Quality: Powerful Ideas to Improve Healthcare
A Favorite Buzzword for HMOs A recent article in The Wall Street Journal, describes "Quality" as the favorite buzzword these days for many health maintenance organizations. The author says HMOs are responding to a consumer backlash and increased pressure from employers to improve quality of care. HMOs are trying initiatives such as disease-management programs, health screenings and patient-satisfaction surveys. Will these initiatives lead to better care? That is the basic question of the article. The author quotes an internist who says, "There is a difference between a program in name and one that gets results."

Quality as a Process … Not a Program We believe "Quality" cannot be a "Program." As we have seen many times in healthcare practices, "new programs" are started and then stopped after other "new programs" come along. For quality improvements to be successful, they must be seen as a "process." That is, an ongoing process of continuous quality improvement leads to better care.

The Three Keys to a Successful Quality Process For a quality process to be successful, we believe it must have three major parts:

  • Corrective Action System
  • Internal Quality Audits
  • Management Reviews

This triangle shows the relationship of the three parts of a quality process:

 

A Corrective Action System provides ongoing documentation of quality issues which must be resolved to ensure continuous improvement. For example, if patients are continually complaining about their inability to reach the office on the telephone, a corrective action is needed. It is recorded in the corrective action database and assigned to one person or team to resolve the problem.

Internal Quality Audits provide a regular review of each process in a medical practice. For example, if documented procedures call for patient prescriptions to be called in by the end of the day, an internal audit could check actual performance to the stated procedure and document the results. These audits focus on process improvement, not placing blame.

Management Reviews are a regular part of the quality system to ensure its ongoing effectiveness. We recommend monthly examinations by physicians and administrators of the status of corrective actions and internal audits.

We believe improved quality processes have a strong, positive impact in patient care and in holding down healthcare costs. It is time to move quality from buzzword to commitment in improving healthcare delivery.