TED演讲:医生们可以互相学习(4)
They published the data,
他们发布了这些数据，
and it actually transformed clinical practice in the country.
而这一举动改变了整个国家的临床实践。
Everybody saw this makes a lot of sense.
大家都发现这样做很有意义。
Since then, they publish every year.
从此以后，他们每年都做数据发布。
Once a year, they publish the league table:
每年发布一次积分榜。
who's best, who's at the bottom?
谁拔头筹，谁垫底，
And they visit each other to try to learn,
他们还通过访问来相互学习，
so a continuous cycle of improvement.
进入了一个不断进步的循环。
For many years, Swedish hip surgeons had the best results in the world,
多年来， 瑞士的髋关节置换手术的治疗效果问鼎全球，
at least for those who actually were measuring,
至少对那些有真正参与评估的医生来说，
and many were not.
不过也有人没有这么做。
Now I found this principle really exciting.
我发现这一实践非常振奋人心。
So the physicians get together,
即医生们聚到一起，
they agree on what quality is,
共同决定什么是高质量，
they start measuring, they share the data,
他们开始量收集并共享数据，
they find who's best, and they learn from it.
他们发现哪个方法最好，然后加以学习。
Continuous improvement.
不断改进。
Now, that's not the only exciting part.
这还不是仅有的振奋人心的地方。
That's exciting in itself.
当然这本身已经令人振奋。
But if you bring back the cost side of the equation,
但是，如果把成本放回到我们的公式里，
and look at that,
然后观察它，
it turns out, those who have focused on quality,
你会发现那些重视质量的（医院）,
they actually also have the lowest costs,
恰恰在花销上是最少的。
although that's not been the purpose in the first place.
虽然这并不是当初刻意设计的。
So if you look at the hip surgery story again,
如果回头再看髋关节手术的故事，
there was a study done a couple years ago where they compared the U.S. and Sweden.
几年以前，他们做了一个研究拿美国和瑞士做了比较。
They looked at how many patients have needed to be re-operated on seven years after the first surgery.
他们调查了在第一次手术后7年内需要再手术的病人的数量。
In the United States, the number was three times higher than in Sweden.
在美国，这个数字比瑞士高出三倍。
So many unnecessary surgeries,
太多不必要的手术，
and so much unnecessary suffering for all the patients who were operated on in that seven year period.
给这些七年内再次接受手术的病人带来了太多不必要的痛苦。
Now, you can imagine how much savings there would be for society.
现在你可以想象换种方法能给社会节省多少开支。
We did a study where we looked at OECD data.
我们根据OECD数据做了一个研究。
OECD does, every so often,
偶尔，OECD（经济合作与发展组织）会根据
look at quality of care where they can find the data across the member countries.
他们可以找到的会员国家的数据来调查医疗护理的质量。
不同医院的不同手术有着不同的结果。但是病人不知道数据, 所以使得选外科医生成为了一个高风险的猜测游戏。史帝芬·拉森（Stefan Larsson）研究了当医生开始衡量并分享他们的髋关节手术的结果时（比如说什么是最有效的方法）会发生的情况。如果医生们可以相互学习并形成一个反馈循环，医疗保健会不会变得更好、更便宜？
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