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The Cost of Medical Quality

By Daniel L. Gee; MD MBA

The cost of medical quality actually goes up when the variation and error rate of a process goes up. For example, the costs of pharmaceutical errors alone, in terms of lives and money, are huge. Consider the legal implications of incorrect procedures to an institution. Coding errors that lead to variability in reimbursements costs physicians and other providers, lost revenue.

Think also of the cost of additional safeguards, such as inspectors, that must be put into place to oversee defective processes. When a process is improved, the cost of quality goes down. There are fewer costs due to redundancy, lost time and lost labor.

A Variations Analogue

The concept of looking at medical variations in a process is analogous to the process of teaching a child to ride a bicycle for the first time. The child will be wobbly when he or she gets on the bicycle, at first and, may even fall, several times. As long as you are watching closely, to help the child back on the bicycle, help steer a little and provide encouragement, the child soon learns to ride smoothly and it appears all so natural. The child soon learns to balance from the feedback gained from you and the internal feedback from the brain. After studying the learning process closer, you may find the child to be more successful learning on a set of training wheels or on a bicycle a little smaller in size.

Regardless, the closed loop feedback, analysis, and monitoring by a teacher or process “champion,” keeps the child from wobbling too much and to stay on a straight and narrow course.

A Closed Feedback Loop

Businesses and medical practices wobble too in their processes and, in Six Sigma terminology, this wobbling is the variation that needs continual feedback to help correct and stabilize. Unlike riding a bike, where when once learned it becomes natural and smooth, businesses continue to wobble in their processes and may fall without ever being able to get back up. The institution of Six Sigma methodology is a closed feedback loop to prevent instability in processes.

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Assessment

Virtual perfection may not be as easily attainable in an industry – like medicine – as computer chips coming off an assembly line; and the healthcare industry certainly has its share of “wobbliness;”

It is, nonetheless, the desire to constantly improve operations, perfect the way healthcare business is done – and tune in to what the patient needs – that separates the Six Sigma Sx improvement method from those QI techniques that have come before.

Moreover, the benefits of setting high performance goals, is a strategic decision to accelerate improvement, promote continual learning and sustaining efforts to succeed. It is a cultural change in medical mind-set to attain quality at its highest level.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your SS experience with medical variations? How should we define cost; in economic or human terms? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: Quality Initiatives | Tagged: CPHQ, Daniel Gee, healthcare quality improvement, medical quality, medical variations, Six Sigma | 4 Comments »