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The quality tools developed by corporate America offer process improvement opportunities that health care professionals can no longer afford to avoid, says one quality expert. "We’re talking about things like process benchmarking, performance measurement, and root cause analysis," says Gretchen Gemeinhardt, PhD, senior consultant with the American Productivity & Quality Center (APQC), a nonprofit quality improvement organization based in Houston.
Gemeinhardt conducts needs assessments for health care organizations and sometimes is retained by these organizations as a process improvement consultant. She is encouraged by what she sees during those contacts. "We are definitely seeing movement in the right direction, an awareness of the need for and a willingness to pursue these process-related improvement opportunities," she says. "But there is not necessarily the know-how on where to begin. So much emphasis has been placed on patient-based outcomes and not the things that drive outcomes."
There still are significant barriers to change, and old attitudes die hard. "The quality tools came out of business; they have been used most effectively in business, but many health care organizations insist they are not businesses," says Gemeinhardt. "In most cases, health care professionals are not dying to be the first movers. They don’t want to be the guy who spends the bucks and goes down that road first. There is also a reluctance to transfer from other industries."
But, she insists, these quality tools are what will allow health care organizations to "really figure out how to survive in the marketplace. [Health care organizations are] still really tenuous in the way things are being performed; there’s a need to focus on organizational excellence measures."
One of the ongoing problems is that health care organizations get recognized for their quality measures in clinical practice, but not in organizational excellence, says Gemeinhardt. "It’s outcomes that get you in the Top 100’ hospitals — not a high level of employee satisfaction and organization efficiencies. In business, there have been a number of ways to recognize that type of excellence," she notes. "There is a definite opportunity for the awarding organizations to support hospital work in that direction by adopting a more balanced approach, because it helps the long-term viability of those organizations."
In line with the movement to a greater use of quality tools, Gemeinhardt sees more emphasis on process benchmarking. "Health care organizations have been looking at their numbers compared to other institutions for a long time, but not at how XYZ hospital achieved those numbers and how I can get there," she notes. "They’re out there trying to invent the wheel when the wheel’s already been invented."
Historically, there has been a reluctance to share in health care, and that must change, Gemeinhardt says. "I think if anybody’s smart, he or she will change," she predicts. "There’s an opportunity there, and people will capitalize on it."
• Gretchen Gemeinhardt, PhD, Senior Consultant, American Productivity & Quality Center,123 N. Post Oak Lane, Houston, TX 77024. Telephone: (713) 685-4777. E-mail: firstname.lastname@example.org.