The vowels of quality

Jan. 29, 2016 / By Cheryl Manchenton, RN

I had the privilege of attending the HFMA Region 11 conference this week. Although there were many great seminars and speakers on healthcare topics, the best presentation was by Johnny Bench. I will show my inner sports geek (and age) by noting he was a famous catcher for the Cincinnati Reds and I can remember his playing days in the 70s against my St. Louis Cardinals. His presentation was titled The Vowels of Success, and he encouraged each of us to identify our own vowels. I did think about my own vowels. However, that pesky voice in my head asked…what are the vowels of quality? With a nod to Johnny and his inspiration, what follows are mine.

A is for…Attitude and Accuracy

I co-presented at this conference with a client who shared one of her organization’s keys to success in improving quality scores: A “can-do” attitude. Their team believed failure was not an option and chose an attitude of collaboration and determination. Ask yourself if you or your team members have a “we’re going to take this hill or die trying” attitude….digging in to “win” on a particular diagnosis. We may win the battle but lose the war all for the sake of being “right.”

Ensuring that we have the “right” diagnoses and codes (even when it does not shed a favorable light on our institution) is the right thing to do and ensures that the integrity of the data is upheld and can result in meaningful improvement in outcomes when needed.

E is for…Excellence and Education          

The hospital performance rankings on the CMS.gov website utilize less than 20 metrics to assign a hospital’s star ranking (from a low of one to a high of 5). Of more than 3,700 hospitals nationally, only 17 have achieved a 5 star ranking. Shocking? Disappointing? Certainly. But that doesn’t mean we shouldn’t continue to strive for excellence. Not only in quality rankings but in real patient outcomes.

So many roadblocks to improving quality outcomes could be overcome or avoided by educating all stakeholders; even those with strong knowledge of certain quality metrics. Topics can include basic coding guidelines and principles, methodology of performance matrices, clinical education, etc. In undertaking a shared education, we can ensure all are on the same page and spark great discussion and decision-making.

I is for…Individuals and Invention

Johnny Bench noted “there is no I in team” but stated that we each need to endeavor to be the best “I” we can be. As a team, we count on each other to grow in our knowledge and understanding of quality outcomes and in being good team members. I don’t wish to be the weak link, do you?

We may need to invent (or reinvent) new ways of collaborating, communicating and identifying quality concerns. Doing things “the way they have always been done” obviously is not successful if outcomes still need improvement.

O is for…Openness and Organization          

We need to be open to new ideas or knowledge. Not just in a passive manner by listening to others knowledge and opinions, but also in an active manner through continuous study and research. The quality landscape is constantly changing and evolving; if we are not current, we may not be able to realize the best quality performance.

Organize (or reexamine the current structure of) the workflow for quality reviews. Ensure the workflow is thorough yet efficient, using lean principles to eliminate any redundant or unnecessary steps.

U is for…Understanding and Utilization

Understanding how other team members think — their perspectives and agenda — makes us better team members and may help us to avoid the adversarial relationships that sometimes occur.

So many times I observe institutions who collect data but do not do anything with it. Dig deep into the data to identify trends and concerns and to prioritize those that are the most problematic.

What are your vowels of quality? Perhaps it is a good time to pause in your quality endeavors to identify not only your own but also your team’s vowels of quality.

Cheryl Manchenton is a Senior Inpatient Consultant and Project Manager for 3M Health Information Systems.