Yesterday I posted on this year's "100 Top Hospitals: National Benchmarks for Success" list, released this week by Thomson Healthcare. I promised I would post today about how to get from here to there.

I bet you lost sleep with anticipation!

Again, I want to quote Steven Pearlstein's column last year on this issue, specifically the story of how Winchester Medical Center in Virginia responded to its "somewhat disappointing" report a few years ago:

Winchester Medical Center set a goal of making the Top 100 list by 2008. It hired a consultant, altered its executive compensation to put a bigger emphasis on quality and organized teams in every department to implement small changes in procedures that translate into big improvements in its quality score.

After nurses took extra time to take fuller medical histories, and body hair was clipped rather than shaved before surgery, and the timing was changed on when antibiotics were administered, for example, surgical infection rates fell by 75 percent.

And by creating special emergency teams to focus on heart attack patients as soon as they were picked up by an ambulance, Winchester reduced the time it took to get a patient to a catheterization lab to 40 minutes from an average of 120. 

This is proof that hospitals can learn. While Winchester indeed learned a new way of doing things, we need to move towards a better way to disseminate health best practices, so that other hospitals can more easily learn from Winchester's hard work.

A recent paper by Thomas Bodenheimer takes a look at the "Science of Spread" - or, how dissemination in the health world differs from the non-health world. Donald Berwick's life's work is to disseminate best practices, but also has written an academic how-to manual on spreading innovations in health care in one's own organization.

Relevant and rewarding non-health dissemination works include Malcolm Gladwell's The Tipping Point and Made to Stick by Chip and Dan Heath, as well as Everett Rogers' Diffusion of Innovations, which Bodenheimer cites as the seminal work on the topic.

Here at the New America Foundation, we are trying to do our part. My boss Len Nichols and I are putting the finishing touches on a case study of the Hill Physicians Medical Group, an independent practice association in northern California that is helping its affiliated-yet-independent physicians improve the quality of care they provide by gaining their trust and then working with them as collaborators. We'll post a link on the NHD blog when it's finished.