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Escape Fire: Designs for the Future of Health Care

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Spanning a decade (1992-2002), these speeches echo the theme that our health care system needs fundamental change and a revolutionary new design. Throughout the book, Berwick identifies innovations and ideas from a number of surprising sources--a girls' soccer team, a sinking ship, and the safety standards at NASA. Escape Fire takes its title from the 1949 Mann Gulch trage Spanning a decade (1992-2002), these speeches echo the theme that our health care system needs fundamental change and a revolutionary new design. Throughout the book, Berwick identifies innovations and ideas from a number of surprising sources--a girls' soccer team, a sinking ship, and the safety standards at NASA. Escape Fire takes its title from the 1949 Mann Gulch tragedy in which thirteen young firefighters were trapped in a wildfire on a Montana hillside. The firefighter's leader, Wag Dodge, devised a creative solution for avoiding the encroaching fire. He burned a patch of grass and lay down in the middle of the scorched earth. His team refused to join him, and most perished in the fire. Dodge survived. Berwick applies the lessons learned from the catastrophe to our ailing health care system--we must not let ingrained processes obstruct life-saving innovation. Not content to simply define the problems with our flawed system, Berwick outlines new designs and suggests practical tools for change: name the problem, build on success, take leaps of faith, look outside of the medical field, set aims, understand systems, make action lists, and--the most fundamental of all--never lose sight of the patient as the central figure.


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Spanning a decade (1992-2002), these speeches echo the theme that our health care system needs fundamental change and a revolutionary new design. Throughout the book, Berwick identifies innovations and ideas from a number of surprising sources--a girls' soccer team, a sinking ship, and the safety standards at NASA. Escape Fire takes its title from the 1949 Mann Gulch trage Spanning a decade (1992-2002), these speeches echo the theme that our health care system needs fundamental change and a revolutionary new design. Throughout the book, Berwick identifies innovations and ideas from a number of surprising sources--a girls' soccer team, a sinking ship, and the safety standards at NASA. Escape Fire takes its title from the 1949 Mann Gulch tragedy in which thirteen young firefighters were trapped in a wildfire on a Montana hillside. The firefighter's leader, Wag Dodge, devised a creative solution for avoiding the encroaching fire. He burned a patch of grass and lay down in the middle of the scorched earth. His team refused to join him, and most perished in the fire. Dodge survived. Berwick applies the lessons learned from the catastrophe to our ailing health care system--we must not let ingrained processes obstruct life-saving innovation. Not content to simply define the problems with our flawed system, Berwick outlines new designs and suggests practical tools for change: name the problem, build on success, take leaps of faith, look outside of the medical field, set aims, understand systems, make action lists, and--the most fundamental of all--never lose sight of the patient as the central figure.

30 review for Escape Fire: Designs for the Future of Health Care

  1. 5 out of 5

    Angi

    Don berwick is inspiring! Amazing though how little has changed over the ten years of his speeches.

  2. 5 out of 5

    Brian

    The only reason I rated this book 4/5 is because of its age. A lot of the issues it raises still plague the industry, but the system has evolved somewhat. There are still powerful takeaways here. I found myself frequently underlining key points and inspirational phrases throughout the book. I recommend this compilation for anybody working in healthcare. It doesn't matter if you're a doctor, nurse, or administrator. You need this book to open your eyes to the vast potential inherent in what you d The only reason I rated this book 4/5 is because of its age. A lot of the issues it raises still plague the industry, but the system has evolved somewhat. There are still powerful takeaways here. I found myself frequently underlining key points and inspirational phrases throughout the book. I recommend this compilation for anybody working in healthcare. It doesn't matter if you're a doctor, nurse, or administrator. You need this book to open your eyes to the vast potential inherent in what you do.

  3. 4 out of 5

    Jgknobler

    I read this because the author is my daughter's boss (and he is a terrific boss.) The ideas are better presented in this week's NY Times Magazine cover article about Dr. Brent James. The movement to improve quality of and access to medical care, while reducing waste and cost, is an important one. Dr. Berwick also has some interesting ideas about giving patients more control of their care. As a literary effort, however, this collection of keynote speeches at an annual conference is repetitive and I read this because the author is my daughter's boss (and he is a terrific boss.) The ideas are better presented in this week's NY Times Magazine cover article about Dr. Brent James. The movement to improve quality of and access to medical care, while reducing waste and cost, is an important one. Dr. Berwick also has some interesting ideas about giving patients more control of their care. As a literary effort, however, this collection of keynote speeches at an annual conference is repetitive and not specific enough. It would be interesting to hear in more detail about some actual instances in which Berwick and the Institute for Healthcare Improvement consulted.

  4. 5 out of 5

    Rhonda Sue

    This book was just ok. Collected speeches of the author. Ideas on patient centered care, social justice and progressive ideas regarding socialized medicine. Some good ideas here but it was hard to digest. Political bias interferes with the book-if you don't agree with the premise, it's a tough read. This book was just ok. Collected speeches of the author. Ideas on patient centered care, social justice and progressive ideas regarding socialized medicine. Some good ideas here but it was hard to digest. Political bias interferes with the book-if you don't agree with the premise, it's a tough read.

  5. 5 out of 5

    Tom

    Good reading for anyone who cares about US health care systems... which sooner or later affect nearly any person living in the US. I appreciate someone taking the time to examine deeply the kinds of systemic improvements needed.

  6. 5 out of 5

    Emma

    Favourite keynote speeches: Sauerkraut, Sobriety, and the Spread of Change Why The Vasa Sank Eagles and Weasels Dirty Words and Magic Spells Every Single One Plenty

  7. 5 out of 5

    Victor

  8. 4 out of 5

    Monica

  9. 4 out of 5

    Jim Duncan

  10. 5 out of 5

    Stacie

  11. 5 out of 5

    Douglas Abel

  12. 4 out of 5

    Mary Pinkney

  13. 5 out of 5

    Shawn

  14. 5 out of 5

    Bob Borek

  15. 4 out of 5

    Kathleen Thompson

  16. 5 out of 5

    William A. Hazel, Jr

  17. 5 out of 5

    Elnora Darland

  18. 5 out of 5

    Janine

  19. 5 out of 5

    Kathleen

  20. 4 out of 5

    Dan

  21. 5 out of 5

    Carrie

  22. 5 out of 5

    Jon Silver

    this is a great book for anyone interested in healthcare system improvement and being inspired

  23. 4 out of 5

    Kim

  24. 5 out of 5

    Shireen Mansouri

  25. 5 out of 5

    Les Johnson

  26. 4 out of 5

    Pamela

  27. 5 out of 5

    Barbro

  28. 4 out of 5

    Ben Frisch

  29. 4 out of 5

    Cmeryl

  30. 4 out of 5

    Ashley

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