Healthcare organizations (HCOs) are always working to improve the quality of their care and the efficiency of their business operations. More often than not, the approach to improving quality, performance, and efficiency is through a quality improvement (QI) project. The term “project” in this respect, however, is misleading at best, and potentially counter-productive at worst.
Given the common definition of the word “project” (as defined by the Project Management Institute), the phrase “quality improvement project” implies that improving healthcare quality is “a temporary group activity designed to produce a unique product, service or result… with a defined beginning and end in time.” Unfortunately, in many cases, this is exactly what happens.
Some healthcare organizations focus on improving quality in bursts, for short periods of time. This attention to QI is usually in reaction to some negative event such as a critical incident, or after a “eureka moment” where an executive member learns something new at a conference or after seeing a product or consultant demo. Once the initial excitement wears off the initiative, however, the unit, department, program, facility, or entire enterprise reverts back to its initial sub-optimal state.
Even HCOs with quality improvement entrenched in organizational culture and with well-evolved quality improvement frameworks rarely initially achieve total success, and must revisit areas of improvement (often multiple times). This is because achieving change within healthcare organizations is difficult, and much like breaking a bad habit, rarely is sustained after the first try.
Healthcare is in a constant state of flux. Innovations in healthcare technology are ushering in change at an ever more rapid pace, emerging diseases and changing patient demographics are presenting new treatment challenges to clinical staff, and organizations themselves face on ongoing barrage of new regulations and changes to funding models. What might have been an effective and/or necessary process, workflow, or policy twenty years ago (or even two years ago) is likely no longer relevant, or is in need of major updating.
Healthcare organizations, now more than ever, must evolve and adapt not merely to maintain (and improve) quality, performance, and patient safety, but to survive. Of course, the standard principles of providing safe, efficient, and effective patient care will never change – but exactly how that is done must always change.