In his keynote presentation at IHI’s National Forum in December 2015 and on a recent WIHI, President Emeritus and Senior Fellow Don Berwick introduced the concept of “three eras” in health care. Era 1 represents the roots of the medical profession: a beneficent and self-regulating profession. In era 2, which represents much of today’s current health care environment, measurement and “rewards and punishments” tend to dominate. In this article, Berwick presents nine changes he believes, combined, will shape a new era 3 driven by transparency, improvement science, less inspection, and more civility.
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