The Three Kinds of Process Improvement Principles

In the Healthcare Industry, Process Improvement is an ongoing practice and should always be followed up with the analysis of tangible areas of improvement in all departments.  When implemented successfully, the results can be measured in the enhancement of increased patient satisfaction, more efficient care, better population health, development of the skills of employees in all levels of the healthcare organization including non-medical staff, efficiency and reduced cost of care, and all-around increase in productivity.

Now that we understand what process improvement in Healthcare is, we will be better prepared to understand What are Process Measures in Healthcare.

Process Measures in Healthcare

Process improvement is a broad term that covers various layers of the healthcare industry.  One area is the area of measurement.  There are three types of measures: Outcome Measures, Balance Measures, and Process Measures.  Of this three, Process measures is the most important. These three measures all in one way or another follow the Process Improvement Principles.  The three measurement principles are discussed below:

Outcome measures

Outcome Measures are the high-level clinical or financial outcomes that concern healthcare organizations.  They measure the quality and cost that targets improvement.  These measures are often reported to government and commercial payers.  Outcome measures are important because the ultimate goal of measuring, reporting, and comparing health outcomes is to improve the patient experience of care, improve the health of populations, and reduce the per capita cost of healthcare.  Some of the principles of process improvement emphasize that managed care means managing the processes of care, not managing physicians and nurses and effort should ways be made to put the right data in the right format at the right time in the right hands.

Balance measures

Balance measures are the metrics a health system must track to ensure an improvement in one area isn’t negatively impacting another area.  For example, let’s say the length of stay (LOS) in labor and delivery is the outcome metric. The hospital wants to reduce LOS and save money.  The balance metric might be patient satisfaction.  If mothers feel rushed toward discharge, the outcome there might be a negative impact on patient satisfaction.

Process measures

Process measures are the most important and are the specific steps in a process that lead — either positively or negatively — to a particular outcome metric.  For example, let’s say the outcome measure is the length of stay.  A process metric for that outcome might be the amount of time that passes between when the physician ordered the discharge and when the patient was actually discharged.  Digging even deeper, you might look at the turnaround time between final take-home medication being ordered and medication delivery to the unit.  If it takes the pharmacy three hours to get the necessary medications to the floor — potentially delaying the discharge — you’ve pinpointed a concrete opportunity for healthcare process improvement.  Process improvement does not leave any stone unturned.  It seeks to constantly make processes more efficient and cuts waste.

One champion of quality measures was the renowned Deming.  Deming clearly understood the importance of data and the fact that for quality control in healthcare, if you cannot measure it—you cannot improve it.  Meaningful quality improvement must be data-driven.  This is particularly true for quality control in healthcare.  You’re basically dead in the water if you try to work with healthcare providers and you don’t have good data. I think everybody recognizes that.

Deming said, “In God we trust…and all others must bring data.”

Process Improvement principles are very important in process measure because they determine the root cause of a problem as opposed to staying on the surface level.  One of the greatest benefits of having this process metric data on hand is the ability to identify what is really causing the problem in your organization.  Problems don’t usually originate from people but from the process of the organization.  In most organizations, however, the system of incident reporting doesn’t recognize this fact.