Today, there is a disconnect between stakeholders in healthcare. Executives, providers and quality leaders are not aligned on priorities, and very few are making progress on sustainably solving the most complex problems. Labor shortages, preventable medical errors, rising healthcare costs and inefficiencies are among the problems creating a national healthcare crisis, which will not be resolved with superficial fixes. It is time to shift from approaching quality as compliance to quality as a driver of excellence.
Why quality? As healthcare organizations seek progress on goals and improving patient outcomes, many executives have failed to recognize quality as a long-term strategic priority, rather than a regulatory and compliance function. Too many executives have isolated quality functions by department when they should instead take a broader view.
Intensified since the onset of Covid-19, hospital margins were still negative at the end of 2022 at -0.2 percent, according to data from Kaufman Hall. These margins, resulting from low patient volumes, revenue decreases and rising costs, show no indication of turning around unless quality is leveraged as a business strategy. As hospitals struggle to get funding from reimbursement models, executives must take advantage of the opportunity to leverage quality principles that will reduce waste while also driving value.
Safety and waste are quality issues
Preventable medical errors provide a clear example of healthcare waste. The U.S. Department of Health and Human Services – Office of Inspector General (OIG) reports that millions of Medicare patients yearly experience adverse and temporary harm events as a result of medical care or in a healthcare setting. Some of which have serious, long-term implications for patient health – not to mention the effects on patients’ families – and these concerns remain a challenge for providers across the country.
The most recent OIG report reveals that one in four hospitalized Medicare patients experienced harm in October 2018. For nearly a quarter of these patients, the events resulted in additional costs to Medicare. In that same report, physician-reviewers determined that 43% of the harm events were preventable if patients received better care. These findings demonstrate the need for executives to reevaluate their safety and quality procedures and determine how their workforce fits into the equation.
Pull the workforce lever
The single biggest lever available to affect change is the workforce. Executives need to focus on reskilling and upskilling to expand the level and type of quality and safety work. Improved workforce skills paired with better coordination of quality work is what will achieve long-term, sustainable results.
The National Association for Healthcare Quality (NAHQ) conducted research that provides an evidence-based understanding of the relative strengths and weaknesses of the quality and safety work being performed by people working in healthcare. Though previous studies have been clear on what the issues are, we now know how to fix them: through a capable workforce.
Furthermore, the research suggests that the healthcare workforce is focused too narrowly on three domains of quality—regulatory and accreditation, patient safety, and quality leadership and integration – while neglecting other areas like population health and care transitions, performance and process improvement, health data analysis, professional engagement, and quality review and accountability. This is troubling because high performance in all domains is the key to progressing on goals.
It is imperative for CEOs to prioritize investing in quality and safety professional development to ensure their workforce is ready to meet healthcare’s biggest challenges. Investing in workforce readiness can lead to better financial results for healthcare organizations across the country. Amid the economic pressures facing the industry, there is no better time than now.
Time to double down on quality
Improving the quality and safety of healthcare in today’s complex environment requires a broader, action-orientation perspective of the knowledge, skills, and abilities required to make improvement happen. By expanding the level and type of work being done in quality and safety, healthcare CEOs can deliver coordinated, patient-centered care and drive value through improved outcomes in the long-term.
Looking ahead, leveraging quality as a business strategy will be key for healthcare executives to shift from striving for compliance to striving for excellence. A quality mindset can serve to eliminate debilitating waste while creating a more reliable operating model. When things get tough in other industries, like airlines or manufacturing, they double down on quality principles. The time for healthcare executives to double down on quality is now.