Other Performance Improvement Tools: From Compliance to Excellence

Improving healthcare processes and outcomes and maintaining these achievements within the healthcare system is a multifaceted journey. The continuum in Fig. 25.1 depicts a model of different improvement methodologies and approaches to address a wide range of organizational needs. Although this model does not claim to include all existing improvement methodologies, it represents a spectrum of the most common approaches used by healthcare institutions in the United States (US) and across the globe.

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Different zones and methodologies of healthcare performance improvement.

A wide range of performance improvement methods can support healthcare organizations in their journey to excellence.

In general, we can group these methods into three main zones, based on their primary focus and application:

• 1.

  Compliance Zone : Methodologies in this zone primarily focus on organizational processes and compliance with regulatory, healthcare, or internally defined requirements. Compliance with ISO 9001 requirements (e.g., policies, procedures, records) and with The Joint Commission requirements are two common examples of this category. Later in this chapter, we will review ISO 9001 in more detail.

• 2.

  Improvement Zone: Although not entirely separate from the concept of compliance, the methodologies in this zone assume that the basic compliance measures are already in place and direct their attention to continuous improvement. These methodologies are best known for their “project” approach. Lean and Six Sigma are two of the best-known models in this zone that are often used by healthcare institutions. An earlier chapter (see Chapter 24 ) deals with Lean and we will discuss Six Sigma in more detail in this chapter.

• 3.

  Performance Excellence Zone : Performance excellence frameworks provide a model to integrate the culture, vision, tools, and measurements for improvement across different functions and areas of the organization. These models are the embodiment of Dr. Deming's “Total Quality Management,” often structured around specific criteria element. The High Reliability Organization Maturity Model, Baldrige Criteria for Performance Excellence, and European Foundation for Quality Management (EFQM) model are some examples for these frameworks, and we will review the Baldrige model in more detail later in this chapter.