At the Cutting Edge

Western health care systems are under increasing pressure to increase their per¬formance, become more responsive to their clientele, become safer, deal more pro-actively with chronic disease and avoid illness when possible through prevention. The prog¬noses are the same in every Western country: our health care systems will go bankrupt if we do not start to do things differently.

And while costs are going up, more and more reports illustrate that the quality of care lags behind what can be expected from systems as resource-rich as ours. The problems may differ slightly from country to country, but the overall diagnosis is shockingly consistent: we have fragmented provider systems delivering care that is poorly integrated. This is not the fault of individual providers, or of the profes¬sionals that deal with the patients: it is not a lack of will or motivation. The problems are system problems – and they have to be dealt with as such.

Yet within the systems that we have, many improvements are already possible. One crucial insight that has become apparent in the last decade is that improving quality and safety through better healthcare processes can yield truly impressive results. In addi¬tion, increasing financial returns through smart re-design is equally possible – even within the often perverse financial incentives our systems contain.

What is still often hard to convey, however, is that delivering higher quality health care is often less expensive. More effective and safer care results in fewer complications, fewer errors, and less ‘repair work’ resulting from broken processes.

Marc Berg (2011)

At the Cutting Edge brings together under one cover a book of readings based on the work, insights and reflections of a team of leading clinicians and innovators from Plexus, the health care consultancy group, based in the Netherlands and their associates. The contributors are Walter Balestra; Marc Berg; Rene ML Brouwer; Cornelis de Pee; Ed Deen; Maud Elias; Valerio Francati; Stef Groenewoud; Judith Houtepen; Joep Jacobs; Ivo Ketelaars; Nico Klay; Mark Lenssen; Alex Lindenburg; Jaap Maljers; Radjesh Manna; Ilse Matthijssen; Leonore Nicolai; Rianne Quak; Daan Rooijmans; Neil Ritchie; Kees van Bemmel; Jack van de Schraaf; Wencke van der Meyden; Joris van der Putten; Ewoud Verheij; Liesbeth Vinke; Erik-Jan Vlieger; Menko Vlieger; and Douglas Woodhouse who has also acted as editor of this version.