Spanning a decade (1992-2002), these speeches echo the theme that
our health care system needs fundamental change and a revolutionary
new design. Throughout the book, Berwick identifies innovations and
ideas from a number of surprising sources--a girls' soccer
team, a sinking ship, and the safety standards at NASA. Escape
Fire takes its title from the 1949 Mann Gulch tragedy in which
thirteen young firefighters were trapped in a wildfire on a Montana
hillside. The firefighter's leader, Wag Dodge, devised a creative
solution for avoiding the encroaching fire. He burned a patch of
grass and lay down in the middle of the scorched earth. His team
refused to join him, and most perished in the fire. Dodge survived.
Berwick applies the lessons learned from the catastrophe to our
ailing health care system--we must not let ingrained processes
obstruct life-saving innovation.

Not content to simply define the problems with our flawed
system, Berwick outlines new designs and suggests practical tools
for change: name the problem, build on success, take leaps of
faith, look outside of the medical field, set aims, understand
systems, make action lists, and--the most fundamental of
all--never lose sight of the patient as the central
figure.