I am reminded of the old joke about the holiday ham:

A young bride is preparing her first holiday ham as her adoring husband watches. She slices off one end of the ham and sets it aside and puts the remainder in her roasting pan. “Darling,” her husband asks, “why did you lop off the end of the ham?”

“Why—I don’t know. My mother always did,” she replies. Curious, they call her mother, but her answer echoes her daughter’s: “My mother always did.”  When grandma is called, she has the same answer.

Happily, great-grandma is still on the scene. Her answer to the question is quick: “Why,” great-grandma says, “so it will fit in the pan!”

The obvious point being that sometimes we need to question whether old routines still serve us well. A more subtle point for anyone involved in improving performance is to recognize a workaround for what it is. The more than 3,500 unit-based teams at Kaiser Permanente have daily opportunities to question “the way we’ve always done it.” And as team members become skilled at problem solving and create a culture where asking questions is encouraged, they can create systemic solutions to recurring problems.

In these and other ways, they will create more efficient, cost-effective and safer ways to deliver quality health care. It is essential work, as the cover story of this issue, “Affordable Health Care for All,” makes clear. And the work already is well under way: Every story in the Winter 2013 issue if Hank highlights a different way that teams are improving quality while working to keep Kaiser Permanente affordable.

Kaiser Permanente is the model for the future of health care. Check out this issue's stories and be inspired.

Stories in the Winter 2013 Issue

• Affordable Health Care for All
• Four Ways to Save
• Keeping Better Track of Your Surgical Instruments