The Quality Improvement Challenge. Richard J. Banchs

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      Director of Business Process Improvement

      Omron Automation Americas

      USA

      © 2021 John Wiley & Sons Ltd

      All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

      The right of Richard J. Banchs and Michael R. Pop to be identified as the authors of this work has been asserted in accordance with law.

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      Limit of Liability/Disclaimer of Warranty The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

       Library of Congress Cataloging‐in‐Publication Data

      Names: Banchs, Richard J., author. | Pop, Michael R., author.

      Title: The quality improvement challenge : a practical guide for physicians / Richard J. Banchs, Michael R. Pop.

      Description: First edition. | Hoboken, NJ : Wiley‐Blackwell, 2021. | Includes bibliographical references and index.

      Identifiers: LCCN 2020039053 (print) | LCCN 2020039054 (ebook) | ISBN 9781119698982 (paperback) | ISBN 9781119699002 (adobe PDF) | ISBN 9781119699019 (epub)

      Subjects: MESH: Quality Improvement | Physician's Role | Quality of Health Care–organization & administration

      Classification: LCC R690 (print) | LCC R690 (ebook) | NLM WX 153 | DDC 610.69/5–dc23

      LC record available at https://lccn.loc.gov/2020039053 LC ebook record available at https://lccn.loc.gov/2020039054

      Cover Design: Wiley

      Cover Image: © Artur Debat/Getty Images

       Richard J. Banchs, MD

      To my beautiful wife, Lorelle, who continues to support me on my continuous improvement journey through life. She makes me a better man.

       Michael R. Pop, SSMBB, MBA

      Efforts to improve the quality of healthcare have focused on increasing accountability, measurements, and new payment models. These and other efforts have failed to achieve a meaningful and sustainable improvement. Patients continue to experience fragmented, impersonal, inconvenient, and unsafe care while providers are increasingly becoming burned out by a system overburdened with administrative tasks. The current approach seems at odds with the mission of providing high‐quality care. A fundamental change is needed in how we deliver care, and how we go about improving it.

      It is widely accepted that physician leadership is an essential requirement for successful quality improvement efforts. Yet physicians have been reluctant to engage, either because of the constraints of their overbooked clinical schedules, their perception of QI, or because quality priorities are often set by outsiders rather than chosen by physicians based on their insights, experience, and expertise. As a result, physicians have been marginally involved in operational improvement, and for the most part, have relinquished that responsibility to managers and hospital administrators. A strategy for improving healthcare delivery that continues to ignore the engagement of physicians is doomed to fail. Physicians should lead improvement efforts: they are well positioned to accept the improvement challenge. They have valuable insights into processes, have been trained as problem‐solvers, and making things better speaks to their intrinsic motivation. Their engagement is critical, will serve their patients well, and may be the new role physicians need to gain a sense of purpose, restore their identity, and decrease burnout.

      This new role is going to require knowledge and skills that graduate and postgraduate education has not provided. To date, medical education has focused almost exclusively on the acquisition of scientific knowledge and clinical facts. This book has been written to fill this knowledge gap. Principles and practices of improvement methodology, team dynamics, and organizational change management are presented in a straightforward and clear way for any physician, young or seasoned, seeking a template for an improvement initiative. The material in this book synthesizes current knowledge on the subject from multiple authoritative sources and combines disciplines as diverse as Lean, Six Sigma, Human‐Centered

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