BMJ  2003;326 (17 May), doi:10.1136/bmj.326.7398.0-e

Editor's choice

Need good results? Fiddle them

The first 150 words of the full text of this article appear below.

Don Berwick—one of the world's leading thinkers on improvement in health care and a friend of mine—tells a story that illustrates how data on performance can mislead. He was responsible for quality assurance in a hospital. The radiology department had spectacular results. Patients waited hardly a moment. Everybody was satisfied. Why did the department do so well? Don wanted to find out and encourage the department to share its learning. "How is it," he asked the director, "that you get such good results?"

"Simple," she answered, "we make them up."

I was reminded of this story as I read the results of a BMA survey that showed how hospital trusts had poured scarce resources into accident and emergency departments during the week when performance tests were conducted (p 1054). Some even cancelled operations in order to free up beds to speed up admissions. The result was a huge . . . [Full text of this article]

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