To radically redesign healthcare, start with one unit

It is a widely held belief among health care leaders that comparing their hospitals and clinics to peers is very important. Benchmarking seems to assure leaders that as long as their organization's performance is 50% of the national average or better, things are okay. But U.S. health care quality and safety is abysmal: The evidence suggests that between 240,000 to 400,000 deaths occur each year due to medical errors. Probably more go unreported. Therefore "50% or better" performance is no consolation for patients. Leaders should count every instance of patient harm as a personal affront.