Healthcare needs build a new bridge.



 At Institute for Healthcare Improvement National Forum,  Don Berwick, MD, former CMS administrator used a 1930s engineering feat in Honduras as a metaphor for today’s healthcare system. 

The Choluteca Bridge was built by the U.S. Army Corps of Engineers with such design strength, it could withstand the worst of hurricanes that affected the area. When Hurricane Mitch came in 1998, it destroyed 150 Honduran bridges, but not the Choluteca Bridge. Instead, the storm rerouted the Choluteca River. So now, the Choluteca Bridge is useless.

More detail from Iowa Hospital Association blog:

Dr. Don Berwick declared that today’s health care organizations are like the Choluteca Bridge.  They were designed and built for a different river – the river of heavy-duty, high-volume, invasive procedures.  The river of serious illness. While the temptation is great to try and redirect the massive river to flow back under the first bridge, the work set before health care leaders is to build a new bridge – a bridge of authentic prevention. Dr. Berwick said, “Hospitals cure disease but they do not prevent it.  And they cannot prevent it, because they aren’t set up to do that today.  Prevention doesn’t have any cathedrals.  The result is a continuing misallocation of effort.  If the Martians came here to visit, they would call this insane.  We let bad things happen and then fix them.  Well, why don’t we stop them from happening?   Simply put, we just haven’t built the institutional structure for prevention.” – See more at:

The National Academy of Engineering and Institute of Medicine of the National Academies directed attention to the issue of systems engineering and integration with their joint report in 2005, “Building a Better Delivery System: A New Engineering/Health Care Partnership.”   The collaboration between clinicians, engineers, researchers, educators, and experts from medical informatics and management will  analyze, define, design, develop, test and implement high value and comprehensive solutions to many of the challenging problems in clinical medicine.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: