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. 2001 Sep 29;323(7315):746–749. doi: 10.1136/bmj.323.7315.746
Traditional approach New rule
Care is based primarily on visits Care is based on continuous healing relationships
Professional autonomy drives variability Care is customised according to patients' needs and values
Professionals control care The patient is the source of control
Information is a record Knowledge is shared and information flows freely
Decision making is based on training and experience Decision making is evidence based
“Do no harm” is an individual responsibility Safety is a system property
Secrecy is necessary Transparency is necessary
The system reacts to needs Needs are anticipated
Cost reduction is sought Waste is continually decreased
Preference is given to professional roles over the system Cooperation among clinicians is a priority