Category Archives: Radiology Innovation and Quality

There is a fine line between “quality improvement” and innovation. Some may argue that quality improvement is a fix – making something better, more successful, or less error-prone.  Innovation, they might, involves creating something truly new, something that had never existed.

But if one insists on that definition, then some of the world’s most respected “innovators” were not innovators at all.  Steve Jobs did not create the first portable MP3 music player, only the arguably best.  Alexander Fleming did not invent the first antibiotic, only the most effective and famous.  Issac Newton was not the first to describe gravity, only its most mathematically characterized incarnation.

Innovators is a misnomer, coming from the Latin word novus (i.e. new), convincing us that one must strive to create something novel (i.e. novus) to innovate.  Innovators do not create something new; they are fixers of broken systems.  They are masters in the their traditional crafts who felt unsatisfied with the status quo’s offering, be it in technology, medicine, or physics.  They are quality improvement experts.  They did not need Level-5, 5S’s, 5Y’s, 6-Sigma, 12-Step QAPI, DMAIC, FADE, DOWNTIME, Kaizen, balanced scorecard, Deming cycle, ad infinitum.

I was once told that when someone boasts to love James Joyce’s Ulysses, to ask that person how the book ends.

Like to the lover of Ulysses, the next time you hear someone in love with “Toyota” please ask him/her to describe the Toyota Production System. The short version would do.

When we see others succeed, we ask, “How do you do it?”  They may reply, “Here’s how,” followed by a set of well-intended advice in shortcuts and tips.  We then create a spiffy mnemonic and hold it as the bible for replicating the others’ success.

When quality improvement becomes an increasingly rigid set of criteria, alphabet bundle, and kanzi, it becomes easier to think of it as an end in itself.  Let us “do quality improvement.”  Let us find a project to applying these incredible principles (and they are incredible, but they are not hammers).  Let us refer to it as “QI” because that’s a thing now.

But sometimes quality is just about mending the gap when you see one.  Sometimes being methodical helps, but being passionate – not just mending a gap, but your gap – is probably all the requisite there is.  “Doing the QI,” then, may sometimes become an unintended obstacle.