As a contribution to the celebration of all of those who work diligently and passionately in Healthcare Quality, we would like to plant a seed of thought, an innovative vision, of pursuing the goals of Quality (and its intimate partner, Safety) to get better outcomes, more consistently, while using less effort and cost, and feeling less frustration. In other words, an easier path to improvement.Historically, “Quality” has been tightly associated with “reporting” and it may be understandably difficult for many to separate their thinking in that regard from the collection and manipulation of data, research on and calculation of Performance Measures, visual analysis of number grids and graphs, generating and compiling reports, and sitting though hours of review meetings to share and discuss the information. And much of the effort in Quality reporting targets higher level management and especially external parties, rather than the clinical staff themselves. Many describe such responsibilities as overly mechanical and time-consuming, seriously reducing the time and brain power left over for the cognitive work of imagining, planning and confirming improvement in healthcare delivery. Even highly-respected overt methodologies, which supposedly serve that improvement goal, often add to the mechanical effort requiring procedural education, special forms, jargon, and more meetings.To a great degree, much of that is accepted, personally and organizationally, as being “the Quality job”, but perhaps there is vision of something different. A breakthrough.
The reason we talk about a breakthrough is important. There is a very strong tendency, while trying to improve processes, to simple tweak the same activities and artifacts that have been part of the process for a long time. That is definitely the case with quality. If we focus on the cognitive path, from observation to improvement, and design optimally for the digital/electronic medium to support that, then real progress can be made. This must not be equated to having users take on the mindset, language or skills of “techies”. It should be the case that the power of technology and especially the design expertise that is coupled to it, is delivered into the operative “space” of the targeted users.
When that is done well, much of the mechanics, physical activities and artifacts can be eliminated and the most precious resource of the clinical staff – their professional intellectual capabilities – are channeled toward the improvement goal. To put that in tangible terms, this vision is about one place where all the information involved in the Performance Measures of Quality Management, in Safety Event reporting and investigation, and in the Action Plans for Performance Improvement exist in intuitive, connected, workflows. The net effect is a design that radically reduces both labor and mental exertion to get actionable insights.
Realizing such a vision may be challenging because of departmental, process, policy and political barriers, the natural inhibitors of fear, ego and comfort, and the tyranny of time and money invested in the “old ways”. But why should you or your organization let those stand in the way of your passion to pursue Quality the way you’ve always known it should be done?