For years we in healthcare have heard via the QIT (Quality Improvement Team) processes (that incidentally go back to the 80’s) that we need to measure what we do and how we do it. Measure, analyze, report and change; the mantra of QIT. So it strikes me as somewhat strange that all of the sudden ‘data analysis to drive change’ and operations should be such a new thought.
I remember working in a hospital setting (one of the big chain hospitals) and going to QIT management “retreats.” The goal was to introduce the QIT methods to management and encourage change (revenue enhancement/cost reduction) through QIT processes. We developed teams and learned how to act as productive teams through games. These teams were tasked with processes to be measured, reported and analyzed. We followed a regimen of tasks that included what to measure, how to measure and how often to measure. Many were time studies of operations.
What is most important to remember is that it changed virtually nothing. It was an exercise we went through for about 6 months, but daily reality set in and everyone simply got too busy doing the same things the same way to take the time to measure any more. And leadership was distracted by HMOs that scared the life out of everyone. So QITs went by the wayside and we still talked the talk when together in groups or meetings, but no one had the time to walk the walk.
So now almost every healthcare article talks about big data, big data analysis, how healthcare can be improved by collecting analyzing and reporting on big data, it sounds vaguely like all the QIT hype.
I believe that the QIT process was proven to work if you worked it. The problem was real life got in the way. So how will big data processes work as real life continues to get in the way?
“The risk of providing evidence and metrics is that now you are being measured. And what if you don’t measure up? Once you discover which departments are carrying expensive variations, you can immediately repair them.” This quote was in a recent article singing the praises of measuring. On the surface you just want to shout “well, GLORY BE! THAT’S THE ANSWER!”
But how do you solve the real life problem getting in the way problem? Change management has always been about how do you sell the change. Isn’t it time for real life solutions to be applied to real life problems and, along with data analysis and measurements, you address how to keep it going while you are changing the fabric of healthcare? Here this scenario. The analysis shows that 2 people, instead of 6, can perform the tasks at hand Then real life (one called in sick, the other has sick kids at home and is not in a good mood and on the telephone every 15 minutes) suddenly takes the measurements out of the sterile environment they were extracted and places them right in the middle of a 35 bed surgical ward. How do we feel now?
Data analysis will help us conform to standards and save money, but let’s keep it real and balance the change decisions with real life. Otherwise, 30 years from now we will be talking about the newest thing to make real changes in healthcare and someone will remember the similarity to big data and remember that it went by the wayside because real life got in the way.