The 2015 Garrod Lecture: Why is improvement difficult?

摘要: The pressing need to measure and improve antibiotic use was recognized >40 years ago, so why have we failed achieve sustained improvement at scale ? In his 2014 Reith Lectures about the future of medicine, US surgeon Atul Gawande said that failure in medicine is largely due ineptitude (failure existing knowledge) rather than ignorance (lack knowledge). Consequently, it notable most interventions antimicrobial prescribing are either designed educate individual practitioners or patients policies restrict make follow policies. Interventions enable apply knowledge through decision support, feedback action planning relatively uncommon. There an urgent design reporting change behaviour. However, achieving will also require a more profound understanding role context. What makes contexts receptive which elements context, under what circumstances, important for human performance Answering these questions interdisciplinary work with social scientists integrate complementary approaches from factors ergonomics, science educational research. We rethink professional education embrace complexity teams learn practice. Workplace-based learning students early-career professionals become agents transform training burden on clinical into driver improvement. This better resources, key sustainability scale.