LaFollette Article Sparks Curiosity

Thank you for the eyeopening article, “Quality Pros Break Through the Healthcare Barrier” (Dan Vnuk, November 2005, p. 30). It is exciting to know the healthcare industry is recognizing the need for process control and is looking to quality professionals.

Congratulations to Will LaFollette and his team at the Marshfield Clinic. I wish them the best. I respect Marshfield Clinic’s management for its vision, and I hope many other organizations will follow the same path. I am curious to find out whether there are any healthcare institutions in Canada that have already taken steps in this direction.

I am an ASQ certified software quality engineer and work as a process specialist for a software company making medical devices. The healthcare industry has always fascinated me, but like many other quality professionals, I wonder where and how I can fit in the industry with an engineering degree and no education in the healthcare field.

I look forward to more such articles in Quality Progress.

Cedara Software
Mississauga, ON

QFD Article Valuable To Healthcare Industry

Vincent Omachonu and Paul Barach provide a two-fold service to the healthcare industry with their research on using QFD to improve a managed care organization’s member handbook.

One, the research is well explained and the article well written. I agree with the authors that the products of healthcare are often ill defined and intangible. It is only through using the tools we have that we can hope to get ever closer to better definitions and tangibility. Small steps are much better than none.

Second, I am pleased to see the use of QFD. This valuable tool has gone out of favor lately yet offers such an excellent breakdown of questioning, analysis and priority.

I suspect the redesign of the member handbook gained not only from the QFD process but from the skill of the two professionals wielding the tool. Very well done.

Management and Performance Systems
Tavares, FL

Healthcare Issue Raises Issues, Lacks Balance

There is much to be said for interdisciplinary collaboration and continuous quality improvement in healthcare. Achievements featured in the articles in the November 2005 issue should be acknowledged. However, a lack of balance in those articles also deserves notice.

Opening paragraphs again proclaim nearly 100,000 yearly deaths in the United States due to medical error. We manage what we measure, and epidemiology seeks to measure adverse event rates accurately so meaningful trends can be recognized. That number of attributable deaths should be recognized as questionable.

Readers are told that, as a matter of simple fact, adopting four key practices will virtually eliminate ventilator associated pneumonia (“Change Healthcare Organization From Good to Great,” Glenn W. Bodinson, p. 22). The author cites one research study, then promotes implementation through formation of a leadership team that does not include infection control professionals or hospital epidemiologists. As the stakeholders responsible for running hospital infection surveillance and control programs, their exclusion is an unfortunate oversight.

It would be beneficial to contrast the simple advice given in your magazine with a more comprehensive review of other references, such as a well-respected hospital epidemiology reference book’s chapter on nosocomial pneumonia and its prevention. See the third edition of Hospital Epidemiology and Infection Control, (C. Glen Mayhall, ed., Lippincott Williams & Wilkins, 2004.)

It also is disappointing none of the articles mention healthcare quality improvement resources developed over the past few years through interdisciplinary collaboration of ASQ Healthcare Division members. Those resources include a position paper posted on the division’s website and a series of integrated chapters comprising Section II of Mayhall’s book.

Failure to recognize hospital epidemiologists and infection control professionals can do harm when consultants from other industries dominate our arena. To continue progressing toward superior quality together, those from outside healthcare should pay closer attention to lessons long documented by the work of hospital epidemiologists. In turn, the best future hope for hospital epidemiology and infection control may rest in ISO 9000 and Baldrige criteria rather than traditional accreditation environments.

School of Nursing
University of British Columbia
British Columbia, Canada

Managed Care Article Explains QFD Well

I just finished studying for and taking my Six Sigma Black Belt exam and am waiting for the results. I have not had the opportunity to apply quality function deployment (QFD) in my current position, but reading “QFD in a Managed Care Organization” (Vincent Omachonu and Paul Barach, November 2005, p. 36) not only made me interested in using QFD—it opened my eyes to a whole new industry and made more sense than the information I used in studying for the exam. My compliments to the authors.

Hendersonville, NC

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