I attended a meeting as the Head of Department at one of the major public teaching hospitals in the state this week. The level of frustration with the system is intense. I do not believe it is the fault of the people who are all working towards a common goal. The problem seems to lie more with the system and centralised forces attempting to control everything. The culture of blame where somebody always has to be responsible for an issue has exacerbated the move toward endless meaningless form filling and less and less action. I have tried to establish a meaningful clinical database at the hospital for almost 10 years and we are still battling the centralised forces. You would think it obvious that a busy surgical unit would like to know exactly what is happening yet our datasets are incomplete, inaccurate and poorly coded. I give up!
I recall reading an excellent article on complex systems, including Health, by my Colleague and friend Peter Dietz some years ago. It is an excellent description of the problem we are finding ourselves in and some reasoned thoughts as to how to get out.