Standards Clarification

A bit of a postscript to the last post:

I can almost hear the snorts of disgust. Many in healthcare will be quick to dismiss the last post by telling themselves that "we have standards." I can't allow them to let themselves off so easily.

Of course healthcare employs standards. I was, for a brief time, part of a newly formed HIMSS task force on standards. Healthcare has a wealth of standards, none of which are truly standards in that all use words such as should and unless and if possible.

Healthcare has not seen fit to develop a framework for standards and no ontology by which to bring sense and meaning (and thereby value) to the hundreds of standards vying for attention. In truth, anyone in healthcare can say without fear of contradiction that "we have standards" and none of those assertions mean anything.

If n people or organizations are doing the same work using n (or even n-1) standards, it cannot be said that the work is being done in accordance with standards. This is said routinely by each of the workers but to those who view the work from an objectifying distance, it is quite clear that n standards is no better than no standard.

Measurement of process in healthcare has a long way to go before SPC principles can be applied.

How, by what process, can healthcare practitioners be brought to believe in the power of process standards through which measurement standards can be developed? Whose interests are satisfied by the status quo?