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Creating a culture of QI

Medical Staff Leader Connection, April 12, 2006

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Dear medical staff leader:

The medical executive committee (MEC) is a democratically elected organization appointed to conduct quality monitoring. However, individual physicians must also be held accountable for the quality of care they deliver. To encourage physicians to take this approach, your organization must create a culture of mutual accountability.

Your organization must recognize that true quality improvement (QI) is not an intermittent or retrospective process; it must be ongoing and proactive. It can be problem-oriented--that is, used to improve acknowledge flaws. But ideally, organizations use QI to identify and seize opportunities for improvement, which may mean making something better simply because it is possible to do so.

Ultimately, QI requires organizations to rethink traditional notions of top-down management and hierarchical structure. Medical staff leadership and hospital management edicts do little to prompt significant change and improvement. What organizations really need is top-down support for a QI process that is driven and implemented by physicians and hospital staff members. Improvement initiatives must be embraced and enacted at the lower levels of an organization and medical staff to have a real effect on quality.

This means that medical staff leaders and hospital management must be willing to hand the QI reins to physicians and hospital staff members, to focus on channeling the creative energy and organizational know-how to those individuals, and to commit to welcoming the input and implementing the best ideas that result. It's not easy, but organizations that can make this shift will begin to establish an organizational culture that fosters true QI and embraces ongoing, quality-oriented change.

That's all for this week!

All the best,

Rick Sheff, MD
Vice President
The Greeley Company
http://www.greeley.com/seminars/

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