The Conscious Quality Manager

For at least 3000 years, humans have held special regard for those who help others heal. Some civilizations considered their healers wounded mortals. Other civilizations elevated healers to the status of gods and portrayed them with magic wands. To the ancients, healthcare was an art.

With the introduction of deductive logic and the scientific method, the nature of the healer changed. Healers in Western civilizations began to think like scientists. They took a vow to ”Do no harm.” They based their medicine on hypothesis, measurement, prediction, experimentation, and peer review. Healthcare became a science.

Over the centuries, new technologies, wars, talented individuals, and government interventions have had significant impact on healthcare. Since WWII, individual consumers have come to view healthcare as an entitlement. Since the 1980s, individual and corporate customers have demanded that healthcare implement the same methods that businesses use to assure quality. Healthcare organizations embraced quality assurance.

As healthcare implemented quality assurance methods, the focus shifted from assuring the quality of care of one physician at a time, to assuring the quality of care within the entire healthcare system. Teams of professionals employed quality improvement and planning methods to develop new ways to care for patients. Focusing on the healthcare system shifted the emphasis from the individual physician caring for one patient to teams of healthcare professionals caring for many patients in a population. Healthcare is a form of teamwork and practitioners are team members.

A conscious team member avoids tendencies to collude, scapegoat, tattle, communicate negatively, and expect others to be like me. A successful team member communicates well. Teams use what they know about effective communication as they improve quality and develop implementation plans. Teams that develop effective implementation plans anticipate resistance to change. A successful implementation plan identifies opportunities for participation, guidelines, education, marketing, and incentives—forms of communication. A successful quality improvement team communicates well with its customers.

To the science of measurement, prediction, experimentation and peer review, healthcare professionals are adding the art of communication. The tools of quality assurance that display data, facilitate divergent thinking and support convergence on a decision are communication methods. Written reports, visual presentations, interpersonal relations, and patient education are forms of communication. The conversation between a practitioner and a patient is communication. Effective communication is an essential aspect of an effective quality assurance program.

Assuring quality in healthcare requires that healthcare professionals practice the art of communication. The act of communicating involves words, images, color, sound, body language, and consideration of the audience. The most effective form of communication is dialogue. Four qualities contribute to remaining in a dialogue with each other: suspending, respecting, listening, and story-making. Communicating while suspending, respecting, listening, and story-making is an art. Assuring quality in healthcare combines the science of medicine and the art of communication.