The public needs to be well informed about a powerful health care system that now inpacts our lives everyday, whether we are sick or well.

The book is written for those who wish to gain insight into the nature of hospital service and the components of quality. Chapter 9, "Enabling Public Action," speaks directly to journalists, acknowledging their crucial role in determining whether we have, or do not have, quality care in our community hospitals. It entreats them to look beyond the obvious news in medical journals and hospital press releases and to focus at the direct patient care level because in hospital care, that is where the story is.

It also points to the tradition of silence that has plagued the nursing profession in particular and urges reporters to sharpen their focus on nursing. As the largest professional group in hospitals, nurses are the key to resolving many of our hospital problems. And they know so much that they're not telling.

Excerpt from Chapter 4, "Uncovering the Source of Hospital Mistakes"

The National Institute of Medicine has reported that medical errors may cause as many as one hundred thousand deaths annually and more than ten times that amount of injuries or complications. The American Medical Association disputes those numbers, replacing them with five thousand to fifteen thousand deaths. The discrepancy between the two reflects how one defines a medical error. Both sets of numbers should give anyone considerable pause before entering such a high-risk facility as a hospital, and they do.

Who is making these errors? Both competent and incompetent persons alike. This immediately tells us that the problem is not merely with individuals; it is in the system.

Approximately one million registered nurses with active licenses are not practicing or are practicing only part time. The most significant reason cited is the poor working conditions with which their community hospitals present them.

Excerpt from the Introduction

...the nursing shortage is, in reality, a shortage of hospitals where nurses can practice their profession as it is meant to be practiced.

Excerpt from Chapter 9, "Enabling Public Action"

Most of us have come to expect a lot from our free press. We take instant, accurate news for granted. We shudder to think what it would be like to live in a country where there is no such valuable service to the citizenry...

...There is a concerted effort by the media to dig deeply and explore beyond obvious facts and events to provide the public with important information about their government and political system.

We must recognize, however, that today's health care system has also come to hold extreme power over the lives of the people.

...just as the public needs to be well informed about the activities of their government, they also need to be well informed about an immensely powerful health care system. Legislators must be knowledgeable enough to make health care policy decisions. Individuals need information that enables them to make good personal decisions concerning hospital care for themselves and their families. And community leaders must be able to recognize the level of quality in our hospitals.

...Journalists have a crucial role in determining whether we have, or do not have, quality health care.