Healthcare continues to be a hot-button topic across the nation and world as the 21st-century marches on. While it is only natural that an industry that functions hand in hand with the realities of our individual lives to be contentious at times, the continued divisive rhetoric and expressed frustration of many Americas often seems to be creating more problems than it solves. The fact remains that the need for concerted effort improving healthcare quality for millions of citizens is a greater priority than ever. Local and professional resistance to the shifting landscape of healthcare set against the ever-present backdrop of forecasts predicting economic doom and gloom creates the need for fresh ideas and perspectives about how to manage the evolution of the medical industry.
Despite the amazing advancements science and technology created for managing the health of our populace problems persist. Through the dawning of the digital age healthcare professionals have searched for methodologies and frameworks capable of improving healthcare quality. This search led some outside the traditional realms of thought as principles applied to other industries began to be examined for applicability. Eventually, the path of inquiry led some to the work of Dr. William Edwards Denning
Dr. Deming’s work provided the framework for a self-examination of the automobile industry (among others), first revolutionizing Japanese production in the 1950s. Increased competition from overseas eventually forced American automakers to realize they needed to look at their own process and best practices. Over the last twenty plus years the health industry began examining the work of people like Dr. Denning, searching for ways to take the lessons learned in other industries and apply them to the evolving problems of improving healthcare quality.
Improving Healthcare Quality from the Bottom Up
A process is defined as a series of actions or steps taken in order to achieve a particular end. Within healthcare, the reality of process is endless. From intake to diagnosis to billing and everywhere in between the necessity of well thought out process is obvious in a place that can manage the difference between life and death. Through these decades of growth and change in the populace being served health care has grown by choice and by force. Advancements in technology coupled with fundamental shifts in the way health care is thought about, administered and managed created an opportunity for self-examination.
Some have taken issue with the top-down approach that pervades management throughout the west and specifically America. Boardrooms full of executives who are disconnected from the realities of the day to day reality of process and result may not be the best people to make decisions about operations. This disconnect is obvious to many. While the gap between the haves and have-nots is rapidly exaggerating many professionals recognize the need for change, the need to alter processes based on information from the people actually doing the job. Proponents of Denning’s methods in healthcare advocate for a more inclusive model used while improving healthcare quality. Taking the time necessary to fully grasp the interconnected processes that make up a day in a doctor’s office or hospital is paramount to success in America’s efforts to improve healthcare for everyone, not just the wealthy.
Quality improvement starts with process management
Process management is all about making things better, but when it comes to healthcare, it isn’t a straightforward path. There are thousands of processes that are intricately intertwined in the daily happenings at any medical facility. This is seen as both positive and negative when wanting to implement changes. Luckily with process management, the knee-jerk reaction is not the common means to handling changes. In fact, many in the healthcare industry know that you need to seek out and identify problematic areas.
Following Pareto’s principle of 80/20: 20% of your effort will lead to 80% changes in practices. If healthcare organizations are able to identify the 20% of situational areas that will lead to that 80% of change is the difficult part. But, this is where the crisscrossing of processes plays a part and how the principle works in so many facets of life and business.
The fundamental shift comes packaged within the concept that addressing issues should be preventative rather than reactive. Instead of constantly putting out fires how can you prevent the fire from igniting in the first place? It is in this space that Denning’s idea of process management comes to fruition. Examining the processes that lead to success and/or failure, tracing back the path along its roots gives an opportunity to adjust, refine and reinvent the actions that make up a patient’s experience.
If you can’t Measure it you can’t Improve it
Data is the key to knowing where changes need to be made, but you have to know what is being measured and what to measure against. Within healthcare, finding the data isn’t necessarily the problem; we are all patients at some point and thus we are all generating data points for a system to store. The power is when these data points are able to be analyzed to show deficiencies in an organization. When you have good data, it will show the direction in which improvements will be seen and it doesn’t have any biases, just the fact.
Updating policies, altering practices and creating new processes that incorporate what was learned during failure and, more importantly, success creates a realistic opportunity for improving healthcare quality in the short and long term, locally, regionally and nationally. Through targeted process management daunting problems are able to be broken down into more manageable pieces. Executives taking the time to listen to the people on the ground about what is happening throughout their daily routine before making informed decisions about the best way in which to adjust processes and practice is the only realistic way forward.
Change rarely happens overnight. Taking the long view on progress is the best way to ensure that change begins and continues. There are many individuals seeking paths capable of improving healthcare quality. Utilizing the lessons learned in other industries from thinkers and doers such as Dr. Denning allows new methods to be employed fixing old problems. The myriad issues facing healthcare in America and globally are not going to be solved tomorrow. However, taking the time to recognize that deficiencies exist and must be examined and improved are excellent first steps. Process management is an ongoing process. Humanity rarely rests for long.