Students of improvement in complex, human systems have mixed feelings about public report cards on performance. Here is the problem: On the one hand, all improvement is change, and human systems resist change. Therefore, improvement requires a source of tension, discomfort with the status quo, sufficient to overcome this inertia. Sometimes a charismatic leader or a call upon ambition is enough, but usually not. In the commercial world, conventional wisdom holds that "burning platforms" or "threats to survival" are necessary to build will for improvement. (September 25, 2002)
Journal of the American Medicial Association
2002
http://jama.jamanetwork.com/article.aspx?articleid=195313