Clinical or Nonclinical Quality Specialists
Does the Quality Specialist (QS) need a clinical background? Not necessarily.
Many successful QSs have come from diverse backgrounds, including coding, psychology, industrial engineering, finance, and manufacturing.
My series on “Building The Ideal Quality & Safety Department” continues with this post.
I’ll post information every Monday until we’ve designed an entire department. When the series is complete, we’ll have a monograph, a step-by-step model for designing your dream department – one that gets results AND one where every FTE can be justified by a solid business case. I’ll publish it as an eBook so you’ll have all of this information in one publication. So let’s take a look at the soft skills for your Quality Specialist.
I have received many questions lately about how to staff a quality and safety department. The most common questions are:
- How many staff do I need? Are there any benchmarks for effective staffing levels?
- What type of skills do they need?
- Do they need a clinical background? If not, what other type of education is ideal?
- My organization never approves my FTE requests and we can barely keep up. What can I do?
OMW! Here we go again. Yesterday in an editorial on psqh.com, Don Berwick is quoted as stating at the IHI National Forum in December 2015, that we should “cut in half all metrics currently being used and then cut them in half again.”
I wholeheartedly disagree. And here is why.
Clinical Dashboard – Hemorrhagic Stroke
Creating a clinical dashboard is easier than you think – and with this template and tips you’ll be on your way to having a dashboard in no time.
Quick Tips to Get You Started
First, you need the design for the Total Knee Replacement (TKR) Dashboard. Download it here in excel format.
Second, you need to remember three “truths” about quality data.
The Associated Press reported recently that Medicare launched mandatory bundled payment for hip and knee replacements effective April 1. 67 metropolitan areas are on the list and more will likely follow, so preparing for bundled payment ASAP is the smart play.
What’s Your First Move?
Quality improvement programs often fail simply because they are poorly focused. Many QI programs try to do too much; they try to work on too many small, low-impact, department-level QI projects.
Avoid The 1,001 Quality Improvement Project Trap
The 1,001 QI project trap happens when your organization charters improvement QI projects using a bottom-up approach—essentially allowing departments to charter any QI project they feel is important.
This approach results in hundreds of small, low-impact projects. They bring little improvement value to the organization, take up a lot of energy, and stretch quality department resources past their limits.
Quality leaders feel like they’re doing everything they can to improve quality, but are overwhelmed by so many QI projects, and see little improvement for all of their effort.
You might think it would be just the opposite, but time and time again, we’ve run the numbers—and when there are too many QI projects to support, they fail to achieve results.
So, your first step is to keep the number of QI projects manageable, while at the same time you need to achieve your goal to improve care for as many patients as possible. I know this sounds like a no-win situation, but there is a way to manage a reasonable number of projects while improving care for the majority of your patients.
Here are two ways to focus your improvement efforts that get HUGE RESULTS.
My Grandpa was one of my heroes. He had survived WWI, the Great Depression, and WWII, and yet, he still wore a smile on his face everyday. And he loved his grandkids, and his great grandkids.
I was taking the second part of the boards one day when the dean came into the auditorium and pulled me outside.
She said, “your grandpa has been in an accident. He’s over at St. Mary’s. Go to him and we’ll worry about this test later.”
I had just finished a cardiology rotation at this hospital and one of my professors was Grandpa’s cardiologist. This gave me a sense of hope that Grandpa would be OK.
My professor said, “your Grandpa has a pneumothorax (a collapsed lung); they put in a chest tube to reinflate it; his heart failure is stable; we fully expect that he will make a full recovery.”
I was so grateful my Grandpa had a good prognosis.
The next several days went off without a hitch, but then … three days later my professor called me aside, and he had a grave look on his face.
The controversy about healthcare’s rating agencies continues. Whether it’s that we don’t like their choice of measures, or how the data is risk adjusted, the most recent complaints are that there are too many of them and they all measure different things.
Regardless, rating agencies aren’t going away. Their measures and methods are becoming more sophisticated, and patient interest in hospital quality information continue to increase. And frankly, many quality leaders find their information useful and informative – some such as myself will use this information to help develop our quality and safety priorities for the near term. One such source is Leapfrog’s Hospital Safety Score.
Why You Should Follow Your Hospital Safety Score
First, Leapfrog’s Hospital Safety Score is targeted at consumers and is intended to help them “select a hospital that is prepared to protect them from harm and error.” This is reason enough to follow your score. It seems that anything less than an A, and possibly a B would be embarrassing. It’s also hard to explain when asked why your organization has a C, D, or F by the media, your board, your community leaders, your employers, and your health plan partners.
We have a healthcare crisis of epic proportions – a patient safety crisis. It only came to light in the 1990’s, but its likely existed in all of our healthcare organizations for our entire careers. But so far, we have only made a dent in the problem. Our patients know this and they are afraid, their families are afraid, and when we’re honest with ourselves, many of us worry about being hospitalized in our own organizations.
Here are the sobering statistics:
- 210,000 to 440,000 people lose their lives each year to medical errors in hospitals, according to research conducted by J. James and published in the Journal of Patient Safety.
- Medical errors may now rank as the third leading cause of death in the United States; only cardiovascular disease and cancer takes more lives each year.
- Preventable Adverse Events (PAEs) account for “roughly one-sixth of all deaths that occur in the U.S. each year.
- More than 1,000 people die every day from preventable accidents in hospitals.
- Preventable medical errors, in the form of “oops”, errors of omission, complications, readmissions, and avoidable mortality cost the US economy untold billions each year.
- The average hospitalized patient experiences 1.5 medication errors daily and medication errors are the most common form of error.
- There are more than 6 million patient injuries per year due to errors.
- 40 percent of hospitals received a C, D, or F on Leapfrog’s Safety Score.
- According to the Leapfrog Group, “since Fall 2014, (hospital) performance on safety outcomes – including preventing errors, accidents, and infections – has not significantly improved.”