Learn about 7 common QI trip hazards, and how you can avoid them.
Now, I don’t typically start conversations with negatives, but sometimes when I talk with clients, especially super focused go -getters, they’ll ask me right out the gate, “Tell us what we’re getting wrong so we can fix it!” This episode’s for you, and it’s about quality improvement.
Hi, everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 of the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement experience and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you wanna strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.
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So there are so many quality initiatives going around everywhere. There’s quality measures flying around everywhere. You’re probably involved with some of them. Continuous quality improvement is a thing. I did an episode about QI a few weeks ago. It was well received. This is kind of a follow-up. This is about some common QI trip hazards that I’ve experienced firsthand and also learned about from others.
Now, this advice is not specific to any industry, but most of the examples are from health care. So consider this a refresher for you or the QI person in your life. With links to resources in the show notes with also transcripts to this episode and all episodes and they’re available at HealthCommunicationPartners.com. Okay, here we go.
Number one mistake: Using one size fits all quality guidelines. This means we’ve got to take a close read of any guidelines we’re using to see: how equitable are they? That is, are they working better for some groups than for others, just by how they’re written? I’m going to put a link in the show notes to an article called From Quality Improvement to Equality Improvement Projects. It’s a scoping review and framework. and the authors say, “guidelines themselves might lack inclusivity.” They also have a nice lit review, so go ahead and check out that one in the show notes.
Okay, mistake number two. Thinking all quality measures are created equal. That’s right, the tools you use to assess that quality need to be looked at closely as well. If you want to get really good at this, I’m going to put links in the notes to a Johns Hopkins webinar on equity in quality improvement featuring Dr. Andrew Anderson. Definitely check that webinar out. It’s on YouTube.
Alright, mistake number three. Forgetting to center the person. Person-centeredness is crucial, and yet it can be tough to keep doing, right? We gotta keep tying ourselves back to the person. I’m helping a client with this right now. So we wanna make sure that what we’re doing centers people, people’s perspectives and their experiences. Ask yourself, how straight is the line from this measure to the person that it’s gonna be impacting? Could this line be straighter? Be honest.
Alright, mistake number four. Not talking to the folks on the front lines. Now in QI, it can feel like it’s only the people with the dashboards who can make the calls and be valuable to talk to, but that would be cutting us off from an incredibly valuable set of perspectives: Frontline practitioners. Those involved in the work. No a thing or two about doing the work. So put time in your plans to talk to them and write down what they say.
Mistake number five: letting data collection become a burden. Quality improvement leaders, you need to watch out that the collecting of data doesn’t become onerous in itself, ’cause We’re trying to improve things around here, right? I’m gonna go ahead and put a link in the show notes to an article called Organizational Health Literacy Quality Improvement Measures with Expert Consensus. The authors say “measurement burden is a concern in the US healthcare system.” Now, yeah, we need to be accountable, but that accountability can’t take us away from our work so much, or we’re setting up antagonism and risking resentment. The authors recommend that you ask people at multiple levels “how QI initiatives could help them further their progress” toward other requirements, other aims, other goals. And I really like this advice because, hey, double dipping for the win. People don’t mind being accountable for metrics that matter to them.
This brings me to mistake number six: counting what’s easy to count instead of what matters. You’ve heard this before, right? If quality improvement is gonna be part of how we work, you gotta be vigilant about how you’re doing it. So if it starts to feel like you’re measuring things that are easy to count, but not valuable to people, not valuable to staff, trust yourself, trust that noticing and pause. Take time to step back, take a look. Not just how you’re measuring quality, but what are people expected to do with the outcome of this study, right? What kinds of assumptions are being made about how these measurements are gonna translate into concrete practice recommendations. The clearer they can be, the easier it’s going to be to get people on board with them as well.
Mistake number seven: working in silos or in isolation. Now for this, I’m going to put a link into an article. It’s kind of old. It’s from 2016, but I’m including it because it’s good and also because of the title, Does Quality Improvement Improve Quality. The authors say, “too much improvement work is undertaken in isolation at a local level, failing to pool resources and develop collective solutions and introducing new hazards in the process.” So link to the rest of that article in the notes.
This brings to mind the parable about the blindfolded people encountering the elephant. You’ve seen that one. Though everyone’s individual level deductions in that parable made sense, what they really needed to work accurately and effectively was each other’s perspectives so that they could get the bigger picture. So make sure you give yourself time to talk to your colleagues, help take off each other’s blindfolds, and zoom out to see the bigger picture.
If you want to talk more about quality improvement, find me on LinkedIn. I’m Dr. Anne Marie Liebel. You can visit Health Communication Partners and click on Contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel, additional music from Alexis Rounds.
Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners.com.
