The Emergence of Quality-of-life Indicators

One of the most important activities that healthcare providers must focus on today is how they measure the quality of care that their organization provides. Up until recently, concrete quality indicators consisting of numerical data were the overwhelming choice used by doctors and healthcare management when assessing quality of care. Numerical indicators such as mortality rates, hand hygiene compliance rates, and even cholesterol levels in patients are commonly used in healthcare assessments nationwide. While this approach has been useful in monitoring the quality of care received, a newer (and more subjective) way to measure quality is now becoming more prevalent. This new indicator is the measure of a patient’s quality of life.

According to the 2012 article “The Simple Idea That Is Transforming Health Care,” more and more healthcare providers are assessing quality-of-life measures by asking their patients about how they “feel about their condition and overall well-being” (Landro, 2012, p. R1). With this type of assessment, “nurses or trained counselors meet with people and ask personal questions like: Is your condition inhibiting your life? Is it making you less happy? Does it make it hard to cope day to day? Then the counselors offer advice about managing those problems and follow up regularly” (Landro, p. R1). Rather than being given only abstract numerical goals (such as, blood-pressure levels), patients “are more likely to manage their condition properly when they have more accessible, personal goals, like being able to do more at work or keep up with their kids” (Landro, p. R1). Numerous studies have indicated that patients with increased well-being “have fewer hospitalizations and emergency-room visits, miss fewer days of work and use less medication,” which reduces overall healthcare use and spending (Landro, p. R1).

As future healthcare executives, is important that we consider a more holistic approach to measuring healthcare quality. While quality-of-life indicators should by no means replace concrete numerical data, combining both methods can provide a more well-rounded picture of actual healthcare quality—as well as provide a means for achieving continuous quality improvement in the future.

Reference:

Landro, L. (2012, April 16). The Simple Idea That Is Transforming Health Care. The Wall Street Journal, pp. R1 & R2.

Adverse Events

In almost all cases, the patient’s perspective is irrelevant as to whether or not an adverse event has occurred. If the patient is aware that a medical mistake was made, it would (of course) be an adverse event. If they were rendered unconscious or killed by the mistake (and therefore unaware of it), it would still be an adverse event. The point is, all medical mistakes are adverse events. Furthermore, if a mistake was made that did not harm the patient in any way, it would still be an adverse event because breakdowns of protocol in the medical industry are always unacceptable and need to be corrected—regardless if the patient was aware of the mistake or not.

There are, however, some cases when the patient’s perspective does affect whether or not an event is considered adverse. In the case of plastic surgery (which is highly subjective), a patient’s outcome may not be what they had envisioned. While the surgeon may think he or she did a great job, the patient might still consider it an adverse event (and try to litigate). Conversely, a plastic surgeon may make a mistake during a breast augmentation (putting in “c” cup implants instead of “b” cup, for example) and the patient ends up happier with the larger size. While the patient does not perceive an adverse event has occurred, a mistake was made and should still be considered adverse by the medical staff.

Once again...in the medical field, all mistakes should be considered adverse events. As future health care executives, we need to take the proper steps and create safeguards that prevent mistakes—keeping adverse events from happening in the first place.

Fish Philosophy

When I was working as a retail manager, one of the training tools we used to create a more productive working environment and a higher quality customer service experience was "Fish Philosophy," from the book Fish! by Lundin, Paul, & Christensen. This book used the Seattle-based Pike Place Fish market as the backdrop for illustrating this philosophy. Even though the weather was cold, the fish were smelly and the hours were long, the fish workers made their jobs fun and entertaining for customers by throwing fish through the air to one another, singing songs, and telling jokes to customers. They turned something miserable into something fun by employing main four principles: Choose your attitude, play, make their day, and be present (Lundin, Paul, & Christensen, 2000, p. 70).


"Choose your attitude" refers to the fact that we all choose the attitude we put out there for the world to see. Regardless of whether we are having a good or bad day, the attitude we choose to put out there should always be positive if we expect positive things to happen for us. "Play" refers to the practice of playing at work (while still getting work done of course). Since we spend so much of our lives at work, why not make it a fun place where we look forward to spending time--as opposed to dreading every morning. "Make their day" refers to involving customers/patients in the fun we are having. This creates great memories that can make someone's day that was previously not so special. "Be present" is being fully engaged with customers/patients by not ignoring their needs.


While I know that these four principles may not work as well in certain areas of health care (acute care, for example), other areas such as children's hospitals could definitely benefit from Fish Philosophy. But even with acute care, choosing a positive attitude and being present for customers can make a huge difference at the end of the day. With the focus of health care shifting to patient-centered care, any way that we can enhance the quality of a patient's experience is a good thing.

Reference:
Lundin, S., Paul, H., & Christensen, J. (2000). Fish!. New York, NY: Hyperion.

What Quality Means to Me

As a consumer, quality is one of the most important characteristics I look for when purchasing a product or service. Now that I am a student (yet again) on a limited income, getting "more bang for my buck" is even more important than ever before. This, however, does not mean that I will buy the cheapest thing out there. I have learned from experience that spending a little more on higher quality items saves me more money in the long run (because I do not have to replace them as often). I also shop at places that provide a higher quality customer service experience—such as Publix and Chick-fil-A—because they go above and beyond the call of duty to fix problems when they arise.

As a retail manager, providing a higher quality customer service experience was my number one priority. I made sure that every customer that walked through the door had a positive shopping experience. Even if they came in upset because they had to return an item that did not work for them, I made sure to do whatever it took to ensure that they left happy. Even if the products I sold were not always the best in quality, the high quality service provided customers with enough value to shop with us again in the future. The health care industry could certainly use more of this.

As a future health care executive, I intend to take everything I have learned as a consumer and a retail manager, and apply it to the health care industry. By always keeping the wants and needs of the consumer in mind and by training staff to give great customer service, one can create a higher quality patient-centered environment in health care. Although this approach may be more difficult to implement, it is in the health care provider's best interest. Increased quality leads to repeat customers and more word-of-mouth referrals—both of which ultimately lead to increased revenues in the future.