West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John Kausch’s good management skills initiated the Control Quality Improvement for WFRMC to understand and adapt the external environment, empower clinicians and managers to analyze and improve process, adapt a norm that customer preferences are important determinants in quality which includes both patients and providers in the process, development of multidisciplinary approach that exceeds beyond conventional departmental and professional lines, adopting a plan for ongoing change and adaptation, setting up mechanisms for implementation and organizational learning, and providing motivation data-based cooperation to process analysis and change (Sollecito, W.A. & Johnson, J.K., 2013). West Florida Regional Medical Center reflected PATQC’s strategic impetus by defining their purpose for quality improvement, integrating health quality trends and forming several multifunctional teams sphered by core leadership (McLaughlin, et. al., 2012). In addition, WFRMC identified customers and their expectations, determined training needs for all staff and identified all department opportunities (McLaughlin, et. al., 2012).
Basics
The total Quality Management (TQM) program at WFRMC had its strengths and weaknesses. The weaknesses of the TQM program were the range of acceptability throughout the organization and a lack of computerization which led to a lack of information flow and costly errors (McLaughlin, et. al., 2012). Trying to get the leadership motivated with adapting to TQM was a challenge in the beginning. The enthusiasm of top leaders has caused the TQM process to become effective. Although Health care has a complex adaptive system, leadership is crucial in implementing an improvement system (Sollecito & Johnson, 2013). The strengths of the TQM process were the support of the chamber of commerce, implementation of a quality improvement plan, adapting a successful way to measure improvement and development of cost effective techniques (McLaughlin, et. al., 2012). Corporate headquarters was totally involved in the TQM program with the CEO John Kausch as an active member of the Total Quality Council of the Pensacola, Area Chamber of Commerce (McLaughlin, et. al., 2012) In any continuous quality improvement effort, measurement is the key element (Sollecito, & Johnson, 2013). “Measurement and statistical analysis are used to assess the impact of an improvement effort” (Sollecito & Johnson, 2013). To Measure the impact of the program, the hospital utilized a departmental quality improvement assessment with a scoring matrix for self-assessment (McLaughlin, et. al., 2012). The scoring matrix consisted of five category ratings which each department head had to complete. Univer4sal Charting and Resource Utilization were also used for measurement (McLaughlin, et. al., 2012).
Implementation
To support the tactical programs within the hospital, formed a task force in quality improvement to serve as program support, monitor process and provide education and training (McLaughlin, et. al., 2012). In addition, a patient comment card system was used as a pilot and to evaluate policies and guidelines regarding forming multifunctional teams (McLaughlin, et. al., 2012). The hospital used a computer system medication administration record (MAR) for documentation of the IV usage, universal charting to increase timelines and chart availability, a package price for labor, delivery, recovery and postpartum, and created a pharmacy and therapeutics committee to change the listing of antibiotic doses as tools to support tactical programs within the hospital (McLaughlin, et. al., 2012). The next step for John Kausch in dealing with continuous improvement would be the use of quality improvement tools to show the root cause of problems (Sollecito & Johnson, 2013). Six Sigma is a CQI tool used in statistics to measure variations, identify and remove errors and minimize variability in processes (Sollecito & Johnson, 2013). Application
For West Florida Regional Medical Center to introduce an internal medicine residency program it is crucial that the clinical purpose of the residency program be identified because this defines the components of the microsystem (Mohr, J., Batalden, P., & Barach, P., 2004). WFRMC has to understand the dynamics of effective organizational relationships between microsystems within the same organizations and across different organizations (Sollecito & Johnson, 2013). Since John Kausch already serve on the PATQC his next step would be forming relationships in the community to work together to achieve the residency program. There needs to be integration of information and technology included in work flows, staff focus to assess safety culture, education and training and interdependence of care teams to identify errors (Sollecito & Johnson, 2013).
