Every doctor wants the best possible outcome for the patients in their care. None of us walk into an exam or operating room hoping for a mediocre result. Yet, when it comes to the subject of quality improvement, physicians are divided at best. Not in terms of desiring a greater level of care for our patients, but how to go about it. Sure, there are plenty of continuing education opportunities in the medical field, but few doctors have the time to see a full load of patients and put in the hours required to expand their knowledge and hone their craft. I recently interviewed Dr. Jordan Peck who shared a great deal of insight on the issue of quality improvement in the medical field.
Every team needs a quarterback
There was a time when physicians were the undisputed leaders of medicine. Most doctors were in charge of their own practices or were contracted by hospitals. They essentially owned a business and took it upon themselves to consistently advance the quality of care they provided. In the current medical system, the majority of physicians are employees of the hospital. Quality standards need only be maintained and managed via checklists that ensure accreditation from various governing bodies. The problem is that there is little administrative incentive for quality improvement, only quality management.
In the many quality improvement initiatives he has been involved in, Dr. Peck remarked that most physicians don’t realize the power of their words. Doctors can inspire or disparage every member of their frontline team. Quality improvement doesn’t just start with us, it flows from us into our entire team. “I think that’s one thing we’ve lost,” Peck adds, “…empowering our physicians to feel like leaders again and letting them know the role that they have.” I couldn’t agree more. Every team needs a quarterback and leaders have to lead.
You have to start somewhere
Any problem can feel overwhelming when there are a lot of areas that need addressing to solve them. But you have to start somewhere! One area Dr. Peck and I discussed in our conversation is how to improve the care flow in hospitals. Flow is a quality issue as much as it is an operational one. You don’t want patients in need of emergency care waiting endlessly to get help. Dr. Peck believes there is an opportunity to improve because many hospitals are still developing and implementing best practices in this area.
Another area we talked about needing quality improvement was patient engagement. Many hospitals use “The 5 P’s” as a strategy to increase their patient’s quality of care:
- Potty (Do they have to use the bathroom?)
- Position (Are they comfortable in their current position?)
- Possessions (Are there belongings close enough for them to reach?)
- Pain (Are they in pain or at an acceptable pain level?)
- Peaceful environment (Does their environment help facilitate their healing?)
This method alone is a great start, but Dr. Peck had an idea to make it even better. He suggested posting a sign with these P’s in every patient’s room and if their nurse or doctor forgets a P, they get a free treat from the cafeteria. While this may not work for everyone, ideas like this help patients own the quality of their care and make them part of the solution.