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SEARCHING FOR THE HOLY GRAIL: The Quality Journey In Behavioral Health

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Title: SEARCHING FOR THE HOLY GRAIL: The Quality Journey In Behavioral Health


1
SEARCHING FOR THE HOLY GRAIL The Quality Journey
In Behavioral Health
Thomas R Zastowny, PhD Tom Mosgaller, MSA a.k.a.

Reduce Waiting  No-Shows ? Increase Admissions 
Continuation
2
SEARCHING FOR THE HOLY GRAIL The Quality Journey
In Behavioral Health
Why is it so hard to assure and improve
quality?
Reduce Waiting  No-Shows ? Increase Admissions 
Continuation
3
LEARNING OBJECTIVES
  • LEARN THE QUALITY BALANCED SCORECARD
  • ASSESS THE QUALITY FITNESS OF YOUR ORGANIZATION
  • HAVE SOME FUN!-
  • Try to stay Dry!!

4
HOW FIT,BALANCED AND RESILENT IS YOUR QUALITY
SYSTEM?
5
DEFINING QUALITY
  • CONFORMANCE TO REQUIREMENTS
  • DEGREE OF GOODNESS OF A PRODUCT OR SERVICE
  • REDUCTION OF WASTE IN ALL ITS FORMS
  • QUALITY IS GIVING PEOPLE WHAT THEY
    EXPECT-Satisfaction! Delight!
  • MEETING EXTERNAL ACCREDITATION REGULATORY
    REQUIREMENTS

6
DEFINING QUALITY
  • QUALITY IS WHAT MAKES IT POSSIBLE FOR YOUR
    CLIENTS/CUSTOMERS TO HAVE A LONG TERM LOVE AFFAIR
    WITH YOUR PRODUCTS OR SERVICES
  • LONG TERM LOVE AFFAIRS REQUIRE ATTENTION,
    EFFORT AND DEDICATION!

7
DEFINING QUALITY
  • LONG TERM LOVE AFFAIRS ARE MORE THAN OCCASIONAL
    BELLS AND WHISTLES (FEATURES)
  • LONG TERM LOVE AFFAIRS REQUIRE CONTINUOUS
    IMPROVEMENT

8

Madison in winter !

9

Madison in Spring !

10
THE QUALITY BALANCED SCORECARD
  • FOUR APPROACHES TO QUALITY
  • 1. QUALITY BY INSPECTION
  • 2. QUALITY BY ASSURANCE
  • 3. QUALITY BY PROCESS
  • IMPROVEMENT
  • 4. QUALITY BY DESIGN

11
THE QUALITY BALANCED SCORECARD
Quality Assurance
Quality Improvement
Quality by Design
Quality by Inspection
12
System Characteristics
13
APPROACHES TO QUALITY
  • QUALITY BY INSPECTION
  • RUN WITH THE HOSE AND PUT
  • OUT THE FIRE.

14
Count the Fs in the paragraph
  • Federal Funds are the result of years of
    scientific study combined with the experience of
    years.

15
APPROACHES TO QUALITY
  • QUALITY BY ASSURANCE
  • INSTALL MORE FIRE HOSES.

16
APPROACHES TO QUALITY
  • Examples of QUALITY BY ASSURANCE
  • POLICIES
  • PROCEDURES
  • PROTOCOLS
  • STANDARDS OF
  • COMPLIANCE
  • ISO SERIES
  • JCAHO/CARF

17
APPROACHES TO QUALITY
  • QUALITY BY CONTINUOUS IMPROVEMENT
  • LETS FIGURE OUT WHY THERE ARE FIRES
  • WHY DO FIRES HAPPEN?
  • WHERE DO FIRES HAPPEN?
  • HOW DO FIRES HAPPEN?
  • WHEN DO FIRES HAPPEN?
  • RCAs, FMECAs, Pro Active Risk Assessments

