Making Quality Sexy!!!
Posted on October 10, 2013
Just wanted to welcome our new readers that signed up during the National Health Care for the Homeless Council Leadership Summit. I was honored to help facilitate this great event and work with some amazing leaders from around the country. Your passion fuels this important movement! Also a big thanks to all the Staff at HCH, I always love teaching, learning and hanging out with you all.
Okay, as a former Quality Assurance Director, I realize quality is not the sexiest topic in the world. However, my recent presentation with homeless providers in Colorado Springs on quality improvement got me thinking about the nature of quality in the helping professions. I hope you find this as interesting as I do.
I’ve always struggled to understand how to use quality systems like Six Sigma or Total Quality Management in the helping professions. These quality systems are designed to eliminate error in processes and product. Of course, we can identify errors in our work with clients but it is sometimes hard to connect these errors with what we were trying to accomplish in our mission statements. Sid Kemp’s definition of quality puts this into perspective: “The opposite of quality is error, and quality management is the effort to bring error under control and reduce error to acceptable levels.”
So the question I struggle with is: What is the error we are trying to reduce or bring under control? Of course there are errors in our field such as medication prescription/dosing errors, staff turnover or meeting paperwork requirements. While these things are important, is it any wonder people can get turned off when quality is brought up. Instead of unleashing our motivation and passion it often just tells us what we are doing wrong or poorly.
The real quality question becomes: How do we measure our passion and not only quantify our mistakes? The key is in how we define error. Error, and thus quality, is straightforward when you manufacture widgets. But what is error when we help people heal from trauma, educate first graders, assist homeless individuals to secure permanent housing or work to reduce gang violence?
Over the next several weeks I will put forth my thoughts on rethinking quality and error in the helping professions. Before I get into my thoughts I would love to hear yours. What are the errors inherent to our work with clients? Maybe even more challenging, how do we connect the management of error with our passion for our work and our organizational missions?
Quality management might not be sexy but it is critical and I believe it challenges how we should view and approach our work.
Great post! The thoughts that came up for me on “errors inherent to our work with clients” went in two related directions…how we manage our time, and how we use supervision. I know, I know, these are not sexy ideas, but it’s a starting point for me.
Managing client crises and managing our time are two things that should not be in conflict. Our work can be incredibly rewarding when we get to respond to someone’s crisis, we have a sense of immediate purpose. And I know I’ve been guilty of rearranging my workday to spend hours problem-solving with a client, while my paperwork and reports get pushed to another day. I let the chaos take over my schedule and rationalize to myself that an unplanned emergency demands my attention more than the rest of my work. We need to make room for all of our work, not just the “juicy stuff”.
The second piece of that, are we making time for consistent supervision and support for ourselves, especially around complex client cases? It’s nice to think that you’re a client’s main connection to an agency or service, that rapport is critical to our work, but it’s not in our best interest to do this work in isolation from our own system of support & supervision.
Supervision is where we can apply best practices, ensure thorough assessment and documentation of a client’s needs, and maintain healthy boundaries with our clients. We should welcome a system of checks-and-balances, it’s a means of stepping away from a problem and making sure we’re not getting lost in the details.
I love this:
“How do we measure our passion and not only quantify our mistakes?”
Yes, an important piece of quality is preventing mistakes, and learning from them when they happen. But stopping with basic prevention and safety is like learning the alphabet but never writing a novel or a poem or a love letter.
Quality becomes sexy when we make magic happen.
There was no fire in the clinic today, and the power didn’t go out. We prescribed the right meds for Mr. Jones, and he made it through the lobby without slipping and falling. So now that he’s in front of me, how am I going to help make his life better?
Matt, despite having left the field, I would like to offer my perspective.
As far as errors are concerned, two things came to mind while reading this most recent post. The first is assumptions. We all make assumptions every day about many things around us, but I believe that in your field, assumptions are especially detrimental to clients. It is imperative to force oneself to begin at the beginning and take nothing for granted.
The second, narrative, is related to the first. Sometimes healers can slip into the habit of creating their clients’ stories rather than empowering clients to speak for themselves and live their own authentic stories. Where a client truly desires to end up may not be what one may think they should desire.
I suspect these errors may be reduced by honing one’s communication skills. Am I asking the right questions? Am I truly hearing and listening to what my client is saying? Are my own issues blocking me from communicating honestly with this client? Perhaps this is where passion can be focused.
Thanks for providing this wonderful space.