The Quest for Quality
September 02, 2008
The Quest for Quality
By Jeffrey D. Selberg
We must go beyond individual projects and processes to transform the total culture.
The AHA-McKesson Quest for Quality Prize recognizes hospitals for progress in implementing the Institute of Medicine’s six quality aims: safety, patient-centeredness, effectiveness, efficiency, timeliness and equity. This year’s honorees demonstrated remarkable progress in their quality journeys, making a strong statement that quality improvement must go beyond individual projects and processes to transform the culture of the hospital. The following are some of the important lessons learned from this year’s honorees:
•A board that understands and is fully engaged in quality improvement is one of the most powerful forces for changing the culture of the hospital and achieving the quality aims. Moving the quality report to the top of the board agenda is a good first step, but it is only a first step. The active involvement of an informed and educated board raises the bar for the entire organization.
•Effectively addressing equity is one of the most complex and multidimensional challenges among the six aims.
•Equity doesn’t begin when a patient enters the hospital. It begins in the community with people having access to the health services they need. Access can be affected by costs, geographic distance, transportation barriers, etc.
•Disparities are not only a health status issue, they also are important in terms of employees, board members, physicians and volunteers. If the people working in and governing the hospital don’t mirror the people in the community, outreach efforts will not be enough.
•Hospital leaders must remember that the most obvious or publicized health problems may not be the most serious ones facing the community. Periodic community health assessments, which may be most useful when done in collaboration with other community organizations (including competitor hospitals), are needed to identify the most critical unmet needs. And addressing those needs is frequently most successful when done in collaboration with these same groups (including competitor hospitals).
•Hospitals are becoming aware that they can learn a lot about how to improve just by listening to their patients and their family members. Patient-centeredness goes beyond involving patients in their own health care to involving them on administrative and clinical teams addressing all of the quality aims.
•The most successful hospitals have a well-stocked quality improvement toolbox. As areas for improvement are identified, the appropriate tool is selected for use—whether it is Lean, Six Sigma, PDCA, etc. Overreliance on a particular tool constrains the opportunities for quality improvement.
The AHA-McKesson Quest for Quality Prize Committee congratulates the 2008 winner, Munson Medical Center, Traverse City, Mich.; finalist, the University of Michigan Hospitals and Health Centers, Ann Arbor; and Citation of Merit honorees, Avera McKennan Hospital, Sioux Falls, S.D., and Saint Vincent Health Center, Erie, Pa. We encourage all hospitals to review the Quest for Quality Prize criteria and apply for the 2009 award. Go to www.aha.org/questforquality. Applications are due Oct. 12. •
Jeffrey D. Selberg, president and CEO of Exempla Healthcare, Denver, is chairman of the AHA–McKesson Quest for Quality Prize Committee.
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This article 1st appeared in the August 2008 issue of HHN Magazine.