TAILIEUCHUNG - Escape Fire - lessons for the future of health care

Regulations are also evolving to make pest control less hazardous. As this report makes clear, good pest control cannot be achieved through the sole use of chemicals. Chapter 15 gives a detailed description of the principles and basic techniques of integrated pest mana- gement; it is the key concept that supports sustainable pest management practices and should be enshrined in national regulations that deal with pest control. This report discusses many urban pests, including such emerging ones as non-commen- sal rodents. However, non-vector-borne health threats associated with pets, especially cats (and cat allergens), have not been considered in the report. Similarly, feral cats and dogs are not reviewed,. | Escape Fire lessons for the future of health care Donald M. Berwick md mpp president and ceo institute for healthcare improvement the commonwealth fund Escape Fire lessons for the future of health care Donald M. Berwick MD mpp president and ceo institute for healthcare improvement the commonwealth fund new YORK new YORK The site of the Mann Gulch fire which is described in this book is listed in the National Register of Historic Places. Because many regard it as sacred ground it is actively protected and managed by the Forest Service as a cultural landscape. Escape Fire is an edited version of the Plenary Address delivered at the Institute for Healthcare Improvement s 11th Annual National Forum on Quality Improvement in Health Care in New Orleans Louisiana on December 9 1999. Copyright 2002 Donald M. Berwick. All rights reserved. Published in 2002 by The Commonwealth Fund One East 75th Street New York New York 10021-2Ố92. Book Design Landesberg Design Associates Pittsburgh Photography Imagebank Photodisk cover Paul B. Batalden page 7 USDA Forest Sendee page 8 Eric Carlson pages 14-15 Donald M. Berwick page 36 Steve Starr for Corbis SABA pages 48-49 Printing Broudy Printing Inc. Pittsburgh ISBN 1-884533-00-0 INTRODUCTION On December 9 1999 the nearly 3 000 individuals who attended the 11th Annual National Forum on Quality Improvement in Health Care heard an extraordinary address by Dr. Donald M. Berwick the founder president and CEO of the Institute for Healthcare Improvement the forum s sponsor. Entitled Escape Fire Dr. Berwick s speech took its audience back to the year 1949 when a wildfire broke out on a Montana hillside taking the lives of 13 young men and changing the way firefighting was managed in the United States. After retelling this harrowing tale Dr. Berwick applied the lessons learned from this catastrophe to the health care system a system that he believes is on the verge of its own conflagration. One of the three men who survived the Montana fire did

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