Keeping It Continuous

Gurus bring quality to life for organization founder

by Mary Nicholas

My journey into quality is a story that I’ve told a few hundred times because it’s become a part of my outreach to customers in beginning the relationship-building process that is so critical in business today.

I’m often asked about my journey because I am the founder of an accreditation organization for a specialized sector of the healthcare industry—the durable medical equipment (DME) or home medical equipment (HME) sector. The idea for the organization stemmed from the passing of the Medicare Modernization Act (MMA) of 2003, but when someone asks me: "How long have you been in the business?" I find it is best answered by telling the story of my quality journey.

Studying the concepts

Stepping back in time to the late 1990s, I was going through what most consider one of life’s greatest stressors: change. I’d been working in the human services field for nearly 25 years and because so many other things in my personal life were changing, I thought I would look at a career change, too. I made the decision to return to higher education and pursue a master’s degree in healthcare administration.

It was during my coursework that quality as a field, as a concept and as an art form came alive for me. In class, I was introduced to the works of W. Edwards Deming, Joseph M. Juran and Eliyahu M. Goldratt. I most strongly identified with Goldratt’s concepts—so much so that I sought out one of his workshops, traveled 1,000 miles to attend and achieved my goal of getting his autograph. I placed it right next to the autographed copy of Juran’s Quality Handbook.

Scott Stegall, an instructor in my master’s of healthcare administration program, brought quality alive for me and energized me to positively move forward through the challenges I was facing personally and professionally. It seemed like such a natural path, as if a secret door had opened to reveal a new journey to embark upon. Little did I know then how true that would be.

An opportunity arises

Fast forward to the early 2000s, and I was able to make the career shift I was looking for. I took a position as a quality director for a member service organization that works primarily with the DME/HME industry. I became known as the organization’s "flowchart queen" and "quality geek."

When the MMA was passed, one of the stipulations set into law was to identify that all DME/HME organizations that bill Medicare for reimbursement were now mandated to achieve accreditation to continue to submit claims. My organization’s CEO thought it would be opportune to develop an accreditation organization because there were nearly 100,000 DME/HME organizations and only a few accrediting organizations to accommodate them. I was offered the challenge to develop the accreditation organization, and I wholeheartedly accepted.

In January 2005, the Healthcare Quality Association on Accreditation (HQAA) was formed as a private, not-for-profit organization. In November 2006, HQAA was accepted by the Centers for Medicare and Medicaid Services as a deemed authority for accrediting DME/HME companies. Today, HQAA has accredited more than 7,000 locations in the United States, Puerto Rico, Virgin Islands and Guam.

Quality leads the way

By using and blending the principles of the gurus Deming, Juran and Goldratt, along with Philip B. Crosby, Ken Blanchard and Stephen Covey, quality was the road I took to design, create and implement a new accreditation organization.

Quality is the air we breathe in our organization. Quality is the foundation of our decision making and planning. We have broken a few barriers that once existed in the accreditation world and have set new paradigms that our competitors now follow. Quality was the sustenance for our organization, and it will always dictate what we choose to do and how we choose to do it.

My personal tag line is "keep quality continuous." That is something I strive to live by every day and share with those that I work with. This is my quality journey—one that I know is ever-changing and ever-challenging. With our oxygen tanks full of quality air, we’ll continue to meet our challenges head on and with pleasure.

Mary Nicholas is president and CEO of Healthcare Quality Association on Accreditation in Waterloo, IA. She has a master’s degree in healthcare administration from Des Moines University-Osteopathic Medical Center in Iowa. Nicholas is a senior member of ASQ.

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