National Health Care Quality Strategy and Plan

The Secretary of the Department of Health and Human Services recently put out a call for public input on a national strategy for healthcare quality. You can see the document here.

The proposed framework of the national strategy centers around three principles: 1) Better Care; 2) Affordable Care; 3) Healthy People/Healthy Communities.

The specific questions that the HHS Secretary is asking the public are:

Question 1: Are the proposed Principles for the National Strategy appropriate? What is missing or how could the principles be better guides for the Framework, Priorities and Goals?

Question 2: Is the proposed Framework for the National Strategy sound and easily understood? Does the Framework set the right initial direction for the National Health Care Quality Strategy and Plan? How can it be improved?

Question 3: Using the legislative criteria for establishing national priorities, what national priorities do you think should be addressed in the initial National Health Care Quality Strategy and Plan in each of the following areas. Better Care: Person-centered care that works for patients and providers. Better care should expressly address the quality, safety, access, and reliability of how care is delivered and how patients rate their experience in receiving such care; Affordable Care: Care that reins in unsustainable costs for families, government, and the private sector to make it more affordable; and Healthy People/Healthy Communities: The promotion of health and wellness at all levels.

Question 4: What aspirational goals should be set for the next 5 years, and to what extent should achievable goals be identified for a shorter timeframe?

Question 5: Are there existing, well-established, and widely used measures that can be used or adapted to assess progress towards these goals? What measures would best guide public and private sector action, as well as support assessing the nation’s progress to meeting the goals in the National Quality Strategy?

Question 6: The success of the National Health Care Quality Strategy and Plan is, in large part, dependent on the ability of diverse stakeholders across both the public and private sectors to work together. Do you have recommendations on how key entities, sectors, or stakeholders can best be engaged to drive progress based on the National Health Care Quality Strategy and Plan?

Question 7: Given the role that States can play in organizing health care delivery for vulnerable populations, do the Principles and Framework address the needs and issues of these populations?

Question 8: Are there priorities and goals that should be considered to specifically address State needs?

Question 9: What measures or measure sets should be considered to reflect States’ activities, priorities, and concerns?

Question 10: What are some key recommendations on how to engage with States and ensure continued alignment with the National Quality Strategy?

The deadline for public submission is October 15, 2010 at 5pm. The HHS has created a convenient website for feedback submission at: http://www.hhs.gov/news/reports/quality/nhcqsap.html

Rounding to Influence

A former boss of mine introduced me to the concept of "Management by Walking Around". I've seen many leaders fully endorse using this concept with highly variable results. Maybe there's something more than just being visible?

The Sept/Oct 2010 edition of Healthcare Executive published an article from Dr. James Reinertsen about rounding to influence staff behavior and adoption of best practices. The Institute for Healthcare Improvement has made available the reprint here.

The following is an excerpt of the article:

Rounding to Influence
Rounding to influence is one element of an evidence-based bundle of leadership methods used in highly reliable organizations. Rounding to influence is not quite the same thing as leadership safety walkrounds, in which leaders go to hospital units and visit with staff to send a signal that they care about the hospital’s improvement agenda, want to gain better awareness of safety issues and want to build relationships with frontline staff. While these are all desirable outcomes, they don’t drive the successful execution of specific safety or infection control practices. Rounding to influence is much more focused. It’s not just about leaders being seen—it’s about what leaders are seen doing and asking.