“The more I know, the less I sleep.”
This great quote, from a former colleague Dr. David Rosser, Executive Medical Director of the University Hospitals Birmingham in the UK, nicely alludes to the mix of anxiety, curiosity and desire associated with the quest to provide great quality care. This report, and research conducted by KPMG's Global Healthcare practice on clinical governance and ‘high reliability’ healthcare organizations, is both timely and necessary.
Timely, because of a number of high-profile and widely reported problems in healthcare delivery in various parts of the world. Necessary, because healthcare still has too many of the characteristics associated with an old-fashioned, individual, craft-based system which no longer sits well with what we know works better in the 21st century: teamwork, safety and improvement science, executed on an industrial scale.
As individuals, we would not fly if the current random quality control systems at work in healthcare were adopted by the aviation industry. We have identified four essential elements for healthcare improvement that have been adopted decades ago in other industries. These elements – a culture devoted to quality, accountability, standardized processes and measurement – need to be systematically applied to healthcare. No matter how laudable, our global research suggests that regulation often gives more assurance to politicians and officials than it does improvement for patients. In short, it is necessary but never sufficient.
Real, sustainable change comes from the organizations and hardworking staff that deliver care to patients. Pleasingly, we have found that a number of high-performing organizations encourage patients to become active partners in their care, thereby creating more value.
It’s odd that something so important and personal as healthcare doesn’t have widely acknowledged or adopted ‘industry standards’ of inspection, reporting and improvement. It is high time a debate be started in healthcare to explore whether we should professionalize our best endeavours.
This report also looks at some national and regional attempts to make comparisons easier so that boards and professionals can hold themselves to account in a much more transparent fashion for patients and members of the public alike. Independent assurance is important but delivering quality improvement inside - and across - organizations is mission critical. Through our global roundtable discussions with high-performing practitioners, it is clear that strong purpose, enduring values, great leadership and a restless curiosity to improve truly distinguish excellence.
Finally, as information systems develop and become more reliable and robust, there is a great opportunity for healthcare and life sciences organizations to exploit their growing repositories to capitalize on the ‘Big Data’ trends that have been embraced and exploited by other sectors. We are currently in the foothills of this development but it will come and we should be ready to apply this to the benefit of patients and wider population health.
I’d like to thank the clients, practitioners and guests who participated in this global study and hope you enjoy the report and feel inspired to make a difference.