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New Year's Resolutions for Patient Safety and Quality

Patient Safety Quality Monthly, January 15, 2005

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Dear Colleague,

At the start of every New Year, many people create resolutions for their personal goals. Often, these resolutions are short lived and, at the beginning of the following year, the same goals are put back on the list only to be quickly forgotten.

In healthcare organizations, we also put together our "resolutions" for each year. We call these resolutions strategic goals and budget targets. It is always fascinating to see how much effort an organization places on achieving financial goals. But much like weight loss and exercise, quality and patient safety goals are quickly forgotten, and excuses are made for why they can't be achieved.

One of the key reasons I believe this happens is accountability. Financial targets are presented to us on a monthly, weekly, and-for some organizations-daily basis. Failure to achieve financial targets generates meetings with senior staff and strategic action leaders, and lengthy discussions at board meetings.

What about our quality and patient safety goals? How much accountability do we generate around these needs? Reports are generally only presented to the board on a quarterly basis, little information on progress is given to managers, and the frontline staff has almost no awareness of these goals, much less our progress.

So what's the difference? Financial goals are perceived as organization survival issues-and survival always gets top priority. Quality and Patient Safety goals are generally broader, and softer. They are less driven by a sense of need or urgency unless information shows up in the public regarding poor quality-and then we all scramble. In other words: Financial goals have internal accountability; while quality goals, unfortunately, seem to require external accountability.

What can we do? There are 2 options:

1. Create a similar internal accountability through ongoing data distribution, urgent meetings when goals are not met, and lengthy discussions on the board.
2. Wait for the bad news to come from an external environment.

As we all know, with New Year's resolutions like losing weight and exercise, to have an impact you have to do it all year long. So when December 31 rolls around you're where you need to be. Waiting until December 1 to join a health club won't help you meet your goals by January 1.

Successful organizations make great strides in patient safety and quality goals by creating a sense of urgency the same level as finance.

Bob Marder, MD
Practice Director, Quality and Patient Safety
The Greeley Company

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