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LEADERSHIP BEST PRACTICES | By Chris Cebollero What Makes a Good Quality Improvement Program? The success of your department's QI efforts begins and ends with you AS VALUE-BASED PURCHASING continues to transform the healthcare environment and EMS shifts from an episodic healthcare model to a community-based/primary care model, proving the quality of the services your EMS agency delivers will be vital for future reimbursement. Just thinking you have a quality organization is not enough—you have to prove it. For EMS to be successful as healthcare providers, our quality improvement (QI) programs have to be the driving force in proving not only that we are meeting our customers' needs, but also that they are receiving positive outcomes and we are being fnancially responsible. What Is Quality Improvement? QI is a formal approach to analyzing an organization's performance and developing systematic plans to improve it. Strong QI programs measure where you are, deter- mine where you want to be and fgure out the best way to get there. A successful QI program should address the following areas: 1. Operational systems and processes— It is not possible to make improvements in your organization without having an understanding of your delivery system and key processes. At a minimum your QI programs should focus on the four Ps of an EMS system: • People; • Place; • Performance; • Patients. 2. Delivery and outcome of patient care— A vital measure of quality is our ability to meet the patient's needs and expectations. When considering the best ways to meet the patient's expectations, look at the following: • Improving the processes that affect patient access to care; • Providing care that is evidence-based; • Making patient safety a priority; • Creating a process for patient engagement; • Integrating with other resources in the healthcare system. 3. A team process— At times we are focused on the one or two individuals who fall short of meeting quality measures. Embracing a team approach allows providers to harness the knowledge, skills, experience and perspec- tives to ensure lasting improvements. A positive team approach is most effective when it includes the following components: • A complex process or system that spans across depart- ment responsibilities; • Solutions and understanding that require brain- storming and creativity; • Staff commitment to success in meeting the metric. 4. Data collection and utilization— Data is the corner- stone of your QI program and will show how well the system or processes are working. It's extremely important that data systems are created to measure the essential elements of how your organization meets expectations. Using data will help determine: • What you think is happening vs. what is really happening; • What the baseline should be; • How changes implemented led to improvements; • Comparisons of performance. Performance Measures in EMS Healthcare today is taking some very interesting twists and turns. Hospital administrators are kept awake at night determining how to maximize profts to their bottom line. EMS will soon be in the same boat and need to meet the Institute for Healthcare Improvement's Triple Aim objectives of better patient experience, better health for populations, and lower per-capita costs. Many EMS agencies are moving to meet these objectives today. When thinking about performance measures, even before we pick the appropriate key performance indicators (KPIs) to follow, we need to have an instrument that can assist with measuring our outcomes. This instrument should allow for the following: • Assistance with establishing baseline data; • Help establishing goals based on current performance; • Determining how to bridge the gap between current performance and desired goals; • The ability to track process; • The ability to benchmark and compare results. Once you've determined the best way to gather, measure and interpret the data, you can determine which KPIs best meet your organization's goals. The EMS Leader's Role Your responsibility to create an environment that allows the QI process to function with the needs of internal and 26 DECEMBER 2014 | EMSWORLD.com