18
APPROACHES TO QUALITY
  • QUALITY BY DESIGN
  • LETS FIRE PROOF THE SYSTEM!

19
APPROACHES TO QUALITY
  • QUALITY BY DESIGN EXAMPLES
  • GREEN BUILDINGS MOVEMENT
  • HYBRID CARS
  • RECOVERING COMMUNITIES
  • USE OF EVIDENCE BASED PRACTICES FOR ADDICTIONS
    TREATMENT

20
CREATING A PRACTICE FIELD- Quality by Inspection
Assurance
  • Directions for Building Bridges-PART 1
  • -Objective To build a free-standing bridge that
    meets the following performance standards
  • Must be tall enough (under the span) that an
    object 8 tall can pass under it
  • Must be wide enough that an object 8 wide can
    pass underneath the span
  • Must have enough structural integrity to support
    a gallon of water placed on the central span

21
CREATING A PRACTICE FIELD
  • Directions for Building Bridges
  • You have 10 minutes to plan a bridge that meets
    the performance standards specified above. During
    this 10 minute period you may not start
    construction, but it is allowable to prototype
    your ideas. The completed bridge must be
    free-standing, that is, you may not tape it to
    the table. You may not use any objects or
    materials other than the paper and tape provided.
    The only resources you have are the tape and the
    paper. You will receive no more.
  • After the 10 minute planning phase you will have
    12 minutes to construct the bridge. At the end of
    the construction phase the bridge will be tested
    to see if it meets performance standards.

22
CREATING A PRACTICE FIELD- Quality by Improvement
Design
  • Directions for Building Bridges-PART 2
  • -Objective Improvement Re-Design-Switch Tables
    with your Team and Improve/Redesign the existing
    bridge (at that table10 mins) to achieve the
    performance standards
  • Must be tall enough (under the span) that an
    object 8 tall can pass under it
  • Must be wide enough that an object 8 wide can
    pass underneath the span
  • Must have enough structural integrity to support
    a gallon of water placed on the central span

23
Questions, Comments, -On to the Work-SESSION.
24
ASSESSING YOUR ORGANIZATION
  • Using the four Quality approaches, think of 2
    ways in which your organization has used
    (Worksheet Side 1)
  • 1. QUALITY BY INSPECTION..
  • 2. QUALITY BY ASSURANCE
  • 3. QUALITY BY PROCESS
  • IMPROVEMENT.
  • 4. QUALITY BY DESIGN

25
ASSESSING YOUR ORGANIZATION
  • System SCORE Characteristics Ratings-SAMPLE
  • 1 None 2 Somewhat 3 Excellent (Worksheet
    Side 2)
  • Quality by inspection
  • We have systematic and uniform methods to get
    immediate feedback from customers when there are
    omissions, or errors?
  • Customer feedback is systematically reviewed and
    findings disseminated to the appropriate process
    owners?
  • When errors, omissions and work arounds are
    identified we have system in place to address the
    issues in a timely fashion?
  • Employees see the report of omissions, errors,
    and process work arounds as part of their daily?

26

Quality Scoring Map
Improvement
Assurance
Inspection
Design

27
Questions, Comments, -On to the Work-SESSION.
28
Creating a Learning Organization Environment
  • What is the assessment data telling us?
  • Where are the learning opportunities?
  • What actions can you take to make a difference?

29
SUMMARY
  • Create the will to move up stream
  • Look outside the field for ideas
  • Chose a quality framework that aligns with your
    culture
  • Use all the Quality systems in Harmony Balance
  • Keep working at it. Its a long term love affair!

30
Selected References
  • Baldridge National Quality Program Criteria for
    performance excellence.
  • www.baldrige.nist.gov
  • Quality First Selected papers on Quality and
    Productivity by Dr. Myron Tribus, P.E.
  • Out of Crises Dr W. Edwards Deming
  • The Toyota Way Jeffery k. Liker
  • Making Stone Soup Improvements in Clinic
    access and Retention in Addiction
    Treatment-Journal on Quality Patient Safety,
    JCAHO, Feb 2007, vol. 33, 2., 95-103

31
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