9 'wish list' items from medical staff to you
9 'wish list' items from medical staff to you
Don't be an administrative outsider
If medical staff members were asked what they think of quality professionals at their organization, what do you think they'd have to say? Too often, there is a perception that quality improvement is just another administrative impediment to patient care and interferes with the clinician/patient relationship.
To facilitate involvement of medical staff in your quality improvement initiatives, check out these suggestions:
1. Work with nursing and physician champions.
"I don't think you can affect meaningful change without having nursing and physician champions," says Charles Emerman, MD, associate chief of staff in charge of quality and chair of the department of emergency Medicine at The MetroHealth System in Cleveland. "You need the clinical leadership on board to make things happen."
2. Find out how other organizations have improved compliance.
Once problem areas are identified, come up with recommendations for how they can be fixed. "At the end of the day, a busy doctor can't take a stack of 40 charts and figure out what they need to focus on," Emerman says. "It's got to be the quality professional saying, 'Here is how other organizations have addressed this.'"
3. Improve communication and foster interactions.
By doing this, medical staff will become more open to concepts of quality improvement, and will come to see quality managers as members of the health care team, as opposed to administrative impediments.
"Often, I think that clinical providers are put off by concepts that they are not familiar with," says Joe DuBose, MD, assistant unit chief for Trauma "A" Service at Los Angeles County/ University of Southern California Hospital. "For example, Lean Six Sigma carries with it a unique language and terminology, but it is not on the medical school curriculum. By converting 'quality speak' into terms that providers can understand, you break the language barrier and open doors."
4. Put a positive spin on things.
Instead of saying "I have noted certain deficiencies," say, "I see some great opportunities for process improvement."
"No one wants to be presented with their inefficiencies or deficiencies," says DuBose. "Show a medical staff member how you can help them provide better care to their patients, possibly with a more streamlined and efficient process, and you will make an ally."
5. Take the time to learn why things are done a certain way in clinical settings.
Spend time working closely with medical staff members in their own environments. "You will be better appreciated as a member of the health care team, as opposed to an administrative outsider," says DuBose.
6. Present data in a visual format.
Show your data in a way that is most useful for busy providers. "A lot of words may capture the nuance of a conversation, but there is nothing as powerful as a run chart or bar graph," says David A. Snyder, MD, vice president of patient care quality and safety at MCG Health in Augusta, GA.
"People are busy, and this is yet another thing that they need to do. So presenting it to them in an efficient way is very important."
7. Give accurate and timely feedback about performance.
Providers need to know how they are doing as soon as possible, not seven months later when it's too late to do anything about it, says Snyder.
8. Ask clinicians to give feedback.
Every quarter, Kevin Tabb, MD, chief quality and medical information officer at Stanford (CA) Hospital & Clinics, meets with every department chair and division chief to review the metrics being collected and the performance of every single practitioner.
"It's not simply sending them an electronic copy of the results. It's having a two-way discussion with them about what they find useful, and what they believe needs to be tweaked," says Tabb. "It's a time-consuming process, but it is well worth it."
The actual metrics being collected are revised based on this feedback, to be sure they accurately reflect the quality of care given. "As a quality department, we can't sit down individually with every single one of our more than 2,000 members of the medical staff. But we expect the division chief to do that after we have sat with them," says Tabb. "We disseminate it, and they disseminate it further, and that allows for feedback."
9. Use the right metrics for each specialty or department.
"Like all institutions, we struggle with what the right metrics are to use and present," says Tabb. These differ depending on the institution and the given medical specialty or subspecialty.
For example, mortality is an appropriate metric for departments with large numbers of patients, some of whom are very sick, but it isn't helpful for the dermatology department, since no deaths are expected.
"We have tailored metrics more closely to the specialty involved, as a result of the feedback we have received," says Tabb. "And we have done a large amount of data cleanup, to make sure that the data we provide are clean and correct before they get in front of physicians."
[For more information, contact:
Joe DuBose, MD, Assistant Unit Chief, Trauma "A" Service, Los Angeles County/University of Southern California Hospital, 1500 San Pablo Street, Los Angeles, CA 90033. E-mail: [email protected].
David A. Snyder, MD, Vice President of Patient Care Quality and Safety, MCGHealth, 1120 15th Street, BI-2081, Augusta, GA 30912. E-mail: [email protected].
Kevin Tabb, MD, Chief Quality & Medical Information Officer, Stanford Hospital & Clinics, 300 Pasteur Drive, Stanford, CA 94305. Phone: (650) 723-4000. E-mail: [email protected].]
If medical staff members were asked what they think of quality professionals at their organization, what do you think they'd have to say? Too often, there is a perception that quality improvement is just another administrative impediment to patient care and interferes with the clinician/patient relationship.Subscribe Now for Access
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