Performance improvement up close
By Marc Songini
Working every day around performance improvement initiatives, it’s easy to think of these things only as abstractions. There are so many numbers and targets and goals. There are deadlines and methodologies and meetings in the slow challenging process of attaining excellence. So many acronyms: DRGs, LOS, AHRQ, and so on.
The dynamic changes the day when we actually are admitted to a facility, in great pain or fear. That’s when we hope that the emergency room is state of the art, with top notch networking and computer systems, and there is quick access to our medical records. We think about performance improvement and hope the hospital we are in is taking it seriously, because now it’s our particular health at stake – maybe our life, too. We hope the best doctors are the ones we will see – that they are the ones with performance-based success, and not just the ones who order the most tests.
I have heard it said that if aviation were as dangerous as healthcare, no one would fly. We think about such things when we are being admitted – sometimes too weak or sick to even consciously make a choice. Rather we go with the flow. We hope that the communications in the hospital – from intake to the emergency room to the ward we spend the night – is efficient. We don’t want to be given drugs that might kill us.
We hope that the doctors are all able to collaborate with nurses and other support and technical staff and that they are pointing us in the direction to get better. There are a million details we notice. We hope the nurses handling the IVs don’t have long nails, that there is some sort of rigid checklist someplace, that someone forwarded our specific instructions ahead if we’ve been admitted late at night. We don’t want to sit in pain waiting for medication.
There are so many things that can go wrong. Lab work; the wrong antibiotic; the wrong meal – was it only liquids we were supposed to eat? Or not? We also hope that the cleaning people are diligent. We know of things like MRSA and other infections that are straight from a horror movie
In short, the performance improvement discussion seems quite real when we are vulnerable. And if everything works, the general public just treats that as normal. But for those that understand all the many small cogs that are in the machine that is a hospital, we know it only all succeeds through teamwork, collaboration, and leadership. Working in the field from the administration’s side, we know that success is a choice in a hospital. When inside the hospital as a patient, we don’t see all the invisible forces behind success, but we’re aware that they were there, like the wind that blows a sail. We appreciate someone paid attention to the details.
On the other hand, the general patient, whose loyalty is so desirable, only knows what happened when a cog didn’t fit in right, and they won’t forget it.
Marc Songini is communications manager for HMC.
