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Updated: Jun 9, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
No respect: research in quality, safety, and process improvement
Ilan S Rubinfeld1, H Mathilda Horst
1Ilan S Rubinfeld, MD, MBA, is an Attending Physician in Trauma and Critical Care and Acute Care Surgery at Henry Ford Hospital in Detroit, MI. He is also Assistant Professor of Surgery, Wayne State University School of Medicine; Associate Program Director, General Surgery Residency, Henry Ford Hospital; and Associate Medical Director, Surgical Intensive Care, Henry Ford Hospital.
Abstract:
The need for good quality and safety research has never been more imperative, but even as we encourage and promote such work, we seem to suppress it through institutional bias and inertia. Indeed the culture of health care seems to have a love-hate relationship with quality-improvement work as a whole. In this commentary we explore some of the implications of the application of pure science standards at the sharp end of clinical practice, where the down-and-dirty street-level improvement work happens.
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