NAHQ: Quality professionals and quality work essential during crises such as coronavirus pandemic

By Christopher Cheney

The coronavirus pandemic has illustrated the value of quality professionals and their work in healthcare, according to a recent whitepaper from the National Association for Healthcare Quality (NAHQ).

The pandemic has posed some of the greatest challenges to the healthcare sector in generations, and quality professionals have played key roles such as operating crisis command centers, activating telemedicine programs, and developing safety protocols for healthcare workers and patients.

From a quality and safety perspective, there are three primary lessons learned from the pandemic, according to the whitepaper.

1. “Routine efforts to advance quality initiatives are highly effective, and when we stop or deprioritize those initiatives, health outcomes suffer. Any healthcare leader who has ever questioned the value of routine quality and safety work should take this as the signal that this work matters. And when it is deprioritized, even for a good reason, ground is lost,” the whitepaper says.

2. “Reinstating, sustaining and advancing quality and safety initiatives is the path toward progress in healthcare. A ‘new normal’ in healthcare appreciates that we must be dependent on sustainable systems, process and structure to ensure continuity in the face of known and unknown challenges. Performance and process improvement—and quality management—must be hardwired into the work, so that when a crisis occurs, the focus is not shifted away from quality and safety,” the whitepaper says.

3. “Deploying quality professionals to solve many of the biggest challenges that healthcare leaders face will result in the biggest impact to advance healthcare leaders’ priorities. Healthcare quality leaders and professionals are uniquely qualified to solve problems. Whether leading or sustaining run-the-business quality and safety initiatives or leading in a crisis, these leaders have the tools and competencies to bring order and deliver results,” the whitepaper says.

It is important to maintain routine efforts to advance quality, even during a crisis such as the pandemic, Stephanie Mercado, executive director and CEO of NAHQ told HealthLeaders.

“The run-the-business efforts save lives. When we take our foot off of the gas on those efforts, we can see that patient outcomes suffer. We saw many of these efforts get sidelined during the pandemic—generally speaking, everybody’s attention was shifted to focus on a single clinical condition. The result is that we lost ground—turning back the clock on five years of progress to improve quality and safety metrics. There is recent data that shows there were significant year-over-year increases from 2019 to 2020 in hospital-acquired infections,” she said.

Hardwiring performance and process improvement (PPI) as well as quality management in healthcare ensures that quality and safety efforts continue when a crisis occurs, Mercado said.

“Hardwiring PPI and quality management means that we are always looking for what is going right in healthcare, and we are always looking for what is going wrong in healthcare. It also means that we are engaging stakeholders to review their work and do it better. It also means we are activating improvements through a system in ways that are constantly eliciting change management and sustainable improvement throughout the whole system. We do not do quality work because we all of a sudden have time to do quality work. We do it because quality has become the work. It is the way that we have learned to function, and it produces better quality and safety outcomes for patients at a lower cost,” she said.

Quality professionals are equipped to solve many of the biggest challenges that healthcare leaders face, Mercado said.

“Quality professionals do their jobs well because they have the training, the tools, and a deep-seated commitment to improvement as a mindset. That is what makes them a valuable resource in solving challenges in healthcare. … People who pursue a career as a quality professional have improvement as a mindset—it is part of their DNA. Quality professionals have the tools and the methods to understand a problem and create a solution. Just like firefighters rushing into a burning building, quality professionals with the right training can jump into any challenge. For example, health equity and population health are solvable problems with quality tools, methods, and mindsets,” she said.

System sustainability

It is essential to focus on system sustainability in healthcare, Mercado said. “It is important to focus on system sustainability because quality can’t wait. Quality cannot be viewed as just another priority in a long list of efforts that need to be accomplished in healthcare. Sustainable systems are important so that we make healthcare better for the patients and make healthcare better for the workforce.”

System sustainability helps keep patients safe, she said. “When it comes to patients, we have lost ground during the pandemic on healthcare-associated infections, and it is important to focus on sustainability because patients do not expect to go into a healthcare environment after the pandemic and feel less safe getting care. But, in fact, they are less safe.”

System sustainability also positions the healthcare workforce for success, Mercado said. “When we think about the healthcare workforce, sustainable systems will also make healthcare better for the workforce. … If we are going to bring back purpose for the workforce and activate the calling part of their career choice and build a strong culture, then we are going to have to put healthcare workers in situations where they have the best possibility for success.”

System sustainability boosts healthcare worker morale, she said. “People in healthcare are seeing the same medical errors occur over and over again. It is depressing, and it causes burnout. So, a focus on training the workforce on how to help solve these problems before they happen and avoid the harm to patients is an important step in solving the culture and workforce problems that we are facing now. Sustainable systems are designed for the best success and for the types of experiences that elicit joy rather than sadness.”

Christopher Cheney is the senior clinical care​ editor at HealthLeaders. This story first appeared on HealthLeaders Media.