Journal Article
Commentary

Shepherding change: how the market, healthcare providers, and public policy can deliver quality care for the 21st century.

Kennedy P; Pronovost P.

This commentary discusses broad mechanisms and a model to promote change through improved understanding of market forces, provider improvements, and policy change. Using the story of Josie King, the Josie King Pediatric Patient Safety Program, and the related legislative act as background, the authors provide a detailed account of provider change initiatives, drawing on the experience of a comprehensive unit-based safety program. In emphasizing the importance of translating such "local" change to more systemwide efforts, the authors call upon public policy requirements to address several issues. These include a national commitment to financially supporting the science of health care delivery and legislation to both build information technology infrastructure and better align financial incentives.