Putting Codman's lesson to work: Measuring and improving the quality of Italian mental health care

In the early 1900s Ernest Amory Codman, a surgeon from Boston, proposed that physicians should not only measure what they did in the hospital but also track the results of their work over time. He was strongly criticized from his colleagues at Massachusetts General Hospital when he proposed that data on physician and hospital performance should be released to the public: "I am called eccentric for saying in public that hospitals, if they wish to be sure of improvement, must find out what their results are. Must analyze their results, to find their strong and weak points. Must compare their results with those of other hospitals and must care for what cases they can care for well, and avoid attempting to care for cases which they are not qualified to care for well, … must welcome publicity not only for their successes, but for their errors. Such opinions will not be eccentric a few years hence" (1).