Close the Gaps

No matter what side of the Affordable Care Act you stand on, you can probably agree to this: Everyone seems to be spending more of their own money on medical care these days.

And when people spend more of their hard-earned paychecks on something—doctor visits, airline tickets, you name it—they pay more attention to what they’re getting in return, and naturally, they usually expect more.

That’s what the Mayo Clinic Arizona faced: services falling short of patient expectations. So, as an organization that provides a service, how do you ensure you set reasonable expectations—and meet them—to satisfy your customers and keep them coming back?

"Patients are apt to shop for services more discriminately, using publicly available data to choose organizations with the best quality and patient satisfaction scores," wrote Denise M. Kennedy, the author of "Mind the Gaps". "Healthcare organizations must improve service quality."

Using the gaps model, managers did just that and improved customer satisfaction scores by being better at identifying, categorizing and analyzing the likely causes of poor healthcare quality and making the necessary changes to close the gaps.

A better way to pinpoint root causes is the centerpiece of another feature article in this month’s edition. "Solid Footing" offers advice on one way to jump-start your root cause analysis (RCA): Incorporate conservatism, modesty, simplicity, generality and refutability when formulating a good hypothesis.

"A hypothesis that fulfills all of these virtues would be simple, general and make few assumptions, and it shouldn’t contradict what is already known to be true," wrote Matthew Barsalou, who it seems has become QP’s unofficial resident RCA expert. "It also should be possible to test the hypothesis."

Still, this doesn’t guarantee that a hypothesis is correct, he explained. "Proper application of these virtues can lead to a more robust hypothesis that can push the analysis forward" and "provide the RCA investigator a starting point for the investigation."

A worthwhile reminder for us all—whatever the situation—about the importance of building in sufficient time to step back and prepare before a needless rush to judgment that could push matters in the wrong direction.

Mark Edmund
Associate Editor

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