Quality Quintet

Indeed, all hospital employees, regardless of rank, should be embassadors of quality for the benefit of patients and their families.

In previous posts, I have written about the essential roles of the Board of Directors and the C-suite. Individual roles are important, however, regular communication, teamwork, accountability, and consensus are even more critical to building a top performing organization.

I believe that there is a core group of leaders within a hospital that must share common ground in order for the Quality and Patient Safety strategy to be successful.

I call this core group the Quality Quintet. I recommend its members to be:
- Chief Operating Officer
- Chief Medical Officer (or VPMA)
- Chief Nursing Officer
- Director of Quality (or VP)
- President of Medical Staff

These clinical and administrative leaders must invest their time and energy in learning about the most germane elements of the quality and patient safety hospital agenda. In turn, they must use this knowledge/information to communicate with one another and build trust. The ultimate goal is to etch out a winning strategy that will yield first-rate patient outcomes.

Again, those organizations that are often cited as top performing (i.e. Mayo Clinic, Hackensack University Medical Center, Sutter Auburn Faith Hospital, Beth Israel Deaconness Medical Center, Cincinnati Children's Hospital and Cooley Dickinson Hospital, to name a few) each have a highly functional and supported Quintet that works in sync.

To this end, it is strongly recommended that members of the Quintet meet regularly and seek clarity and consensus.


Some hospitals accomplish this structure via their respective Hospital Quality Committee or Medical Executive Commitee, or Senior Leadership. Others have established a separate work group soley for the purposes of the Quintet. In either case, the objective is to design methods so that both administrative and clinical leadership work in concert.

In synthesis, I challenge those eligible organizations to strive to develop a Quality Quintent, if not already in tact. Successful execution of the Quality and Patient Safety strategy depends on it.

Hospital Quality Overwhelming, But Necessary

Whether one works in a large urban teaching hospital or a small rural community, the professional life and responsibility of the Healthcare Quality Professional is arduous, and often times overwhelming.  The national hospital quality agenda contains essential elements such as: continuous preparedness for Joint Commission accreditation and/or state conditions of participation, data reporting transparency, ongoing physician practice evaluation, patient satisfaction benchmarking, bedside medication verification, computerized physician order entry, electronic medical record implementation, infection control, case management, responding to patient grievances, and effective information management, to name a few.  How does one effectively manage these program elements so that the RIGHT patient, receives the RIGHT care, at the RIGHT time?

Ask any of my peers throughout the country, and they will tell you there are several organizational ingredients that contribute to successful program development and implementation.  Furthermore, I would argue that program sustainability is severely compromised without all five (5) of these ingredients firmly place.  You will find that the Institute for Healthcare Improvement (IHI) provides first-rate research and recommendations in how to incorporate many of these ingredients into your organization.

• Substantive engagement by the Board of Directors, which is reflected by the agenda outline and time spent on Quality and Patient Safety
• Senior Management stewardship and accountability for Quality and Patient Safety operations and strategy, which is demonstrated by the utilization of transparent scorecards or a system dashboard
• Proper buy-in and support of the CFO with the Quality and Patient Safety hospital strategy
• Partnering with the medical and nursing staffs to deliver the clinical elements of the program.  The President of the Medical Staff, the Vice President of Medical Affairs, and the Chief Nursing Officer and Director of Quality, should work closely on matters pertaining to clinical performance improvement.
  
• Proper funding and staffing of Information Technology services

I shall provide further depth to each of these ingredients in future blog posts.

-soft on people, hard on processes