Healthcare Quality Improvement From Deming’s Perspective

Given the massive scope of the American healthcare industry and the millions of people it touches each day — including physicians, administrators, and patients — there is little wonder that its growth has spawned as many questions as it has delivered diagnoses, answers, and cures. But there is centric ideal that needs to be watched and it is the healthcare quality improvement.

The Journal of the American Medical Association (JAMA) notes that “serious and widespread problems exist throughout American Medicine” and that these issues are often related to overuse, underuse or misuse — in all sizes of communities — various fee-based medical services.

The Agency for Healthcare Research and Quality (AHRQ) cites examples of these inconsistencies of uses of various services. AHRQ reports one case of underused services comes from a study on Medicare patients who had heart attacks, but only 21 percent of eligible patients were prescribed beta-blockers. The mortality rate of heart patients who used beta blockers was 43 percent lower than those who did not use them. Instances of overuse of services include the excessive prescription of expensive antibiotics and inappropriately performed hysterectomies.

Culling theories, information and insights from The National Roundtable on Health Care Quality, JAMA’s Roundtable report concludes that it is possible to precisely define and measure the quality of healthcare. The question is how to improve that quality.

Improving Healthcare Requires a Large-Scale Systematic Effort

The Brookings Institution featured a 2013 story on “Improving Health Care Quality: The Path Forward,” exploring various ways to get the nation to focus on improving healthcare quality for everyone’s benefit. The article notes that the intricately layered American healthcare system needs a massive overhaul — involving every facet of the system from healthcare reforms in the healthcare to private and public collaborations, as well as support providers and patients — to effectively run, serving patients’ needs and keeping the industry operating at a cost-effective level.

While originally devised for the automotive industry, some of his principles are just as applicable to the healthcare industry. Specifically, there are five principles of Dr. William Deming’s scientific process will help bring about the systematic changes necessary to improve healthcare quality.

What Are Quality and Patient Safety Measures?

Quality refers to how a healthcare organization seeks to improve the outcome of various healthcare services and the resulting outcomes for groups of patients. The National Institute of Medicine is charged with solving the primary problems of quality in healthcare. However, a distinction must be drawn between how healthcare is administered and how the healthcare recipient’s outcome and satisfaction compared to the treatment, explains the Health Resources and Services Administration.

Safety measures define how well a healthcare organization was able to ensure patients did not acquire any subsequent infections and problems. These problems or complications would have otherwise risen from failure to educate patients on proper care of themselves, failure of healthcare staff to maintain proper patient supervision, or failure of healthcare providers to ensure safe—sterile and proven—practices through all medical treatments, hospitalizations, and treatments.

What Is the Best Path Toward Improving the Quality of Healthcare?

  1. Focus On Process Management– The healthcare industry features a highly complex system, with thousands of interconnected processes; and by using Pareto’s Principle, the industry should look at 20 percent of its challenges and work on improving those to get 80 percent of the impact overall.
  2. Data and Measurements Create a Foundation for Improvement– It is critical to know where the problems and inaccuracies lie within the system in order to tackle them. Providers respond to data, so it is essential to always back up any criticism or challenges with cold hard facts and figures.
  3. Manage the Processes of Care; Not Providers– Deming notes that ordering physicians, nurses and caregivers will not create a cooperative environment, which is essential when the goal is to improve healthcare for everyone. Managing the processes of care, through careful engagement with providers, will bear more fruit than casting orders. When it is clear to clinicians that they will benefit from an overhaul of the system, it easier to enlist them as part of the solution.
  4. Data Formatting Is Critical– Not only do physicians need the right data, but they need it in the right format and at the right time.
  5. Ask the Right People the Right Questions: Bring In Healthcare’s “Smart Cogs”– The medical professionals — the physicians, the clinicians, the nurses and the office administrators — who best understand the processes and uses of care can do the most to help streamline and improve the troubled healthcare system.

Looking Toward the Future of Improving the Quality of Healthcare

Continued focus on quality measurement by examining factors that include financial incentives, alternative payment methods, organizational factorsDeming’s Five Principles of Process Management offer just one way toward improving the healthcare system. Some of the key factors that everyone implementing initiatives — at the various government levels, as well as those in the private sector, within healthcare organizations — can focus on in the future include:

  • Empowering patients to act as co-managers in their healthcare, partnering with their physicians and taking ownership in their care and the services they use
  • Improving communications between providers and patients through technology

The Brookings Institution notes that a firm focus on person-level care might serve as a critical component in improving the quality of healthcare.