As a health care professional who is closer to the end of her career than the beginning, I am prone to view the current state of health care quality as a culmination of decades of strategies, collaborations, regulations, competition, legislative actions, and heuristic thinking swirling madly around the people who rely on us so greatly: our patients.

It is tempting to become cynical, especially now, as we attempt to make radical changes in our health care system, but I find myself in a unique situation that helps me avoid gloom.

In my role as quality and safety director at Santa Clara Valley Medical Center in San Jose, Calif., I work with physicians and nurses who make miracles happen every day. I see teams of professionals working in symphony–like harmony to assist individuals who are often at the lowest point in their lives, and executive leaders struggling to do the right thing in the face of forces beyond our control and a changing financial landscape.

I have the privilege of working with staff who are dedicated to supporting quality improvement initiatives to better care delivery and ensure the viability of our organization. As a faculty member for the Industrial and Systems Engineering Department at San Jose State University, I am energized by the intelligence and commitment of my graduate students, the engineers and nurses who study the impact that integrating engineering and health care can have in creating better, safer health care.

So while I have no idea whether our current course will result in genuine improvement and know that the effort we will all have to expend is monumental, I see great reason to hope.