Quality improvement should be a system-wide initiative. Many healthcare facilities think of quality only as it applies to the clinical side. They concentrate on outcomes defined by accrediting bodies such as JHACO. Many businesses are like this too. However, the best organizations use quality tools throughout their organization. I want to show you the benefits of doing so.

As a healthcare professional would you even think of just treating one part of the body to keep a patient healthy? For instance, do you think that just by concentrating on the heart that you can keep the rest of the body healthy? Certainly not! Healthcare professionals know that to keep a body and mind healthy they must concentrate on the whole body. That's why we give patients regular physicals.

A healthcare facility or site is much like a human body. All parts much function well to insure positive outcomes—patient health, a good bottom line, and time and staff to get things done. A hospital is more than just the doctors and nurses. The administrative staff and all other supporting staff are important too. For instance, in a recent issue of Quality Progress an article highlighted a change in food delivery which greatly impacted profit and patient satisfaction. The hospital decided to let patients order food from a menu much like any commercial restaurant at any time convenient to the patient and not too unreasonable for the hospital. They responded to patient needs and wants and saved money doing so.

If your site is a family doctors office, do you think that the only important functions are those provided by the doctors and nurses? What do you think a patient would do if he or she got excellent delivery of primary health treatment and prevention but had a horrible experience with billing? That patient might very well end the relationship with your facility.

Research has shown that the key to profits is customer loyalty. One of the key ingredients of customer loyalty is quality of service and product delivered by satisfied employees. That means that every facet of an organization is important in delivering a service or product.

So how do you get started?

--Leadership is a key ingredient. Leaders at all levels must support system-wide quality.

--Gather information on quality improvement ideas from all areas and staff. No one's ideas are unimportant.

--Form cross-sectional teams to solve the important problems that you have identified.

--Gather baseline data about th

e process as it exits now so you know when you are improving and by how much. Monetary measures are important.

--Make a detailed plan that all team members can agree upon and educate the staff about the tools needed to implement the changes.

--Implement the changes and measure your success.

--Make the new, improved methods standard operating procedures.

Many of the ideas above come from Lean Healthcare ideas and other quality improvement initiatives, such as Baldrige and Six Sigma. The CFO of one local hospital with whom I spoke—Metro Hospital of Grand Rapids, MI—stated that Lean was one their primary tools and that it had made an enormous impact at their sites. Metro was even recognized recently in a national publication of The Institute for Healthcare Improvement as a leader in quality.

Implementing quality improvement throughout an organization is a difficult task. For many, this approach is a radical cultural change. Such changes fail without commitment from leadership and steady and firm hand guiding the changes. I suggest that you start small and spread the initiatives methodically throughout your organization. At each step demonstrate to all the benefits for the organization and to the individuals. Doing so will ensure that many will buy into the changes and commit to continuing quality improvement. I know of some organizations, which have gone through several Lean training initiatives but have failed to maintain it system-wide for a variety of reasons. They end up losing many opportunities to improve the bottom line, increase client loyalty, and improve employee satisfaction in a job well done.

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