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Having great components is not enough. We are obsessed in medicine with having great components, the best drugs, the best devices, the best specialists, but pay little attention to how to make them fit together well. Berwick notes how wrong-headed this approach is. Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence, he says. He gives the example of a famous thought experiment, of trying to build the world’s greatest car by assembling the world’s greatest car parts. We connect the engine of a Ferrari, the breaks of a Porsche, the suspension of BMW, the body of a Volvo. What we get, of course, is nothing close to a great car. We get a pile of very expensive junk.
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