Driving the quality transformation: what's missing?

Around the country, healthcare providers are using the tools of continuous improvement to redesign patient care, match customer needs with available resources, and make management decisions based on data-driven analyses of key processes. Initiatives such as these are producing positive changes within healthcare organizations, but two serious barriers all but preclude improvement at the system level: a compensation process that punishes innovation and the emergence of integrated care systems that lack a common vision. Unless these barriers can be removed, insists the author, healthcare providers ultimately will be unsuccessful in their effort to improve value for their customers.