title: Out of sight, out of mind: why doesn't widespread clinical quality failure command our attention?
abstract: This paper examines the tolerance by all stakeholders of increasingly well documented evidence of serious and widespread clinical quality failure in the United States. Using research evidence from psychology, it describes specific cognitive and motivational impediments to the perception of quality failure-those shared by all stakeholders and those particularly relevant to patients and their families and to health care professionals. The authors endorse efforts by the National Quality Forum and others to make quality failure more publicly visible. They also point to the pivotal role of health care industry leaders in sustaining focus on a problem that inherently resists visibility.
authors.affiliation: Pacific Business Group on Health, San Francisco, USA.
authors.forename: Arnold
authors.initials: A
authors.lastname: Milstein
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Adler
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D032882:Comprehension; D003657:Decision Making; D006801:Humans; D007857:Leadership; D019300:Medical Errors; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D011639:Public Opinion; D011785:Quality Assurance, Health Care; D017603:Signal Detection, Psychological; D012938:Social Perception; D012941:Social Responsibility; D014481:United States