Saturday, April 11, 2009

Quality

Swam next to Lynne, David, Steve, Jeff, Tom, Larry and Chuck.  Mike and Clint coached.

10 x 100 @ 1:30
  8 x 100 @ 1:25; pulled these
  6 x 100 @ 1:20, wanted to hold 1:10 but wasn't feeling that great, HR around 150
  5 x 100 @ 1:15, made 'em
  4 x 100 @ 3:00 from a dive, went 1:03, 1:03, 1:03 and 1:02, maintained a long stroke, got touched out by Chuck on the first one, but he faded a bit after that; this was a solid effort
100 easy

Quality is easily measured in the pool but more difficult to quantitate in healthcare.  The government and third party payers plan to use quality metrics as a way to reduce costs.  In other words, physicians and hospitals will be paid less if they fail to achieve pre-specified benchmarks ("pay for performance").  The reality is that many facets of what we do elude quantitation.  The cath lab, for example, is a black box whose contents are poorly understood by referring physicians, their patients, and even many general cardiologists.  The American College of Cardiology uses procedural volume as a surrogate marker of competency, but many high volume operators lack formal training in interventional cardiology and are not board certified in this subspecialty.  The basic technical skills required to implant a stent in a coronary artery can be learned quickly, but acquiring the judgment to properly select cases and the experience to recognize and properly deal with the unexpected is a much longer and more complicated process.   Even with formal training, the variability in these skill sets between operators is striking.  

2 comments:

  1. Found your blog through your wife! I am going to pass this on to my son (he is a senior in high school) as he understands the swimming language way better than me. Of course he is at swim practice right now (he has doubles on Saturdays) so I will do it later. He came within an inch of swimming for UT next year but decided to head up to Palo Alto instead. Eddie Reese came to our house during the recruiting process and I have to say he one of the most impressive individuals I have ever met. UT has an amazing program!

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  2. "Quality is a characteristic of thought and statement that is recognized by a non-thinking process. Because definitions are a product of rigid, formal thinking, quality cannot be defined." - Robert Pirsig, Zen and the Art of Motorcycle Mainenance

    Careful. Don't think about 'Quality' too much or next thing you know you'll be riding around the country on a motorcycle, calling yourself Phaedrus, before finally checking into an insane asylum.

    -Eric

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