*conduct an informational interview with an expert to discover
issues concerning Quality Improvement. The person you choose does
not have to be in healthcare. He/she can be a manager or supervisor
of any kind as long as they can answer the required
questions.
Information to include:
• The person you interviewed, when, where, and why.
• Required Interview Questions
1. Define the change process or outcome you improved.
2. What data did you collect and how was it reported?
3. How did you know that change was an improvement?
4. What quality tools did you use?
5. Did you pilot test or segment the change processes?
6. What changes, if any, did you make once evaluation was
complete?
• A summary of the information you gained from the
interview.
• Personal reflections and conclusions that resulted from the
experience and the knowledge you gained from it, and how you could
use some of this knowledge in your own practice.
Expert Answer
The person you interviewed, when, where, and why.
Healthcare admin(operations manager) at a small size hospital was interviewed at his hospital. The aim was to understand the quality improvement initiatives at small size hospitals
1. Define the change process or outcome you improved.
Patient satisfaction (using Patient-reported experience measures (PREM)) was the outcome measured and improved. This shows patients perception of the healthcare experience they received. The measure helps in real-time tracking of satisfaction for improvements and response
2. What data did you collect and how was it reported?
A satisfaction survey (scale of 1-5) about the care the patients received was conducted during their exit from the hospital. This was done for both outpatients and inpatients. Demographic data- age, sex, income, race, and education were also collected along with it.
3. How did you know that change was an improvement?
The survey is made as a regular part of the healthcare quality improvement initiative and is being made as a routine for all patients.
The results are tracked regularly and deviations are noted down immediately for addressing issues. Statistically, tools like ANOVA etc are used to ensure whether the changes are statistically significant and do not take place by random
4. What quality tools did you use?
- Satisfaction survey questionnaire (Likert scale 1-5)
- Control charts – to track and ensure that the mean satisfaction score is beyond lower limit
- Histogram –to see whether there is change in proportion of people in different scores
- Fishbone diagram to get picture of all the possible causes for high and low scores
5. Did you pilot test or segment the change processes?
Yes. Initially, it was conducted only for patients who stayed for more than one week in the hospital. Later it was extended to all departments (OP-Out patients and IP-in patients)
6. What changes, if any, did you make once evaluation was complete?
Improvements were made in the areas of waiting lines, costs, ambiance, and behavior of service providers through training.
Adoption of technology like electronic medical records was made
A summary of the information you gained from the interview.
The manager started this as a pilot project and extended it to all departments. Surveys were taken from all patients. Results were meticulously tracked. Analytical tools like SPSS were used. The causes behind the scores were understood and improvements were made in segments where the hospital lagged.
Hospital personnel was educated about the quality initiative. A six month period produced statistically significant improvements. The hospital is now looking for continuous improvement.
The project helped the administration to understand consumer perception of the brand.
• Personal reflections and conclusions that resulted from the experience and the knowledge you gained from it, and how you could use some of this knowledge in your own practice.
If you can’t measure, you cannot manage
The interview helped me in understanding how various tools can be used and how even a simple tool or measure can be of great use. It also showed how such measures can help us to boost employee morale.Measuring and tracking go a big way in helping managers get a detailed as well as a big-picture view of what is actually happening in the organizations. It also helped me in realizing that how a structured approach to management is essential and how even a simple tool can be of significant use.
Now I could use such tools in my organization for quality improvement initiatives. This will help me to understand the system, track the system and make changes to improve it.