Moving the Quality Needle Realistically

Are you familiar with the starfish story? It is about a young man who is walking on a beach onto which thousands of starfish have been washed ashore. He begins to pick up and gently return each starfish back into the ocean. An older man on the beach approaches the young man and asks him why he is bothering to return the starfish to the sea as there are so many and it will not make a difference. The young man holds out a starfish in his hand and tells the older man, “It makes a difference to this one.”

So, what is the moral of this story as it applies to quality? The young man celebrated each starfish that he returned to the sea as a win regardless of the time and effort applied to reach his goal. The same is true in quality; small wins in moving the quality needle forward are important and should be applauded by everyone in an organization.

As quality leaders, we often get bogged down in the numbers. By how much did we improve satisfaction? Can we reduce waste by this much by this time? It’s the nature of the job – quantifying a problem that we see and figuring out how to improve that problem as much as we can. However, it’s not why we do what we do. We work in healthcare. The nature of the job is to provide care to patients and families during their most vulnerable moments.

At some point, we all likely made the decision to get into the field because we wanted to make an impact on people. As we all know, there are roles where this impact is more apparent than others. If you are a clinician, your impact may be obvious. But the further you get away from direct patient care, the easier it is to forget why we do what we do. This is important to keep in the front of our minds as we lead QI projects. In the chase for improving numbers, we must remember that the numbers reflect something much more important – a better experience for one additional patient and their family.

While we would ideally all love to reach the goals we set during the time frame we set, that is not always going to happen. But if we improve even by 1%, that 1% reflects an actual person. As QI leaders we will always be tasked with providing the biggest impact possible, and we should. However, in the search for making large changes, we must take the time to celebrate positive change. As the person responsible for leading the charge to sweeping organizational change, this will help accomplish two things: 1) reflect to your organization the progress that you have made and continue momentum, and 2) remind us our work, whether we reach out goals immediately or not, impacts real people.

So, as we continue down our QI journeys, let’s try to keep the young man with the starfish as inspiration. While we hope to be perfect to all patients, we may not get there for all. But like the young man said, “It makes a difference to this one.”

By Jennifer Kennedy, Senior Director, Quality & Regulatory, NHPCO, and Jon Nicolla, President, Prepped Health