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Practical Solutions for Healthcare Management and Policy (Collection) by Carolyn Pexton Dr. Brett E. Trusko Praveen Gupta, Dr. H. James Harrington, Douglas A. Perednia M.D., Jim Champy, Harry Greenspun M.D.

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16. The End of an Era

“A designer knows he has achieved perfection not when there is nothing left to add, but when there is nothing left to take away.”

Antoine de Saint-Exupery

All machines with moving parts wear over time. Generally speaking, the useful life of any machine is inversely related to the machine’s complexity and the number of moving parts. Engines are a marvelous example. The famous Rolls-Royce Merlin engine that powered the Spitfire and Mustang fighters of World War II was composed of 14,000 parts, and needed to be overhauled after only 800 hours of use. A modern jet engine might have only 4,000 parts, but is far more powerful and can run for at least 3,500 hours between overhauls. When it comes to complex systems with lots of ...

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