Remembering my Dad on his birthday...

Striking a balance between between celebration and acceleration.

Recently, I've been thinking a great deal about pacing. When I recall CCRMC's efforts with System Redesign which began in 2005, I remember many of the crucial lessons learned from our participation in the IHI 100k lives Campaign. One year ago today I wrote about our redesign efforts and again today my thoughts drift to System Redesign, an important anchor in our transformation efforts.

Although System Redesign is no longer a group, rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize meaningful and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to those we serve. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I already stressed measurement, but I thought I would throw it in once more for good measure! We learned how important it is to acknowledge and celebrate all efforts - even what seems the smallest accomplishments - and to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left out. Celebration and acceleration, do you remember?

Like so many of you, I too am eager for a new day. I still haven't come to any definitive position on pacing other than action is needed for change. I acknowledge "soon is not a time." However, I do believe that big change begins with a bold aim and a small test. It starts with us, transforming our system, one test at a time.

It looks to be exciting days ahead.

More very soon...