ABSTRACT
In healthcare we spend too much time arguing about what standard to follow (e.g., how to wean a patient from a ventilator) because there are many times when “expert opinion” rules, and everyone is an expert. It is far more important first to agree to a standard practice, follow it, and then improve it. This is critical to the idea of a healthcare standard, such as stepped diabetes care or hardwiring the practice of immunization or adherence to CMS core measures. A standard is a rule or example that provides clear expectations. Continuous improvement methods depend on identifying, setting, and improving standards. Without an initial standard, how can you measure the effectiveness of the improvements you make to achieve that standard? How can you improve the standard? How can you set additional goals and know if you have achieved them? Standards form the baseline for all improvement activities, and new standards define the breakthrough goals you strive to achieve as your continuous improvement activities gain momentum.
