It is defined as an "understanding of and commitment to improvement to undertake ongoing, continuous QI work beyond any particular project" and requires knowledge and understanding of QI approaches, the ability to use data and feedback, and commitment of leadership and staff to dedicate time and resources to QI activities [ 18].
This however requires an awareness of the problem, as well as a commitment to improvement in care practices amongst institutional authorities.
While the spectre of preventable hospital deaths may prove helpful in raising interest in patient safety and a commitment to improvement, overestimating the size of the problem and the risk to patients may induce unjustified levels of anxiety and fear among the public.
Telling me his story, Kurita quoted what he described as an old Japanese saying about perseverance: "Sit on a stone for three years to accomplish anything". Admittedly, a tenacious commitment to improvement seems to be part of the Japanese national heritage, showing up among teachers, autoworkers, sushi chefs and tea-ceremony masters.
This year, it highlighted improvements at Harper's, where bylines by women have increased by 11 percentage points to 38% of the total since last year, reflecting "executive editor Christopher Beha's public commitment to improvement".
