Steven Lewis: This Just In: Systems Designed to Fail, Fail :: Longwoods.com (apology, inquiries, restitution....)

Blogger's Note: Steven Lewis is always worthwhile reading, this particular essay discusses several widely known national traumatic events of which harm was caused to many due to system failures, in part;  Longwoods Publishing (sometimes) requires registration (free/sometimes free)

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Essays -0001

This Just In: Systems Designed to Fail, Fail

Steven Lewis

"First there is the disaster that comes to light long after the fact. Then there is the inquiry. Then there is the scathing report that meticulously unearths the causes of the disaster. Then there is the apology (they're allowed now - it's the law!). Then there is restitution. Finally there is the commitment: never again. And then the same thing happens, somewhere else, again, and again, and again....."

"It is delusional to believe that everything is now out in the open, with nothing more to uncover. It's not just the outliers who cause harm; because medicine is so fraught with unjustifiable variations in practice, it is certain that the errors resulting from "satisfactory" practice far outnumber the misdeeds of the visibly incompetent. The graveyards are filled with anonymous victims whose stories will never surface in a public inquiry." 

Essay - Steven Lewis - The Fraser Institute Wait Time Reports: Madness in the Method, but Method in the Madness :: Longwoods.com

Essays 2011

The Fraser Institute Wait Time Reports: Madness in the Method, but Method in the Madness

Steven Lewis

"The answer lies in its (The Fraser Institute) mission statement, helpfully reproduced at the end of the wait times report: “Our vision is a free and prosperous world where individuals benefit from greater choice, competitive markets, and personal responsibility.” Public health care sucks because it must suck, because it’s public. Therefore, let’s gather skewed estimates on a hot-button issue, retail them as hard data, and lure Canadians toward the promised land of private medicine."

full free access: How Research Influences Policy Makers: Still Hazy After All These Years — J. Natl. Cancer Inst. Steven Lewis (author)

"Libraries have been written about the theory and practice of public policy making. Yet, this enormous scholarship has proved insufficient to lift the veil of mystery and idiosyncrasy that shrouds the art of decision making. The heady ambition to turn both clinical practice and health policy into evidence-based bastions of rationalist decision making has been downgraded; the vocabulary is now “evidence-informed,” and the realm of admissible evidence has been greatly expanded to include preferences, political contingencies, and psychology (1). This newfound conceptual modesty and nuance does not suggest that we should abandon efforts to understand decision-making processes and to enhance the role of research-based evidence in policy. It merely confirms the complexity, contingency, and messiness of the terrain............This leads to a second issue: the definition of “use.” The questionnaires simply asked whether the respondents intended to use the brief. We do not know what “use” means.." cont'd

article/opinion piece: Canadian medical Association - CMA Emerges Dazed from Cave, Writes Report :: Longwoods.com

About the Author
Steven Lewis, President Access Consulting Ltd., Saskatoon & Adjunct Professor of Health Policy, University of Calgary and Simon Fraser University

Systems Designed to Fail, Fail :: Steven Lewis (author) Longwoods.com

"....governed by the duty to put patients first..."
Note: background on Steven Lewis:


Bio: 
Steven Lewis is a health policy and research consultant based in Saskatoon, and Adjunct Professor of Health Policy at the University of Calgary and Simon Fraser University (where he was Visiting Scholar from January to April 2007). Prior to resuming a full-time consulting practice he headed a health research granting agency and spent 7 years as CEO of the Health Services Utilization and Research Commission in Saskatchewan. He has served on various boards and committees, including the Governing Council of the Canadian Institutes of Health Research, the Saskatchewan Health Quality Council, the Health Council of Canada, and the editorial boards of several journals, including the newly launched Open Medicine. His published work covers topics such as reforming and strengthening medicare, improving health care quality, primary health care, regionalization, and the management of wait times.