Building The Ideal Quality & Safety Department

Technical Expertise Required for Your Quality Specialist

I have received many questions lately about how to staff a quality and safety department. The most common questions are:

  1. How many staff do I need? Are there any benchmarks for effective staffing levels?
  2. What type of skills do they need?
  3. Do they need a clinical background? If not, what other type of education is ideal?
  4. My organization never approves my FTE requests and we can barely keep up. What can I do?

How Quality & Safety Programs Save Millions

BETTER QUALITY = LOWER COSTS

One of my favorite speeches is titled, “How Quality & Safety Programs Save $Millions.” In it, I share 10 case studies that illustrate how quality programs can eliminate waste in healthcare organizations, especially hospitals. It seems that the more I give the presentation, the more I keep emphasizing three key points. They are:

  • BETTER QUALITY = LOWER COSTS
  • SAFER CARE = LOWER COSTS
  • BETTER PATIENT OUTCOMES = FINANCIAL SURVIVAL

I frequently deliver this speech to C-suite executives, and groups of CFOs and physicians. One evening, the group decided to add up the savings from the ten case studies. We were astounded to see the total impact!

$256,354,000

How did these organizations generate more than a quarter of a billion dollars in savings? I’ve attached a reprint of the article where I review each case study (Thanks to HFMA for allowing me to reprint it here).

But we still have many doubters. Our peers, colleagues, and friends who still don’t understand the financial impact of well designed, well executed quality and safety programs. I often ask myself, “why do they still doubt that better quality and safety reduces costs?” “Why don’t they believe?” And then one of my friends reminds me that many quality programs, maybe the majority, suffer from poor design, or poor execution, or are plagued by the 1,001 QI project trap. All of which lead to little improvement, a lot of wasted effort, and no financial return for their organization. But it doesn’t have to be this way.

I hope these case studies give you some hope, maybe even some inspiration, that when you design your projects with an eye toward true outcome improvement, and execute your plan with precision, that these results are also within your reach.

I also hope that you can use these case studies to convince your organization, your leadership, and your finance colleagues that there is a financial return that comes with better, safer care. Once they’re convinced, getting the resources you need to prove this in your organization maybe just a little easier. To help you in this regards, I’ve attached the slide deck I use to make these points. I hope that you find the slide deck and the article helpful in your endeavors. After all, at the end of the day we’re doing all of this for our patients.

How to Avoid the 1,001 QI Project Trap

Strategically Focus Your Quality Improvement Priorities for Maximum Impact

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.

The Top 10 CEO Roles in Quality – Part 2

In my first post on this topic, I covered the first THREE Critical Roles for CEOs in your organizations.

We reviewed that some CEOs have embraced the quality agenda and gladly lead the charge.  They lead high performing organizations that are often listed in the Top 100 hospitals and the Healthgrades Distinguished Hospital lists.  But in organizations where the CEO is silent, quality performance can be mediocre or worse.  A CEO who is active and involved is one of the keys to a top performing organization.  And because better quality = lower costs, they often lead the most cost effective organizations as well.

Here are the next three CRITICAL ROLES for your CEO:

The Top 10 CEO Roles in Quality – Part 1

Effective quality and safety programs take effort, resources, and unrelenting determination.  They also require leadership from all levels of the organization.  But leadership from the top is critical. As Harry Truman said, “the buck stops here”.  In this case, it “begins and ends at the CEO’s desk”.

Many CEOs have embraced the quality agenda and gladly lead the charge.  They lead high performing organizations that are often listed in the Top 100 hospitals and the Healthgrades Distinguished Hospital lists.  But in organizations where the CEO is silent, quality performance is usually mediocre at best.  A strong, vocal CEO is one of the keys to a top performing organization.  And because better quality = lower costs, they often lead the most cost effective organizations as well.

So, what do these CEOs do that distinguishes them and their organizations?  Here are three key roles that the CEO can play that will propel your organization toward best in class quality and cost effectiveness.