Escape Fire: Designs for the Future of Health Care

by Donald M. Berwick, Frank Davidoff (Introduction)

Spanning a decade (1992-2002), these speeches echo the theme that our health care system needs fundamental change and a revolutionary new design. Throughout the book, Berwick identifies innovations and ideas from a number of surprising sources―a girls' soccer team, a sinking ship, and the safety standards at NASA. Escape Fire takes its title from the 1949 Mann Gulch tragedy in which thirteen young firefighters were trapped in a wildfire on a Montana hillside. The firefighter's leader, Wag Dodge, devised a creative solution for avoiding the encroaching fire. He burned a patch of grass and lay down in the middle of the scorched earth. His team refused to join him, and most perished in the fire. Dodge survived. Berwick applies the lessons learned from the catastrophe to our ailing health care system―we must not let ingrained processes obstruct life-saving innovation. Not content to simply define the problems with our flawed system, Berwick outlines new designs and suggests practical tools for change: name the problem, build on success, take leaps of faith, look outside of the medical field, set aims, understand systems, make action lists, and―the most fundamental of all―never lose sight of the patient as the central figure.

Genres: Health Care, Nonfiction, Medicine

344 pages, Hardcover

First published December 1, 2003

Reviews

[Angi]

Don berwick is inspiring! Amazing though how little has changed over the ten years of his speeches.

[Brian]

The only reason I rated this book 4/5 is because of its age. A lot of the issues it raises still plague the industry, but the system has evolved somewhat. There are still powerful takeaways here. I found myself frequently underlining key points and inspirational phrases throughout the book. I recommend this compilation for anybody working in healthcare. It doesn't matter if you're a doctor, nurse, or administrator. You need this book to open your eyes to the vast potential inherent in what you do.

[Mark]

I was worried that these Keynote addresses from 20 years ago would be outdated. However, Don Berwick is very articulate in expressing the changes that must occur to provide better health care. I would highly recommend this book to anyone who is looking to improve healthcare quality.

[Jgknobler]

I read this because the author is my daughter's boss (and he is a terrific boss.) The ideas are better presented in this week's NY Times Magazine cover article about Dr. Brent James. The movement to improve quality of and access to medical care, while reducing waste and cost, is an important one. Dr. Berwick also has some interesting ideas about giving patients more control of their care. As a literary effort, however, this collection of keynote speeches at an annual conference is repetitive and not specific enough. It would be interesting to hear in more detail about some actual instances in which Berwick and the Institute for Healthcare Improvement consulted.

[Melsene G]

This book was just ok. Collected speeches of the author. Ideas on patient centered care, social justice and progressive ideas regarding socialized medicine. Some good ideas here but it was hard to digest. Political bias interferes with the book-if you don't agree with the premise, it's a tough read.

[Tom]

Good reading for anyone who cares about US health care systems... which sooner or later affect nearly any person living in the US. I appreciate someone taking the time to examine deeply the kinds of systemic improvements needed.

[Emma]

Favourite keynote speeches:

Sauerkraut, Sobriety, and the Spread of Change
Why The Vasa Sank
Eagles and Weasels
Dirty Words and Magic Spells
Every Single One
Plenty

[Pamela]

This book made such an impression on me that I bought it. Originally read as a Pattee loan.

[Jon Silver]

this is a great book for anyone interested in healthcare system improvement and being inspired