Escape Fire

Spanning a decade (1992-2002), these speeches echo the theme thatour health care system needs fundamental change and a revolutionarynew design. Throughout the book, Berwick identifies innovations andideas from a number of surprising sources--a girls' soccerteam, a sinking ship, and the safety standards at NASA. EscapeFire takes its title from the 1949 Mann Gulch tragedy in whichthirteen young firefighters were trapped in a wildfire on a Montanahillside. The firefighter's leader, Wag Dodge, devised a creativesolution for avoiding the encroaching fire. He burned a patch ofgrass and lay down in the middle of the scorched earth. His teamrefused to join him, and most perished in the fire. Dodge survived.Berwick applies the lessons learned from the catastrophe to ourailing health care system--we must not let ingrained processesobstruct life-saving innovation. Not content to simply define the problems with our flawedsystem, Berwick outlines new designs and suggests practical toolsfor change: name the problem, build on success, take leaps offaith, look outside of the medical field, set aims, understandsystems, make action lists, and--the most fundamental ofall--never lose sight of the patient as the centralfigure.