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
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.