DRAFT: This module has unpublished changes.

MHA@GW Module 6: Quality & Performance Improvement

My Development:

 

Of all of the courses in the curriculum for the Executive MHA program at George Washington University, I was looking forward to Module 6: Quality Improvement the most. Lean and quality improvement are what initially piqued my interest in healthcare administration four years ago while I was working at Henry Ford Hospital in Detroit, MI. This course included some information I had learned while there, and enhanced it with history, additional theory and tools as well as challenges of which I can apply at my current employer Providence Health and Services.

 

The history of quality theory was a great introduction to this course and gave me background into the famous iceberg analogy from Phillip Crosby (we do not know the true cost of quality that lies below the surface) and W. Edwards Deming’s fourteen points in management, of which I had never heard. Deming’s third point, about reducing dependence on inspection, was eye-opening because there is a lot of checking in the lab to make sure that labels, tests, and specimens are all correct. These activities are considered to be part of quality assurance to improve patient safety. It is one thing I will keep in mind as I hear about quality improvement projects that depend on double checks.

 

The topic that resonated the most for me was unit six, about variation. The clinical laboratory uses run charts regularly to study quality control performance over time. However, I had not viewed it from the perspective of common and special cause variation in stable and unstable processes. I like this characterization and the discussions we had about what to do to resolve issues in both types of processes. Furthermore, as my organization moves toward engaging caregivers to report errors and events in a new information system, knowing how to review data over time and develop projects to fix these issues will be important for my daily work as a process improvement facilitator.

 

One of the skills that I feel was improved following this class was in presentation development and working as a team. This course required several presentations to be made and presented, and during our preparation for these presentations, my group had in-depth discussions about the material and were able to produce presentations quickly. After each presentation, I learned more about how to present slides and introduce other presenters, which will be useful in my current position because I am part of a team of coordinators that regularly work together on projects and in meetings.

 

Another tool that was discussed often was Plan-Do-Check-Act (PDCA). Before this class, I thought I knew a lot about how to implement PDCA projects and initiatives in healthcare. It turns out that I did, however, applying it to areas that were not the laboratory enhanced my understanding of what frontline caregivers deal with when trying to implement process improvements. This will help me further on in my career as I look at healthcare from a larger scope than the laboratory. Also, I did not realize that an A3 was named after the size of paper on which it was printed. My boss and I had a good laugh about this because we are working on implementing A3s, but in a more manageable 8.5x11inch size.

 

One topic that I think will be difficult for me to implement is avoiding management by results. In the laboratory, we have a lot of metrics that we track over time including turn-around-times, blood utilization, bacterial contamination rates etc. Moving the focus from success or failure based on these results will be difficult to avoid because these are the ways that we assess whether we are successful in our operational goals toward customer satisfaction. Currently, it is a struggle to engage caregivers in the utilization of the event management system, and this can be further exasperated by adding in pressure with metrics like: closure rate, percent events open etc. This seems like a process that could be at risk for inaccurate results due to inadequate event investigation and premature closure in order to keep the metric acceptable. However, to see whether events are appropriately closed would suggest that internal auditing take place. Unfortunately, this would be a waste of effort according to W. Edwards Deming’s fourteen points in management. This is a problem that I am currently pondering for a solution in my workplace.

 

Overall, the Quality Improvement class taught me more tools and strategies to apply in my current position as a laboratory quality coordinator. Also, the history imparted was interesting and gave me perspective on how healthcare organizations have engaged in quality activities over the years. I know that the lessons I learned and am able apply now will carry me on to future positions during my career.

 

Key Competencies:

Change and Innovation

    • Planning and implementing change

Decision Making

    • Solving business problems and making decisions

Project Management

    • Planning and managing projects

Quality Management

    • Quality and performance improvement

Quantitative Analysis

    • Quantitative analysis
DRAFT: This module has unpublished changes.