In today's health care system, faced with powerful evidence of poor quality and high and relatively static rates of errors, the impulse to "just do it", a modern, Madison Avenue version of Goethe’s sentiment, can be irresistible. The challenges of knowing when to apply information vs knowing when we know enough are most aptly demonstrated in the rapid response system (RRS).
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In many hospitals, the cost of an RRS can become hundreds of thousands, even millions, of dollars if dedicated caregivers are made available to provide coverage 24 hours per day, 7 days per week, 365 days per year. These resources could be applied to other potential interventions that may be more effective in enhancing patient safety and improving outcomes.
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Goethe wrote, "Knowing is not enough; we must apply". However, as the provocative study by Joffe et al suggests, before we apply, we must be sure about what we truly know.
The Hazards of Drawing Conclusions From Before-and-After Studies of System-Level Interventions - Knowing May Not Be Enough
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