Identify three factors described by Dr. Berwick that are the most difficult for healthcare organizations to overcome and explain why.

Applying Quality Management in Health
Instructions: Read the following article:
Berwick, D. 2003. “Improvement, Trust, and the Healthcare Workforce.” Quality & Safety in Health Care 12 (supplement 1): i2–i6. www.ncbi.nlm.nih.gov/pmc/articles/PMC176576/pdf/v012p000i2.pdf.
In this article, Dr. Berwick describes several historical and present-day “below the waterline” factors that inhibit healthcare quality improvement. For example, he observes that improvement is limited when the workforce is not encouraged to actively participate in reinventing the system.
• Identify three factors described by Dr. Berwick that are the most difficult for healthcare organizations to overcome and explain why.
• For the three factors you select, describe actions that managers can take to eliminate or minimize the factor so it no longer inhibits operations improvement.

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