Management Principles Developed 75 Years Ago Are Just As Important Today

Implementing process improvement in healthcare is an ongoing process as new challenges are addressed. However, principles developed by Dr. William Edwards Deming about 75 years ago are proving to be extremely useful to healthcare organizations as they strive to improve the delivery and quality of healthcare with limited resources. It's essential to 'triage' the process, focusing on the most critical elements first.

Just what is process improvement in healthcare?

When clinical quality measures is implemented, it does not involve a complete tear-down and rebuild of the existing systems. Instead, a plan is developed to identify, focus on and apply incremental changes to the most important 20% of the processes that will deliver 80% of the impact. While the ultimate goal of healthcare transformation may never be fully realized as the external regulatory and financial environment is constantly changing, constant improvements in electronic data collection and reporting are necessary and ongoing.

One of the major challenges to process improvement are the electronic clinical quality reporting programs (e-measures) imposed on healthcare providers by governmental agencies and others. While hospital administrators and others are trying to use their limited resources most effectively, the varying reporting demands imposed by these agencies result in the duplicate data, inaccurate data and far too much wasted time and effort. The key to process improvement is accurate clinical data delivered to the right person at the right time. Effective process change cannot be implemented if the integrity of the data cannot be relied upon.



The principles of quality improvement in healthcare

The Deming principles that were first adopted long ago by the automotive industry, have now been effectively used throughout the world (although they may never be adopted by government). The general philosophy of the Deming principles is that when the appropriate management principles are put into practice, organizations will be able to simultaneously increase quality and reduce costs.

The Deming principles as applied to healthcare are summarized below.

1. Process management is the method of achieving quality improvement.

2. You can't improve the unknown. Nothing can be improved until there is good data.

3. Managed care refers to managing the process, not the clinicians. The doctors and nurses must be engaged in the process before effective changes can be implemented.

4. Data is only useful when it is accurate, in the right format and in the hands of the right person at the right time.

5. Take advantage of the highly educated clinicians in the healthcare industry. They are integral to the success of necessary changes.

Dr. Deming would undoubtedly be pleased to see the application of his management principles to the healthcare industry. Regardless of the format, accurate and reliable data is integral to the change process. The healthcare industry can only benefit as process and data management lead to improved quality and reduced costs.