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Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence, Second Edition by Joel S. Lazar, Marjorie M. Godfrey, Paul B. Batalden, Eugene C. Nelson

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FOREWORD

Elliott S. Fisher

The problems confronting the U.S. health care system are widely recognized: a rising burden of chronic disease;[1] limited capacity to deliver safe, reliable, and effective care (even when the evidence for specific treatments is strong);[2],[3] fragmented and poorly coordinated patient care that is frequently impersonal, insensitive to socioeconomic, cultural or ethnic contexts, and poorly aligned with patients' preferences;[4] and rising costs that threaten individual, corporate, and government budgets.[5],[6]

As our recognition of the scope of the problems has grown, so has our understanding of the underlying causes of these problems. Although some of the responsibility for poor care rests with our still inadequate health ...

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