaning, Good
Samaritan intervention of the rickshaws near the government hospital who nightly
transfer high-risk women in severe distress to the better facility at BGH. A few get
saved, many die as it is too late but the government hospital manages to keep its
record intact. What can be counted doesn’t always count, and not everything that
counts can be counted.
Last, but not least, we have the environment; viruses, fungi, and protozoa. Add to this
diet, sunlight, exercise, nutrition, stress, sleep, road accidents, murders, and natural
calamities.
Environment
This vastly-complex intersystem of medicine, the human body and environment is
also both dynamic and fast changing. The human body is subject to more stresses,
less rest. The environment is more toxic, the air more polluted, the food more
artificial (with high sugars and high hormones), medicine is more segmented and
intrusive. All of this creates the market conditions for supply and demand of
healthcare. We are willing to pay for the right to live a little longer. Sanitation,
vaccinations, antibiotics, heart surgery, wound management, and healthier diets and
environment have helped us raise our life expectancy from 30 to current 78 years.
But this is neither uniform nor guaranteed at an individual level.
Modern healthcare seeks to remedy this through practiced carefully prescribed
established best practices that deliver near-zero errors for all aspects of healthcare:
preventive, diagnostic, interventional, progressive and palliative.
The System Of Profound Knowledge® (SoPK) propagated by W. Edwards Deming
lays the foundation for any large complex system in four parts: System, Variation,
Knowledge and Motivation.
Healthcare systems have a vast multitude of parameters with a range of possible
values that create an inevitable variation of results built into the design, interpretation,
intervention, and prognosis.
Variability
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