What mental models can help us see the connections, the actions that can connect the parts and pieces of health care?

The Chasm report challenges us to focus on the seperations and the need for connections.

The ten simple rules or ideas essential for crossing the chasm include: cooperation amoung clinicians, knowledge is shared and information flows freely, care is based on continous healing relationships, the patient is the source of control, safety is a property of the system, transparency is necessary, needs are anticipated, and waste is continously decreased.

Simple strong metaphors are needed. Bridges may be such a simple strong image that can help us change the culture to focus on the gaps and barriers that prevent the system from working on the patient's behalf. These same gaps constantly frustrate and demoralize health care workers.

Can we begin to see ourselves and our organizations as islands that the patient must get to and from? Our patients may be swimming in cold water between our islands. If we can see ourselves as islands then we may be able to begin to see the bridges, or land fills, or boats that can connect the patient to us and each of us to the other island that patients must navigate to and from. I belive that the patient frequently must carry the cargo from island to island, since it does not reliably get there consistently any other way.

What do we expect patients to bring to our islands and from whom? What do we expect our patients to carry from our islands and to whom? Can they really do it? If not...

Discussion