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I find inspiration, and occasionally wisdom, in unexpected places, and I hope you'll find some here at Florence dot com, a place for people interested in improving healthcare.

A few months ago, I happened upon a documentary about a senior citizens chorus from Northampton, Mass called Young@Heart. In it, an octogenarian suffering from congestive heart failure sings a rendition of "Fix You," a Coldplay song about learning from mistakes and fixing broken things, which drew critical acclaim for the chorus (plus hundreds of thousands of hits on YouTube and other sites that linked the clip in the fall of last year).

Even if you haven't seen Young@Heart or a clip of "Fix You," I'm certain you know someone like Fred Knittle. He's been in your ER, on your inpatient census, or on your patient roster. And you probably saw him at the Walmart a time or two. To me, Fred Knittle's rendition of "Fix You" says more about healing--and the valor of persevering--than anything I've bumped up against in a very long time. The message hits home, maybe, because Knittle is backed up by his portable oxygen tank as well as his loyal choral compatriots. Or the meaning intensifies because Knittle sings his part and the part of his partner, a fellow chorus member who passed away just days before the piece was filmed. Or maybe it's because Knittle's remarkable baritone croon may not have anything to do with fixing at all.

The thing that I most love about the success Knittle enjoyed is simply that it came at all (he died on New Year's Day in '09). Knittle, if his cheerful optimism and wry accounting is predictive, lived a good life. His obituary shared events and accomplishments that evidence a life well lived: a devoted wife, children and grandchildren, military service, a long career in service to others, a loving, connected community. But it wasn't until Knittle's final years, most probably after receiving a terminal diagnosis, that he returned to a community singing group he loved and produced work that is making people around the world pause for a moment and think, really think, about what it means to care, to heal, to try, and to die.

Renewal coming from a broken place speaks to me. In the healthcare industry, we frequently produce an outcome we did not set out to achieve, making our work, from an engineering perspective, well-intended, but not reliable: in the US medical errors are the 8th leading cause of death. Each year, more people die as a result of medical error than die of AIDS or breast cancer. We are broken.

What ails healthcare is not a "one person" or "one profession" problem nor will the fixes be singular. Healthcare professionals, like the Young@Heart chorus, may appear too old, too tired, too exasperated, or too out-of-breath to always look like credible sources of hope. Fred Knittle didn't look the part either. While most performance problems in healthcare are rooted in our systems, that is, how we do business, solutions ultimately rely on what people come to view as important and how we adapt. I hope you'll return regularly to Florence dot com for cues, clues, and commentary about cutting edge trends in patient safety and that you'll find this a good place to share your insight and experience, whether you're a professional, a consumer, or both.

"Lights will guide you home and ignite your bones, and I will try, and fix you." Thank you, Mr. Knittle.