Quality in Healthcare – had you been there, and more

By Eric Stern, ASQ Senior Member, CQA, and certified coaching system coach.

My personal upsets got me to look for health system quality solutions
It all started when in February 2007 I found out that one of several tumors that appeared on my calf the year before had the signature of malignant melanoma. By May specialists at the McGill University Medical Center identified the only surgeon in Canada qualified to perform a complex perfusion that was expected to completely remove melanoma with a probability of 40%. June the 6th I was wheeled to the operation room, but the Intensive Care Unit did not have enough nurses, so I was sent home. June the 23rd I was again prepared for surgery but all cardiologists who could have assisted were busy with more urgent cases. My surgeon went on vacation in July. It was August the 22nd that I was finally operated. All this while the melanoma could have spread to more vital organs, with little chance of healing. As I write in January 2008 it seems that the operation was successful and, aside of a few secondary effects, there are no signs of melanoma. As I was moved from hospital to hospital I experienced the loss of medical files, the transmission of incomplete and inaccurate medical prescriptions, promises of referrals to other specialists that were not fulfilled and a few other minor upsets. I knew that I cannot change the resource limitations but I thought I could contribute to improvements using quality principles.

The ASQ approach
I convinced my fellow ASQ section executive members to organize an event on the subject. I contacted the quality departments in hospitals that I stayed in, others in other hospitals, nurses from the CLSC, without succeeding in getting them interested in speaking on the subject, or even attending a potential event. They were too busy.

Jill Sporidis from QMI-SAI Global graciously agreed to come to our event and present “Quality Management Systems – Process Improvement Guidelines for Healthcare Service Providers“. In addition to the “regulars”, those who attend most of our meetings, there were a few professionals from the health sector. In fact I know of at least one person who could not come because of a former personal commitment.

We learned about the reasons why the ISO 9001 standard is pretty much applicable in healthcare institutions and have seen a few examples of organizations that have significantly reduced medical errors and costs. When resources are scarce in the health sector in Quebec as well as elsewhere, it is good to have relatively inexpensive ways of keeping us healthy. Still part of the discussion indicated the difficulties involved in getting people in the industry to pay attention to the professional solutions available.

Eric’s bad habits
Some of you have heard my presentation on assessments and how I have an inherent need to save. Some people may call this an obsession. Dr. Steven Reiss calls it a normal motivator for a small fraction of people. To get back to the subject, I was cleaning old “Quality Progress” journals that I had put aside on my kitchen table, to read later “when I would have the time”.

Lo and behold: in July 2006 ASQ had a Quality Institute for Healthcare – Improving Efficiency of Delivery Systems; Dan Reid published in the November 2006 edition an article on “Developing Healthcare Standards” and in May 2008 “Hazardous to Your Health” an update. Interestingly AIAG, the Automotive Industry Action Group had developed a Business Operating System for Health Care Organizations based on the Baldrige healthcare criteria and ISO 9001. Automotive industry methodology has been successfully applied in the health care sector. I am sure there is a lot more in other places that were not stored on my kitchen table .

Be proactive
He concluded the same thing I have concluded at the end of Jill Sporiadis’ presentation: “A grass-roots effort is needed to drive quality into healthcare”. I had the illusion that I could start such an effort. It has become apparent that many others have already started and is up to us to join wherever we think we fit in. I would be happy to continue the discussion with those interested. E-mail me directly to ericst@iseffective.com or go to the my yahoo group: http://tech.groups.yahoo.com/group/Quality_Montreal/ or to the Quality Montreal Linkedin Networking Group: http://www.linkedin.com/groups?gid=90170&trk=hb_side_g