Software Quality Improvement

Save Healthcare

There are three major types of quality problems in Healthcare.

(1) Variation in services - There continues to be pattern of variation in healthcare services.

These include regional variations and small-area variations. This is a clear indicator that

Healthcare practice has not kept pace with the evolving science of healthcare to ensure

Evidence-based practice in the United States.

(2) Underuse of services - Millions of people do not receive necessary care and suffer

needless complications. These add costs and reduce productivity. Each year, an estimated

18,000 people die because they don't receive effective interventions. For example - A study of Medicare patients who had suffered heart attacks found that only 21 percent of eligible patients received beta blockers. The mortality rate among patients who received

Beta blockers was 43 percent lower than it was among non recipients. AHRQ funded study examined the use of beta blockers before heart bypass surgery and found that patients who received beta blocker therapy before surgery had lower rates of death and fewer complications both during and after surgery than patients who did not receive this therapy.

(3) Overuse of Services - Each year, millions of Americans receive healthcare services that are unnecessary, increase costs and may even endanger their health. Research has shown that this occurs across all populations. For example - An analysis of hysterectomies performed on women in seven health plans found that one in six operations was Inappropriate. A study examining the use of antibiotics for treating ear infections in children on Medicaid found that expensive antibiotics were used more often than indicated.

According to the findings, if only half the prescriptions were written in 1992 for more

expensive antibiotics has been written for amoxicillin, a less expensive but equally effective antibiotic, Colorado's Medicaid program would have saved nearly $400,000 that year.

 Here are three ways to improve health care delivery.

(1)  Establish healthcare as a national priority –

a.    Provide Strong Leadership and Clear Aims for Improvement 

b.    Advance Quality Measurement and Reporting 

c.     Create Public-Private Partnerships

 (2) Strengthen the Market to Improve Quality –

a. Encourage Action by Group Purchasers  

b. Strengthen the Hand of Consumers 

c. Focus on Vulnerable Populations 

d. Promote Accountability

e. Reduce Errors and Increase Safety in Health Care

(3)  Build the Capacity to Improve Quality –

a.    Foster Evidence-Based Practice and Innovation  

b.    Adapt Organizations for Change 

c.     Engage the Health Care Workforce 

d.    Invest in Information Systems 

Quality and Language of business

In the ASQ blog site, the author asks fundamental questions...

Do you speak the “language of business”? How important is it, in your experience?

=> Speaking the "language of business" (Cost of poor quality) is necessary but it is not sufficient to reach the upper chambers of management in organizations. 

Top managers must possess core competencies (management and technical) required to lead the organization and they must provide confidence that they can provide long term growth, sustainability, and results. 

Everyone in the society (not just quality professionals and top managers) should think in terms of cost of poor quality for improving the overall quality of life.

    

Social Responsibility - Not an Oxymoron

Views on Social responsibility and connection to Quality -

Social responsibility is not an oxymoron.
For a company in health insurance industry Social responsibility means -

• Promoting the health and well being of the local community (employees and the society)
• Providing affordable healthcare by charging the lowest possible premiums
• Improving the accessibility of the healthcare by including all eligible providers
• Providing high quality healthcare
• Demonstrating ethical behavior (paying claims in a timely fashion, not following discriminatory practices in offering insurance products, Detecting and preventing fraud, abuse, waste in the healthcare delivery systems etc.)
• Provide opportunities for employees to volunteer for social causes (blood donation, renovating of schools, educating society about healthy life style etc.)
• Empowering employees and provide learning opportunities so that they can be more productive at the workplace

All of the above are directly related to quality practices within the organization and quality professional play an important role in educating and obtaining top management commitment to make these happen. Quality managers must work with top management must make sure that company’s mission, vision, values, goals and objectives reflect these. Being socially responsible improves the credibility and trustworthiness of the organization and this leads to long-term sustainability. Corporate profitability and social responsibility is not a zero-sum game. Looking at this from the top management's language of money, quality professionals need to explain this in terms of prevention, appraisal and failure costs.

As an example, how does a quality manager sell to the top management that health insurance company must make efforts to promote the health and well being of the local community (employees and the society).

Healthy population leads to lower healthcare costs. Healthy employees lead to more productivity and reduces company's administrative expenses. Organization benefits, employees benefit, and the society benefits.