Wild Card: Leadership

            The more experience I gain in health care and further along I get in this program, leadership is always a topic for debate and scrutiny. Leadership is so important to the success and productivity of any organization, however, the definition of a leader is somewhat a topic of debate; and no two individuals are alike. Defining a correct or incorrect way of leadership is a bit of a challenge. It is in my opinion a good leader possesses a multitude of skills and attributes that makes them an effective or ineffective leader.

            Leadership is about possessing a high level of commitment and accountability; a good leader is one that is intelligent, takes the initiative, communicates well with others, is approachable, can motivate others and has a clear vision of expectations and goals. Leadership for quality is about inspiring others to be motivated and committed to the cause, adding energy to the room and eliminating those who may suck the energy out.

            Poor leadership can cost an organization. The ability to motivate, give direction and inspire others is easier said than done. Even though a good leader focuses on results and not friendships, it is important to be able to inspire others without being too over-bearing. Many organizations can suffer from incompetent, unethical, and abusive leadership. This sort of leadership can create many problems within an organization and can deplete financial resources and an exorbitant amount of time in correcting areas where mismanagement has occurred.

            It is my opinion that properly training our future health care leaders is key to continuous quality improvement and pivotal to the success of any organization. Leadership is a skill.  To me, it is about the embodiment of core values, the ability to initiate structure, consistency in thought and action, as well as, having respect and consideration for ones subordinates. Although it seems relative, finding a balance between them can pose more of a challenge. Hence, why it is so important to prepare the future health care leaders for the challenges that lay ahead; and to give them the tools to set up a work environment for success. Being a part of the MHSA program has taught me a lot about what it means to lead and inspire others, and is and is hopefully a budding start to a successful career in the health care industry. 

The Patients Perspective

Explain why or why not the perspective of the patient is the most important determinant as to whether an adverse event has occurred.

Even with precise calculations, effective protocol, methodology and practice, adverse or undesirable events are unavoidable. With the fluidity and ever-changing scene in health care, casualties spring up from time to time within health care and usually many factors and individuals are involved. It is important to weigh carefully and determine the precise misstep, or area in which the event took place in order to avoid future mishaps. Patient perspective is undeniably an important part of this process and something to be considered as the patient is usually at the center of the setting; however, it is in the opinion of this student that the patient perspective, although very important, is not the best determinant as to whether an adverse event has occurred.

For example, outcomes may not always meet the expectations of patients even though they may be considered positive from a clinical perspective. The patient experience is subjective and therefore not always the best determinant of a medical error. Patients, in general, may lack the ability to decipher an event as a positive one if the results are not significant in their production of change, or positive change; albeit positive from a clinical aspect. Procedures may be followed precisely to quality standards; however, a patient generally lacks the knowledge or understanding of hospital or facility protocol, for this reason, an undesirable event or outcome may be perceived when in fact there is none.

Likewise, there are always risks with any medical procedure. Potential risks are always discussed with patients prior to treatment in preparation for a best and worse case scenario. Some risks are minimal, while others are adverse. Patients can be sensitive and emotional when it comes to their health and may view the occurrence of a small risk as much more adverse than it truly is. With this being said, I personally feel the voice of the patient is not something to be taken lightly or ignored. The patient voice is an important part to maintaining and improving quality standards for the overall benefit of the community, but not always the best resource for determining an adverse event.

When determining if a medical error has occurred it is important to rely on facts and empirical evidence in culmination with the patients voice. It is important to investigate all avenues leading up to the event in question to identify if and where an error has occurred. Adverse events are usually a combination of latent failure (less apparent errors) in areas such as organization, training, or poor design, and active errors (errors which are immediately apparent leading up to the event). The comparison and intensive investigation of evidence will ensure the efficacy and efficiency of all medical protocol and procedures. 

Electronic Health Records and Health Care Quality

Electronic Health Records, or EHR, is revolutionizing the coordination, standardization, sharing, and analysis of health information like never before. It is helping to create and facilitate interdisciplinary teamwork amongst physicians, as well as transfer medical records in a matter of seconds. Lack of communication or coordination has always been a prominent problem within the healthcare field and EHR is beginning to have a significant impact on a facilities infrastructure; and most importantly, patient outcomes.

EHR can be a powerful source for quality improvement and performance measures. It can store demographic data, aid in managing appointments and schedules, streamline billing, as well as, facilitate communication between doctors and patients. Information now has the ability to be shared within a community or across country through a single integrated application. This type of access, data collection and comparison allows a patient’s entire medical history to be at a physician’s fingertips. A physician is able to direct a more sound course of treatment more effectively and efficiently than ever before, thus delivering a higher standard in the quality of care directly into the hands of the patients. EHR not only improves quality and delivery of care, but safety as well.

EHR will ultimately, in my opinion, reduce health care costs; increase safety and quality not only for the patient, but health care facilities too. Better coordination and organization of care will have effects on things such as reduction of patient readmission rates for recurring or chronic conditions, increase desirable outcomes, increase efficiency and productivity of medical facilities, and increase the overall health of patients by having the ability to more easily direct, or redirect a course of treatment.  Meaningful implementation of EHR ultimately has the ability to improve health not only of the individual, but a community as a whole.

What does quality mean to you?

Quality is an integral part of the health care delivery system. It seems today it is a hot topic for debate and a parameter on which we continuously seek to improve. Quality in health care means different things to individuals, however, when one thinks of quality one word comes to mind: value.  Value in terms of time, efficiency, efficacy, consideration for the individuals thoughts and feelings, and desirable outcomes all contribute to the overall quality of the health care experience.

A patient with a positive health care experience with a company or organization who promotes value and quality as their main priority do well to ensure their own propagation in a highly competitive market. By striving to create a positive experience for all of those under their care, visitors, and/or family members, they increase their brand awareness, increase their market visibility and promote their mission, vision, and values. Providing a quality service or product lends itself to profitability and accountability within the organization.

Quality, however, must start from the inside out, at the core of the health care operation: the employees.  As a future health care executive, it is important to consider quality improvement not only for our patients/guests/visitors, but our staff as well. A satisfied and validated staff is one who will perform well and facilitate our mission, vision, and goals to provide quality service.