At 10 p.m., the phone rings. A patient discharged three days ago is back in the emergency department. The care plan was clear. The medications were correct. The follow-up was scheduled. Nothing was missed, on paper. And yet, here we are again.

The uncomfortable truth

Health care does not have a planning problem. It has an execution problem.

We design excellent care inside the hospital, then we quietly hope it continues outside of …

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Health care has made extraordinary progress in clinical knowledge. Diagnostic capabilities have advanced, treatments have become more precise, and predictive analytics now help clinicians identify patients at risk for complications or readmissions. Yet despite these advances, health care systems continue to struggle with a familiar challenge: Care plans that look clear inside the hospital often break down once patients return home. Medication instructions are misunderstood. Follow-up steps are delayed. Symptoms …

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