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Causes and treatment of ‘improvement fatigue’

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Ian Morrison, Ph.D., a healthcare consultant based in Menlo Park, Calif., asks in Hospitals & Health Networks whether we’re overstraining the ability of front-line caregivers to move from fee for service to fee for value.

“It turns out that, as long ago as 2007, a high-profile group of medical leaders pointed out …the rise of quality and improvement fatigue as a growing consequence of the increased pressures to measure and improve the quality of care. But, in the last eight years, the pace has intensified as bigger strategic commitments are being made to reach the lofty PowerPoint future of health improvement and transformation….”

“In the past few months, I have had many conversations and interactions with health system leaders ….Every one of these people, each in his or her own way, points to what I have come to term ‘improvement fatigue.”’

“They want to understand better the ‘why of change’ in a clear and coherent way, and they need help and support in changing how care is delivered while at the same time they are actually delivering care.”

“This is a key challenge for health system leaders: to learn to spot improvement fatigue and help front-line caregivers overcome it so they can continue to do what they’ve always wanted to do — care for their patients in the best possible way.”

Mr. Morrison cites as reasons for the fatigue:

Obamacare angst.

Need for explanation of the why of change.

Mixed signals.

High stakes. 


The quality police.


The electronic health record.


To  treat improvement fatigue, he suggests:


Telling a consistent, coherent story.

Rethinking physician leadership.

Providing institutional support.

Emphasizing noble purpose.



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