Did you have a chance to read the July 2016 issue of Harvard Business Review (HBR)?
Why would anyone care to subscribe to HBR, you ask? Well, fine, you can read these for free on their website.
July’s HBR has a healthcare focus. First is Michael Porter and Robert Kaplan’s How to Pay for Health Care, followed by Brent James and Greg Poulson’s The Case for Capitation.
Still no? Here’s the quick run down for the closet MBA in you. Continue reading
Dr. Keith Dreyer opens with a keynote during the Intersociety Summer Conference (ISC) with description of data science and overview of how machine learning have evolved over time.
He describes that machines and humans inherently see things differently. Humans are excellent at object classification, recognition of faces, understanding language, driving, and imaging diagnostics. Continue reading
In September, the American Board of Radiology (ABR) released a set of expanded options for satisfying Part 4 Requirements for its maintenance of certification (MOC).
The biggest change includes the ABR’s willingness to include additional areas (16 of them) of involvement in departmental quality and safety other than Practice Quality Improvement (PQI) as qualifying requirement. Continue reading
Image credit: mindwerx.com
Fifteen years after the publication of Institute of Medicine’s landmark report To Err is Human, healthcare process improvement (PI) is finally beginning to take root. Quality improvement (QI) has become a pillar of healthcare for both academic clinicians and private practice alike.
The workhorse of the Donebedian adage of “structure + process = outcome” is on standardization. In a world of static, well-defined products, proper application of PI can dramatically reduce variability.
While incremental improvement continues to be necessary in healthcare – we are a long way away from a six-sigma industry – continued standardization and scientific research alone are no longer sufficient to evolve healthcare.
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.