It isn’t always easy to put your finger on why one product or service is better than another. More often than not, it boils down to something that is more an internal feeling – like taste, how you were treated or convenience – then it is an external bias – like the look of the logo or how many people work there. Truly, this isn’t any different in a service like healthcare, either. However, many times we are limited by factors such as location, what our insurance provider is willing to cover and necessity we have at that moment. As a way of leveling the playing field, and giving every patient the same access to great care, the Affordable Care Act has mandated that healthcare providers improve the overall quality, especially taking into account the patient satisfaction, and to do this all at a lower cost.
Providing even one of these drastic changes in an established healthcare system can be daunting. Implementing all can be seen as almost impossible, but employing quality improvements in healthcare will make achieving this regulation very attainable.
Being very realistic, changes, especially large ones, are riddled with many faceted problems. Probably one of the initial issues is getting everyone on board. This is an all-or-nothing kind of game: either the organization participates or it can be shut down for non-compliance. Obviously, this is the worst-case scenario, and more of what you might face are individuals not being fully engaged. Typically what happens is when there is one dissenter, he or she tends to pull others onto their side, particularly when challenges arise. When there is a divide in groups or departments, aligning to achieve goals will become the impossible task. The old adage of too many drivers going in too many directions gets you nowhere comes to fruition.
Having a core team that handles all the big decisions and is seen as being in-charge will help to eliminate conflicting goals and movement. This group should emanate a number of different characteristics, including being actionable, approachable, have answers and listening to feedback from those in the trenches. When people know who to turn to, many communications issues can be removed. However, the core team must also realize not every department is the same, and that individuals have nuances that will require some flexibility and prioritization. Confidences will rise between each side as problems are worked through and expectations are met.
“You can’t drag people from understanding to action.” Thomas P.M. Barnett
Along with having your core team, everyone must know their roles and perform them. Without a strong foundation of understanding, the structure you are building will slowing fall apart. Then, you are forced to pick up the pieces, which requires a change in focus, not only for you, but possibly for everyone involved. Consequently, momentum and enthusiasm for the changes will be lost and much harder to gain back. By having defined roles, you are also able to assign responsibilities and accountability. This isn’t a time for pointing fingers, however, an important position requires a level of culpability. People are more likely to perform more thoroughly when they know their name and job are on the line.
One of the hardest ideas to grasp, primarily when decision-makers look to implement changes across the board, is that change usually doesn’t happen all at once. To quote Creighton Abrams, “When eating an elephant take one bite at a time.” In this case, take one department at a time; something a little more manageable. Small steps allow for more responsive modifications, better control of the unknown and grant others the insight of seeing what is going on before they will experience it. As a byproduct of slower implementation, you are able to keep the motivation moving forward as milestones are met and other departments find their successes.
Success shouldn’t be shared only by the decision-makers or those high up on the food chain. Everyone should be able to share in the successes, with the understanding that the more you invest, both time and financially, the more you will reap. By making sure there is a strong buy-in, the more everyone feels like they have skin in the game, thus they are invested in success.
Quality improvements should not be seen as a race to a finish line; it is more like moving. There is an end goal of having everything implemented, everyone’s roles defined, and all functioning like a well-oiled machine. However, this doesn’t come about in sprints but in sustaining improvements that have already been put in place and then adding to them. So, like moving, you’ve driven to the next big city, and that is something to be proud of, but you are not yet at your final destination with everything in place. Sustaining you through either kind of journey is the knowledge that you have attained what you’ve sought for.
There are some individuals that don’t see the big picture or hope for the same end results. Keeping momentum going and everyone on task requires a lot of internal strength and belief in what you are working toward. Make sure to listen to their frustrations or feedback because insight will be gained, and the ability to move past whatever challenge lies in the way may be easier than you thought.
Because the healthcare industry is such a diverse and dynamic business to be in, quality improvements are also somewhat subjective. However, as more data is collected, analyzed and as your organization uncovers problem areas, improvements are a direct consequence. Problem areas usually involve duplicate, overlapping or excess processes that may not be visible without exposing patterns found deep in the data. You are already headed down the right road because you are collecting and storing all the information that would be essential to producing relevant insight to indicate your problem areas. The tools necessary to open up that data are analytically based and should be sought out with much research. Evaluating analytic vendors may take some time, but the long-term results will truly help you to achieve quality improvements in your organization.