Planning for Healthcare Improvement: A Goal Without a Plan Is Just a Wish
In my book, Healthcare: A Better Way. The New Era of Opportunity, I argue that healthcare organizations need an effective plan if they expect to work on healthcare improvement and address the quality, safety, waste, and cost challenges confronting our industry. Part 2 of the book is essentially an overview of a comprehensive strategic improvement plan designed to allow organizations to center their efforts on continuous improvement and value production.
Our current health system has accomplished some great things, but is also being overwhelmed by complexity and producing some serious quality, safety, waste, and cost issues. Without a comprehensive plan to support continuous improvement, it is unlikely that any organization can negotiate the turbulent period of transformation that we are now experiencing.
Healthcare Needs to Change to Improve
If we do nothing to change how we are organized and operate, we would be foolish to expect different results. Albert Einstein famously said, “Insanity is doing the same thing over and over and expecting different results.” Paul Batalden, MD, Professor Emeritus at the Dartmouth Institute, stated the same sentiment slightly differently when he said, “Every system is perfectly designed to get the results it gets.”
The fact of the matter is, if a system does nothing to change the way it is organized and how it operates, any system, including a health system, cannot expect to achieve different outcomes. In fact, it will not get different outcomes. This is born out by many health systems that have talked a great deal about improving quality and safety over the past decade, yet have made very little progress to show for their efforts.
A Systematic Approach to Healthcare Improvement
All healthcare organizations would benefit from developing a systematic approach to improvement. In essence, organizations need a strategy and an effective plan for managing complexity and change, with the goal of achieving scalable and sustainable improvements in outcomes over time. Such an effective framework is illustrated on the graphic below. It divides an improvement strategy into three critically important components that in combination can ignite sustainable and meaningful change.
The first component, the Analytic System, is where organizations unlock their data, make it easily accessible to frontline clinicians through automated distribution and provide improvement teams the data presentation tools required to find meaningful patterns in the data.
The second component of a sound strategy is a Deployment System that puts the organizational, team-based structure in place to sustain, spread, and scale up improvements over time in the organization.
Finally, the Content System provides the necessary infrastructure to effectively manage knowledge and routinely implement best practice into every day care in the most efficient and timely manner possible.
In essence, this represents a framework that can help guide conversations about improvement and allow organizations to craft a thoughtful data-driven improvement strategy to support a new way of delivering care that is safer, higher quality, and more reliable for the patients we serve.
The need for a strategy and an effective plan will seem obvious to most who read this article, yet it is interesting how many modern health systems do not adopt serious plans to truly change the way they are organized and operate in order to produce value. Rather than continuous improvement being at the core of how they operate, the quality improvement initiatives at many organizations are organized more as an add on. These initiatives are too often peripheral to how an organization actually operates, instead of defining who they are.
Planning for Healthcare Improvement Initiatives
Planning is one of the most important tools organizations use to achieve important goals. Planning is preparing a sequence of action steps and metrics to achieve a specific goal. If you do it effectively, it is possible to considerably reduce the necessary time, effort, and resources required to realize goals. Without a good plan, an organization is unlikely to achieve its goals and is likely to take many unnecessary, inefficient, and unfocused steps. With a good plan, an organization can avoid or at least see a looming crisis. Without a plan, a crisis can unexpectedly erupt.
A plan is like a roadmap. When following a plan, an organization can always see how much it has progressed towards its goals and how far they are from the desired destination. Knowing where you are is essential for making good decisions on where to go or what to do next.
Developing a strategy and plan takes time and resources. It requires the time and commitment of some of the most highly paid and highly experienced people in an organization. If an organization isn’t willing to invest what is needed to develop an effective plan and successfully execute it, they probably should not embark on the journey in the first place. Poor planning can be worse than no planning at all.
In addition to helping an organization achieve its goals, a good plan sets direction and establishes priorities, effectively communicates important messages, drives alignment, and simplifies decision-making.
Organizations need to consider each of these three elements of a sound improvement strategy in greater detail. But for now, let’s agree on one point. A goal without a plan is just a wish.