Critical Success Factors for Performance Improvement Programs
In another example of the old saw, “it's not the tool, it's how you use it,” the Journal of Quality and Patient Safety published a study ($20 full text) by the University Health System Consortium. A survey of 41 organizations to determine the organizational elements that predict successful performance improvement program and support change initiatives. Eight factors were identified for an effective performance improvement program:
- Strong administrative executive and performance improvement leadership
- Active involvement of the Board of Trustees
- Effective oversight structure
- Expert performance improvement staff
- Physician involvement and accountability
- Active staff involvement
- Effective use of information resources/data for decision making
- Effective communication strategy
They concluded that organizational processes and structures are prerequisites to improving health care quality and productivity.
[Source: FCG Clinical Performance and Pay for Performance News Summary]
Quality as Gospel
This story in Modern Healthcare explores hospital executive's growing passion for quality, and how to get it. In the world of mangement trends there seems to be a shift afoot away from Six Sigma/Lean Manufacturing (which reportedly has a 30% to 40% failure rate) to Kaizen and the Toyota Way.
Regardless of your choice of business tool, the key lesson is management committment and involvement — actively leading your organization through change to improvement.
Toyota Assembly Line Inspires Improvements at Hospital
The Washington Post has a nice story about Virginia Mason Medical Center in Seattle. It seems they've adopted the Japanese management concept of Kaizen, or continuous incremental improvement to streamline operations.
Like the Japanese automaker's plants, the glistening new cancer center here was designed around themes of high quality, super-efficiency and putting the customer first. Errors are embraced as learning opportunities, and every one of Virginia Mason's 5,000 employees is encouraged to offer ideas.
In adopting the Toyota mind-set, [Gary] Kaplan [Virginia Mason chief executive] said, the 350-bed hospital has saved $6 million in planned capital investment, freed 13,000 square feet of space, cut inventory costs by $360,000, reduced staff walking by 34 miles a day, shortened bill-collection times, slashed infection rates, spun off a new business and, perhaps most important, improved patient satisfaction.
Such a radical new management style did not come without strains. A few top executives have left, and many physicians have balked at what they consider threats to their autonomy. Sending teams to Japan and hiring consultants cost about $1.5 million.
HHS Publishes RFI Responses
To date, I've chosen not to post about David Brailer and government involvement in driving greater health care IT adoption and standardization; these topics are really beyond medical device connectivity (although they are major drivers for additional device connectivity). However, this caught my eye.
Last fall, HHS issued an RFI for comments on how a national health information network should be structured, financed and governed. Now, the department has released an 80-page summary (pdf file) of the 512 responses it received (press release here).
“The responses from the RFI yielded one of the richest and most descriptive collections of thoughts on interoperability and health information exchange that has likely ever been assembled in the U.S.,” said David J. Brailer, M.D., Ph.D., National Coordinator for Health Information Technology. “In reviewing these responses, we were able to take advantage of leading health IT expertise across the federal enterprise, a solid example of collaboration on health IT across the federal government.”
JCAHO Releases National Patient Safety Goals for 2006
The new Patient Safety Goals for 2006 are now on the JCAHO web site. The hospital goals for next year are more refinements of previous year's goals; there are no completely new goals. For next year, there is continued focus on “handoff” communications, meds safety, and falls.
