Kathleen Jennison Goonan, M.D. is the Executive Director of the Massachusetts General Hospital Center for Performance Excellence (MGH CPE). MGH CPE is focused on strategic, comprehensive organizational transformation for health care and related industries and provides coaching and consulting for senior level health care executives who are working on strategies for comprehensive and sustainable performance excellence. Team expertise includes Baldrige, Lean, Six Sigma, regulatory and accreditation standards, health care quality, patient safety, strategic planning, performance measurement, process improvement, and transformational change. Dr Goonan has twenty years of experience as a physician executive and ten years of clinical practice experience as a board-certified internist. She is co-author of Journey to Excellence: How Baldrige Health Care Leaders Succeed (Milwaukee, WI: ASQ Press, 2009).
MedHealthWorld interviewed Dr. Goonan about the challenges of achieving continuous performance improvement in health care and the impact of Electronic Record adoption and other HIT advances on provider performance and quality.
MedHealthWorld: Could you summarize the services that the MGH Center for Performance Excellence offers?
Kate Goonan: Our goal is to support senior health care executives in achieving their vision for performance excellence and organizational transformation. We are a team of Baldrige quality experts operating a separate consulting practice through MGH CPE. Our team studies best practices and then works to transfer those best practices to help clients by helping them to chart a course towards continuing and sustainable improvement. We work to help build an organizational development plan that involves performance excellence on all levels, from clinical quality and patient satisfaction to brand leadership and improved financial results. Today’s health organizations are often caught up in a whirlwind of changing demands, requirements and expectations for performance that come on top of cost pressures and process management issues. Senior health executives need a comprehensive and integrated strategic framework to address these complex challenges while creating a high-performance culture throughout the organization and that’s the type of expertise that we provide.
MHW: How do you integrate the Baldrige quality process into this consulting service?
KG: One of the main questions that health care executives ask is whether there are specific clinical quality and other performance methodologies that they should be using. Of course, there a number of well-regarded general quality and performance tools available today, such as Lean and Six Sigma as well as total quality management, ISO processes, and other strategies that apply to organizations in all fields and have been implemented over time. And there are many health care specific regulatory, accreditation and certification standards. We focus on the Baldrige Criteria for Performance Excellence because this program has developed specific Health Care Criteria that are designed for planning, implementing and measuring overall organizational quality and performance. The Baldrige Health Care Criteria provide a framework that health care executives can apply to all aspects of their organization and it has been effective in many different types of health organizations. Journey to Excellence tells the story of how 9 Baldrige Award winners in health care achieved success within this quality framework.
MHW: Health IT, electronic medical records, and telehealth are receiving increased attention and are expected to play an important role in addressing current health system problems. Do you see healthcare technology having a positive impact on performance improvement?
KG: Technology has the potential to create enormous quality benefits and I believe electronic records and other health IT can become a tremendous asset over time. Achieving the goal of providing full, integrated patient information at the point of care will address many current issues with performance. But a short term problem in many health care organizations that the technology implementation and certification requirements (such as for as electronic health records) are causing huge pressures to change, but there are still a lot of organizational challenges to be addressed. One critical challenge is that making effective use of this new technology requires that organizations have both well designed processes and an organizational culture that is receptive to change.
But health care historically is a bit of a process illiterate enterprise and we are not comfortable with designing and managing our own processes or with rapid technical change. So health IT has the potential to be very useful in the right context – but isolating technology and implementing it without an appropriate organizational process may well create organizational difficulty, resistance and conflict. From the point of view of MGH CPE services, the requirement for implementing electronic records and other technologies is adding to the demand for an integrated framework for planning and implementation.
Combine this technology with more emphasis on reimbursement and incentive models for care providers and we expect to see more research and development on those fronts as well as on overall health quality and performance metrics.
Dr. Cronin is a Professor of Management in the Information Systems Department at Boston College. To read more of her articles, please visit her columnist page.Edited by
Erin Monda