“Each year… 2 million Americans acquire an infection while they are in hospital. Ninety thousand die of that infection… the one thing that halts the spread of infections: washing hands”
Not performing a simple standard process correctly and diligently undermines an otherwise effective process.
“People underestimate the importance of diligence as a virtue…. it is defined as ‘the constant and earnest effort to accomplish what is undertaken.’ “
Better, a surgeon’s notes on performance, Atul Gawande
By diligently doing the basics well can significant improve performance, without the need for technology, change or invention.
The Apgar score, allows nurses to rate the condition of babies at birth and after 5 minutes on a scale of 0 to 10, based on immediately visible and very simple measures of health.
“The Apgar score changed everything… wasn’t just a matter of giving the clinicians a quick objective read of how they had done. The score changed the choices that they made about how to do better.”
The score doesn’t change process or improve technology, it simply makes performance visible allowing better choices to be made. And allows numeric measurement and encourages competitive comparison.
snippets of cloud 
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