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