We have entered into the most important improvement project of our generation, Healthcare Reform.  I believe that the reform process is about Transformation through measurement to facilitate system design, producing outcomes we will all value. Regardless of where an improvement is taking place, the people and the culture of the environment impact the process and the outcome.  Individuals who work to improve anything understand and value the impact of culture on the improvement process and seek to understand and create a final product that works for the situation and the individuals.  The current reform efforts could be seen as using the nation as a testing site, all at work on different parts of the issue, all contributing to the solution.  Some aspects of the design will need to be developed to meet the needs of the unique culture of the individuals it is designed to support while other solutions should be the same for everyone.

Despite the fact that I believe that we have a long road ahead of us as we design for the future, I for one am hopeful that we as a nation will embrace the variety of solutions ahead of us to address the problems of a diverse nation. I am proud to be a part of the solution working with the professionals at the nation’s safety net facilities as we embark on this journey.  This is our moment, the chance we have waited for, to make a difference, not only for one encounter but for a lifetime, a generation, the future.