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Opinion: Clinician-led quality improvements can transform a hospital’s care

The current national strategy for improving health care relies heavily on accountability based on metrics developed by outsiders. That's a fatal flaw.

In hospitals across the country, doctors and nurses often feel like small cogs in very big wheels, unable to provide input into how hospital systems function on behalf of their patients. That’s one of many contributors to burnout.

Nine years ago, when I began a new job as an intensive care physician at Christus St. Vincent Regional Medical Center in Santa Fe, N.M., our well-trained physicians and nurses operated as individuals — undoubtedly doing their best, but without consensus or coordination. There seemed to be little attention paid to the systems we used, or to reflection about how clinicians could work together to provide the best care.

The consequences could be

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