Health care providers everywhere are employing
different strategies for achieving health care excellence—from
CPOE adoption, to integration of evidence-based decision
support, to organization-wide interoperability initiatives.
These efforts are not unique, but actually reaching and
sustaining high levels of quality can be difficult for even
the most ambitious hospital. Patrice Spath, health care
quality specialist and president of Brown-Spath &
Associates, has seen many facilities struggle with turning
their good intentions into reality, but believes that with a
shift of priorities, it is still possible for them to attain
their long-range improvement goals.
"Most of our health care goals for more seamless,
efficient care are basically the same as they were 30 years
ago," says Spath. "It's not for lack of trying. But,
over the years, we've largely kept doing the same things over
and over again, and ending up with the same process issues.
Our projects have lacked focus, our quality measurement is
sporadic at best, and there have been few substantive changes.
We need to begin thinking differently about how to improve
care, if we ever want to move forward."
Beyond
the Fires and Fixes
Many hospitals approach process issues as though they're
stamping out fires, according to Spath. When an urgent
problem comes up, it is fixed; however, most of these
corrections are not truly sustainable improvements. "With
all of the demands our industry is facing from consumers,
time is running out for temporary fixes and maintaining the
status quo," she says.
"We all have a vested interest in making substantial,
positive changes at our facilities, and getting them to stick.
The closer I get to Medicare age, the more strongly I feel
about this: it's our hospital too. What we do, or do not do,
to improve the quality of care will affect all of us someday,
when we eventually become the patients ourselves."
To implement lasting improvements, Spath believes that
hospitals should focus less on quick fixes and more on
building an organization-wide capacity for excellence. "Superior
quality and high reliability needs to become part of our day-to-day
culture," she says. "Organizations such as the
Joint Commission and Malcolm Baldrige have already
established the blueprints—what we need to do now is to
integrate these standards into all of our processes, and make
excellence our way of doing things on a regular basis. And
while technology will certainly help us to do that, it's
leadership, not I.T., which is the most important driver of
success."
Leading
the Way Toward Excellence
So, how can health care executives create a capacity for
excellence at their organizations? Spath says that simply
being mindful of what's going on at your hospital, and having
the resilience to bounce back when things go wrong, will help
to encourage long-lasting improvement. "In today's world,
you need to be aware of what is happening throughout your
facility, and be able to manage unexpected events," she
explains. "Mistakes will happen, but the important thing
is that you can quickly detect, adapt, and recover from them."
Spath also noted the importance of seeking out feedback and
opinions from a variety of staff members, including those
working at lower-levels. "Always empower the staff who
are actually on the floors, using different technologies and
going through the processes. Defer to their expertise, as
they're the ones who may have the best view of what
improvements are needed," she says. "And encourage
people to ask for help when they need it. Hiding errors will
not help you; when something goes awry at your hospital, look
at it as a teaching moment."
One thing that experience has taught Spath herself is that
excellence is more about the journey, than the destination.
"Health care is evolving so quickly now, that you always
need to be thinking ahead about how your words and actions
will champion quality," she says. "By leading
proactively, we all have the power to create an environment
where excellence flourishes, and patients benefit. Now, it's
up to us to use it."
MEDITECH
Medical
Information Technology, Inc.
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Westwood, MA 02090
781-821-3000
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