Does your QI program need some QI? (Part 1 of 2)

by Kyle Vath, BSN, MHA, RN

As we near the fourth quarter of the year, QI coordinators all over the country are planning to ramp-up a new year…bracing for the ever-present mantra…”That’s a ‘quality’ issue”. Barely before your blood glucose levels return to their pre-holiday-gorging state, there’s no doubt that some QI coordinator somewhere will again be overwhelmed by a broad-spectrum of concerns.

So how do team members who have such a broad job description stay focused and start the new year off intentionally? Over the next two weeks we will suggest 7 ways to finish the year strong…

#1 – Go (almost) Paperless

In this era of hybrid reporting (some reports are manual pencil and paper and others are computerized), paper is not yet totally a thing of the past. But much of the clutter filling our cramped and dimly-lit QI offices is unneeded and decreases our efficiency. Before the new year, work to put at least one “paper something” on the computer…and then throw that “paper something” in the recycling bin. Physical clutter can translate to mental clutter and results in stress and burnout. Plus, digitizing documents provides the power of the key-word-search and copying and pasting – both time-saving hacks.

Scanning documents that are hand-written logs or items that cannot be digitized is another great way to clear out your clutter. If you don’t have a document scanner, spend the money and buy one. In 2018, more than two dozen paper hanging file folders is unnecessary. The age of multiple four-drawer filing cabinets is (or should be) a thing of the 1980s. Usher in the coming year with a 21st century (almost) paperless office.

#2 – Begin With The End in Mind

It happens each year. You run through the finish line at the end of the year, take a quick breather over the holidays, and then jump back into work, pounding out your year-end reports. But you sit down at your desk and a cold sweat comes over you. Your hypertension control numbers are awful (or worse, same as last year). But December 31st has come and gone and there is nothing you can do to make it better. You make a mental note to work on improving those numbers this next year. But before you know it, you’re buried in the day-to-day and it’s November in the blink of an eye-and you still haven’t done anything to “move the needle”.

So let’s do something different this year. Before you even start cranking out your quality reports, spend two hours (schedule it on your calendar) reviewing your outcomes from the previous year. If you are like most of us, your “areas-in-need-of-improvement” look a whole lot like the previous year’s “areas-in-need-of-improvement”. Look at the areas with the poorest outcomes and select the worst 3. Then look at those 3 metrics and choose the one you think is the easiest one to improve (maybe you have a volunteer that specializes in that area or you just got a grant for a related project). Plan a simple QI Project and plan out the steps for the entire next year. Make sure to plan these events within the first 9 months of the year so you have time to see a positive change.

Then, pull out your health center’s QI Plan if you have one. (Yeah, you know. That thing you worked on a few years ago that told the board what you were going to do…and that you haven’t thought about since…Yeah. That one.) Read it from beginning to end. Underline or highlight all of the areas that explain something that you will do. Then, make sure you are doing them…or that you are going to start doing them in the new year. When your next board meeting comes up, you won’t need to frantically make sure that everything is in order. You’ll be ready.

#3 – Avoid the “Everything’s-Quality-Trap”

Tell me if you have ever been in a health center leadership team meeting like this?

Practice Manager: “We have had an increasing problem with the back office staff stopping up the toilet.”

Nursing Manager: “That sounds like a Quality Issue…[Insert QI Coordinator’s Name]? When are you going to fix this?

QI Coordinator: “I’m not sure that is really a Qual-”

Practice Manager: “But, everything’s a Quality Issue!”

Though this may be a little exaggerated, QI Coordinators around the country have had conversations like this too many times to count. Often, QI Coordinators come into the job as well-rounded generalists. You might have been an ICU nurse who was good with Excel formulas. Or maybe you were an MHA student who just graduated and knew how to make a pretty graph. You know a little about everything and you are a quick-learn. This Jack-of-all-trades job description creates a perfect landing spot for everything from building pivot tables to putting together office furniture.

Yes, everything may be related to the quality of the care you provide. And everyone has the responsibility to look for areas in which we can improve. But not everything should be handled by the QI Coordinator. A problem disguised as a “quality issue” may actually need a manager to…well, manage. Or maybe the health center needs to hire a handyman to go around and change lightbulbs. If this description describes your health center culture, you might need to set the tone early in the year by assertively (and professionally) communicating what you need for to be successful in your role.

By | 2018-09-17T15:23:34+00:00 September 17th, 2018|Uncategorized|17,762 Comments

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