Quality improvement is a marathon, not a sprint

My husband and I both like to run.  I run about 3 miles once or twice a week — if the weather’s not too bad, and if I don’t have something else going on.  Keith, on the other hand, runs half marathons.  He goes for long runs on the weekend for 3 to 4 hours at a time, and shorter runs during the week.  He runs in the heat, rain or cold.  He paces himself, being careful not to expend too much energy early on.  I bolt out at full speed from the start, with the intent to run a 5K as fast as I can.

We both run, but with an entirely different focus and with entirely different results.

In a recent blog post by Paul Levy, former CEO of Beth Israel Deaconess Medical Center, (“Lean Is Not a Program“), he highlights how Lean is a “long term philosophy of corporate leadership and organization that is based, above all, on respect shown to front-line staff.”  As the title implies, he reasons that Lean is not a one-off consulting stint packaged into a clever playbook.

This reasoning applies not only to Lean, but to any effective quality improvement effort.

In the world of 5Ks and marathons, true organizational quality improvement efforts are marathons.  They involve a significant long-term commitment from those running the race.  A weekly sprint is not effective to change culture.  Many hospital systems see the changes in U.S. healthcare on the horizon.  They feel the pressure to focus more on clinical quality improvement and waste reduction, but are too intimidated to commit to training for the marathon and all the hard work that comes along with it.

The challenge is that if hospitals want to see significant improvements in healthcare quality culture that impact their bottom lines and patient outcomes, they need to make that first step in committing to change.  They need to engage their clinicians and staff with a shared vision for superior value, lower cost healthcare and go through the many steps required to make that a reality.

With a shared vision in mind, hospital leaders must embrace the expertise of their front-line clinical staff to inform them where changes need to be made in everyday practice.  In order to earn buy-in from the medical staff, administration needs to show them that they are listening and are committed to providing the resources they need to do their jobs as effectively as possible.

Once improvement is underway and organizational culture begins to progress from complacency to active problem-solving, hospital leadership must sustain this movement by delivering on its promises and encouraging this new way of thinking.  It takes the entire team, from leadership to management to the front-line clinical staff to keep the momentum going to achieve results.

Although training for a marathon is classically thought of as a solitary endeavor, preparing for the marathon of effective clinical quality improvement requires a commitment from the entire clinical and administrative staff.  An organization that focuses on the occasional sprint rapidly loses the gains it works so hard to win.

Alexandra S. Brown is associate director, Healthcare Delivery Institute, HORNE LLP.

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