TL;DR: When leaders impose arbitrary targets without improving the underlying system, people will find ways to hit the number without helping the patient. The problem isn’t the people — it’s the design. I’m here in the UK for work, and the BBC morning news show had a story about what they call “Accident & Emergency” here in the UK. There’s a lot of discussion, generally, in the news about improving true service quality instead of … Continue reading NHS 4-Hour ER Targets: What Happens When Hitting the Number Matters More Than Helping the Patient