Healthcare has its share of problems and challenges that are usually out on public display, especially every time something dramatic or drastic happens. At times, the government has stepped in to stipulate quality minimum requirements that must be met and maintained. Other times, healthcare organizations have stepped up to the plate and made bold declarations of self-improvements and challenged others in the industry to follow suit. Whichever way that change comes about, the true need for outcomes improvements in healthcare cannot be understated or undervalued.
Setting out to make quality improvements needs to be done in incremental steps. Many organizations and facilities have begun with these 4 steps:
- Identify the problem
- Set realist/achievable goals
- Manage the change
- Measure the change
Because quality is not just stumbled upon, it is necessary to make a plan, see it through, implement changes and gauge where things are from there.
Identify the Problem
Many problems, especially deep-seeded ones, are not readily visible when assessing a healthcare system. Some obviously problems may be on the surface and easy to identify and change, however, the majority are not even visible, and are not easy to change. This is where you turn to the data that is the lifeblood of everything happening inside the organization. Within the data you are able to:
- Assess the quality of care that is given
- Understand the costs of care and expenditures needed to sustain the system
- Follow patient’s experiences and satisfaction
By being able to determine where quality of care is slipping or where waste is occurring in the organization, you can then work to make changes. These kinds of decisions are fact-based and data driven rather than a gut feeling or guess as to where deficiencies may be trending. Shining a light on the problem may feel initially like diving in to the depths of failures, but this is how corrective measures begin, and there is nothing wrong with finding fault as long as you are willing to make adjustments.
Setting Realist/Achievable Goals
All too often once problems have been pinpointed, the first reaction is to take on all of the issues and try to resolve them as quickly as possible. This usually leads to an overabundance of headaches, conflicts and turnover of staff. Not everything should be tackled at once, and not every issue needs to be addressed immediately. Take a breath and realize that there are many moving parts with many individuals that will need patience and persistence to accompany any plans for change.
First and foremost, patient care needs to be at the top of the list. If there are immediate concerns that patients are not receiving the highest quality of care, implement modifications to ensure safety and health.
Another important fact is that perfection from both patient and professional is not achievable. To find betterment in quality, it is necessary to know what other organizations have accomplished, know the needs within your community and achieve the minimum standards set forth by the government.
Manage the Change
The greatest change comes about under managed and controlled progress. Most people don’t like change, especially when it’s force upon them. Compromises must be made and communication should be a high priority. Just as stated before, flooding everyone with every change identified only provides everyone with a reason to be defensive and put up emotional walls, and in an industry based on service, this is detrimental to everyone involved.
Additionally, when large changes coupled with many changes, it is nearly impossible to understand when something isn’t working or where something might else actually might be working but is being covered up by so many other problematic situations. In this case, ambition across a world of change is not going to get you anywhere, but ambition shared at a focal point helps to sell the idea, keep others motivated and doesn’t spread anyone too thinly.
Many organizations choose a problem that exists throughout the organization and throughout many departments and then chooses a single department on which to implement changes. In this respect, the single department becomes a testing chamber and an example. If adjustments are positive and well received, it makes it that much easier to move on to different departments build on that success. If the adverse is the case, modifications or termination of changes do not have such rippling affects through the system as a whole.
Measuring the Change
To know if real success is taking place, it is necessary to track and measure the processes and progress. This can be somewhat difficult because your organization may not have tracked some elements that are now being effected by the change. Having a team of teams of people dedicated to all aspects of this process need to be keen to identifying new areas of interest, areas of concern and have the ability to speak freely when dealing with these sorts of events. This may sound like common sense, however, many team members have been let go, silenced or quit when presenting factual evidence of furthering problems or stagnation of progress. They are the messenger and negating their finding only worsens the opportunity to meet a goal.
Measuring of changes has helped many facilities to meet standards already established by government or other regulating forces. Due to the many changes that have been demanded by the government over the last several years, many organizations have found the they are deficient in meeting these new regulations and thus have been able to identify, plan and meet them much more quickly and efficiently.
Healthcare and the many organizations found within are not looking for nor want more regulations to govern them, but they do truly want quality improvements in healthcare. Taking what regulations are already out there and better defining expectations will go a long way to making those improvements and creating a self-regulating environment. As more and more organizations make sure they are at the top of their game, this pattern of problem solving will be utilized for both big and small problems.