I’ve been really enjoying those commercials from Ally bank that feature either a studio session, a job interview or a blind date in which someone who seems normal or even out of the ordinary comes up with the line, “I love my bank!” It’s a great way to market a product and also get out the message that “quality matters.”
Quality is a word that’s not taken lightly. A few decades ago, Ford Motor Company stressed that “Quality is Job 1” and that helped them to maintain their presence in the automotive world during the recession of the 90s and into the future. Even with the most distressing economic downturn of the last 80 years, Ford managed to continue its work and even rejected the bailouts.
I think these two examples show that in order to love something, there has to be quality.
And that includes healthcare.
I bring this up because I had the great fortune of attending the Annual General Meeting of the Canadian College of Health Leaders, Eastern Ontario Chapter and was impressed with a panel session that discussed the concept of Excellence in Health Care. Atop the agenda was quality. As the speakers gave their presentations and then the panel followed (you can learn more by checking out the tweetcast at #EOC11), you could easily see that message from the CEOs of hospitals and health care facilities, the Presidents of several Patient Care organizations and other distinguished leaders in Canadian healthcare was based in the two above examples.
They want you to love your healthcare because Quality is their Job 1!
I’ll be honest, it’s not that easy. There is a long struggle ahead and there will continue to be numerous hurdles, pitfalls and unfortunately the embedded distrust of hospitals as places where you go to die. It’s been like that for over 400 years and it will be almost impossible to change the mindset of certain individuals. One individual is trying to change all that. Hugh MacLeod, the Chief Executive Officer of the Canadian Patient Safety Institute (CPSI), is doing his best to ensure that patients not only get the quality they deserve, but also have it on paper and in the cloud.
Apart from being the global hub for Patient Safety Alerts and offering a dizzying collection of information related to achieving (and receiving) the best quality, some novel ideas are coming from CPSI, one of which I need to mention.
Surgical Checklist Consent
Before I get into this, I should step back one moment to describe a process that people such as myself and thousands of other researchers who work in clinical settings. It’s called Good Clinical Practice (GCP) and it is a legislated means by which any research that is done with human participants must follow a very strict set of procedures and paperwork. It’s an absolutely rigorous and at times painful system to implement but also necessary to ensure that any work can be traced back to a source, whether it be a chemical, a worker or a germ.
One aspect of GCP is that all procedures must be standardized and made public. These Standard Operating Procedures (SOP) are critical for any good practices, whether they be in a lab setting, clinical setting or manufacturing setting. These procedures are essentially checklists of tasks that need to be performed in a certain order and approved not by one person but by as many as three. Quality in this sense is maintained through an approval chain, transparency to the public and democratization of the knowledge that is being sought and gained.
Going back to Hugh MacLeod’s concept, many medical procedures that are more complicated than say checking the lymph nodes of the throat or using a stethoscope, require the healthcare worker to follow a set of procedures in a certain order in the same vein as an SOP. When one works in teams, each person how has to follow their own set of SOPs as well as the SOPs of the group and at times have to know everyone else’s SOPs. For comparison sake, one can see what a similar set of procedures looks like in animal surgery, specifically the anesthesia of rodents. That’s one out of probably half a dozen that are involved.
Just imagine how complex human surgery is.
This is where the checklist comes in. The checklist has been in use in numerous fields where life and death are at risk. Pilots are perhaps the most widely known users of checklists and they have been the model for the evolution of checklists in healthcare. By using simplified wording, identification of critical points in the procedure, and ensuring that everyone involved has the proper knowledge and training, a checklist could be as short as a few pages yet could help to save a life (or hundreds) each time it’s used. It’s good for pilots and it’s especially great for surgery.
Here is where Hugh MacLeod takes the idea from good procedure to excellent quality. By incorporating the checklist as part of the informed consent form prior to surgery, the patient becomes part of the quality management team. The patient only signs the consent form on condition that the checklist is followed, signed, sealed and possibly delivered.
Surgical informed consent is never an easy document to sign, especially when there are particular risks associated with the procedure. What the Surgical Checklist Consent does is ensure that the patient understands exactly what will happen inside the surgery room and that each and every person in the surgery room is doing exactly what is necessary to make the surgery a complete success. And, at the end of the day, the surgical checklist consent assists in making sure that actions performed by the healthcare staff are recorded and reported to the true supervisor or a surgical procedure…the patient.
Now that’s Quality.
I’d like to hear what you think of quality and what else you would like to see to keep every patient safe and help everyone love their healthcare…