Last week we talked about the changes occurring in healthcare and how W. Edwards Deming said healthcare would be the last industry to embrace change because of doctors unwilling to make the changes. Today, the healthcare industry is going through some big changes but all employees, not just doctors, must be involved in those changes to improve the quality and safety of healthcare.
The position of the Office of National Coordinator for Health Information Technology was created in 2004 under Executive Order and Congress officially enforced the position in 2009 under the HITECH Act to encourage healthcare providers to implement electronic records. This is requiring major work system changes. Teams from all professions in a facility should be involved in looking at how the changes in electronic healthcare will impact the work system to improve patient care.
Healthcare teams can utilize the same quality tools Deming embraced that will help to improve patient care and safety. In fact, some of the 14 points Deming identified remind me of the quality and safety issues healthcare faces.
The first point talks about “creating constancy of purpose toward improvement of product and service.” To me, this relates to the “5 rights” of clinical decision support: the right drug, the right dose, the right route, right time and the right patient. This, of course is very important in the healthcare field and recent technology changes can help to ensure the “5 rights” occur but for it to be effective employees, including doctors and nurses, must embrace the change. This is why employee engagement is needed to help create consistent and safe patient care. We’ll blog later about this technology change and others that help healthcare employees take care of patients.
Another Deming point is to “cease dependence on inspection.” Joint Commission, which audits healthcare providers for quality and safe patient care, is great at creating standards of use and conducting audits but there shouldn’t be any worry about passing audits. It should be the norm and utilizing quality processes by involving employees as Deming suggested can help to minimize the fear and stress of the inspection. Making sure the standards are met consistently provide not only a quality healthcare system but also a system where patients feel comfortable and safe. This, too, is a topic for future blogs.
The final Deming point I think relates to healthcare is “drive out fear so everyone can work effectively.” Too many times we place blame before looking at the system. The entire healthcare system in the facility needs to be addressed through employee engagement so the transition to electronic systems can be made safely and mistakes can be eliminated.
Next week, we’ll talk about more about electronic health systems and how employee engagement in the healthcare system can have a major impact on the transition to electronic health systems.
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Sayles, N. (2013). Health Information Management Technology: An Applied Approach, 4th ed. Chicago: AHIMA.