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Response to: ‘working smarter, not harder’ by Professor Iedema
  1. Christopher William Hayes1,
  2. Paul B Batalden2,
  3. Donald Goldmann3
  1. 1 Department of Medicine, St. Michael's Hospital, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  2. 2 The Dartmouth Institute for Health Policy and Clinical Practice, Geisel Medical School at Dartmouth, Lebanon, New Hampshire, USA
  3. 3 Institute for Healthcare Improvement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Christopher William Hayes, Department of Medicine, St. Michael's Hospital, Institute for Health Policy, Management and Evaluation, University of Toronto, 30 Bond St, Rm 1-047 Bond Wing, Toronto, Ontario, Canada M5B 1W8; hayesc{at}smh.ca

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We thank Professor Iedema for highlighting that a gap exists in providers having the skillset to ‘work smarter.’1 We agree that novel approaches to healthcare improvement that move beyond gadget-based solutions and that require a new set of skills of providers and provider organisations are required. The suggestion of videotaping one's performance to review how the system (and its participants) currently operates and to reflect on how to (re-) design their workflows is intriguing. It …

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