Why Should You Care?

Five years ago the Institute of Medicine dropped the equivalent of a bombshell on the healthcare world and corners of the quality world. Its report, To Err Is Human: Building a Safer Health System (National Academy Press, 1999), stated as many as 98,000 deaths each year could be attributed to medical errors that could have been prevented.

As this issue was going to press, a new report, “Patient Safety in American Hospitals,” from Health Grades nearly doubled that estimate to 195,000 annual deaths from medical errors. This latter report used a different methodology than the first, so the two numbers may not represent an exact comparison. But from all indications, the situation is getting worse or, at best, has not improved at all.

What gives? Martin Merry, M.D., a leading advocate for healthcare improvement (see p. 25), has said the majority of doctors, nurses and other healthcare workers—probably at least a 6 sigma level of 99.97%—truly want to help people. Very few, if any, of these dedicated professionals wake up in the morning and think, “I’ll go to work today and make a sick patient worse.”

As a quality professional, you know instinctively the problem is not the people but the system (or lack thereof). Commitment to change and improvement have to start at the top, and each error or type of error needs to be analyzed from a root cause and process perspective. But what else do you know or should you know? Why should you even care?

Currently only about 2% of ASQ members and QP readers work in healthcare. I’ve had readers who work in other fields tell me that as medical consumers, they know they should read articles on healthcare quality but often don’t make the time. In reader surveys such articles often don’t rate as high in value as articles on other topics.

This is completely understandable. We are all bombarded with information, and unless we are lucky enough to have a lot of time on our hands, we have to be selective about what we read and study. Most of us concentrate on information we can use on the job today or tomorrow.

But I bet we all can name someone we know—a loved one or at least an acquaintance—who has been in danger or whose health condition was made worse because of a medical error. Probably an honest, unintentional mistake, but scary nonetheless. That’s one reason to care about healthcare quality.

Another reason is your career. Make no mistake, the quality field is changing. Traditional quality roles are going away or morphing into something else, especially in sectors such as manufacturing. Healthcare is in obvious, crying need for the skills and experience of improvement specialists and systems thinkers. Could this be a new opportunity for you?

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