ASQ Healthcare Division Newsletter

July / August 2009

ASQ Healthcare Division Newsletter

Message from the Chair

Mark your calendars to attend the first joint Conference between the ASQ Healthcare Division (HCD) and the Society for Health Systems in Atlanta on February 25 to 28, 2010. The theme is “Building a Better Healthcare Delivery System.” The call for abstracts is available at

The HCD will also continue to have an educational presence at the annual ASQ World Congress.

What would you say if, the next time you went to an Emergency Department, you experienced virtually no wait to be seen and managed?

There is an evolving list of Emergency Departments in the nation that could be called “No-Wait EDs.” The best practices honed by these Emergency Departments are highlighted in a new Web Cast. We’ve selected six different service delivery models to discuss. The involved thought leaders present the rationale behind their particular Emergency Department service delivery model, and they provide details about how each works. The goal is to stimulate new ways of thinking about and implementing patient care services, not only in Emergency Departments, but throughout hospitals and healthcare systems. Check the Healthcare Division website ( for more information about this thought-provoking educational series, targeted to begin in September 2009.

For the latest information and copies of complete articles referred to in the newsletter, go to our website ( A directory of the HCD leadership is available at the web site, and we have a shared e-mail at

What is YOUR passion? The HCD Leadership Council wants to discover the interests of each and every member of the HCD and ask you: How would you like to be involved? We will establish groups around the themes of interest submitted. Please send us an e-mail at

To submit articles for our newsletter contact Glenn Bodinson at

Dave Eitel
ASQ Healthcare Division Chair

Answering the Call for Leadership in
Healthcare Quality and Patient Safety

In the years since the Institute of Medicine’s landmark reports, To Err Is Human and Crossing the Quality Chasm, those of us in the healthcare sector have recognized that we need to step forward and lead the effort towards the Institute’s call for safe, timely, effective, efficient, equitable and patient-centered healthcare. There is a new and growing requirement for clinical and administrative healthcare professionals to develop expertise and leadership in the fields of healthcare quality and patient safety. These relatively new disciplines have emerged as central to the development of good healthcare, and they necessitate that we acquire substantive new knowledge and skills. Academic programs meeting these requirements have been developed with the goal of providing formal education in these fields. Such programs enable clinicians and senior health professionals to become effective healthcare quality and patient safety thinkers, practitioners, and researchers and provide the basis for leadership in these fields.

I have recently completed such a program—the first in the nation—at Northwestern University’s Institute for Healthcare Studies in Chicago, which results in a Master of Science degree in Healthcare Quality and Patient Safety. My classmates consisted of fellow physicians from both academic and private practice backgrounds, nurses, medical writers, administrators, and the first medical student in the country to achieve this degree. This 18-month, executive program consists of formal courses, starting with an introductory immersion into healthcare quality and patient safety. The immersion program takes place in the summer quarter.  It begins with a reading period, followed by two weeks of classroom-based instruction, enhanced with hands-on visits to the simulation labs at Northwestern’s Feinberg School of Medicine and at Northwestern Memorial Hospital. During the first year, additional courses on the U.S. healthcare system, fundamental methods for healthcare quality and patient safety, and an elective offering students the opportunity to focus on specific areas of interest are offered. During the second summer, students participate in an additional immersion program addressing advanced healthcare quality and patient safety content and skill development. The Master’s program concludes with a mentored capstone course, in which each student designs, implements, and evaluates a healthcare quality or patient safety project. Many of these capstone projects have seeded true quality and safety reform projects that will sustain themselves for decades.

At the outset, all of us entered the program thinking that we had a fairly good understanding of the basics of patient safety and healthcare quality and that we also had recognized a passion to become leaders in the field. By the conclusion of this Master’s level program, we all acknowledged that the program’s faculty and national experts who made up the visiting faculty had showed us how much more there was to learn and how much more needs to be done to raise the U.S. healthcare system to the level of quality and safety that our patients deserve.


ASQ, HCD, Health Reform, and You!
The Summer of 2009 is shaping up to be the “Summer of Health Reform” in Congress. The question has shifted from “If and when Health Reform will happen?” to “What will it look like?” and “How will we pay for it?” The HCD and ASQ are working hard in DC to help shape the answers to those questions and to communicate our theme of ASQ’s value in this monumental debate: “We do not provide healthcare, but we can help those that do provide it, do it better.”

Our staff and volunteer ASQ members have met with the staff of Ted Kennedy’s powerful Senate Committee on Health, Education, Labor, and Pensions (HELP), with congressional staff members, and with potential ally Health Organizations (the National Business Coalition on Health, The Medical Group Managers Association, and the E-Health Initiative, to name a few) to communicate this message and to explain how the ASQ’s Body of Knowledge (QBOK) and its 90,000+ volunteer members can materially assist in the drafting of this legislation and – more importantly – in its implementation.

As the debate has progressed, with the realization in DC that the price tag for the ambitious concept of universal access to coverage may be too high, our themes of waste and error reduction in healthcare and operations quality improvement have gained increasing currency.

The plan for ASQ/HCD activity in DC around Health Reform was conceived at the pan-divisional ASQ Healthcare Retreat called by ASQ President Roberto Saco and HCD Chair, Jim Levett in Chicago in October of 2008. Since that time, I have been asked to serve as HCD legislative point person. The HCD leadership and ASQ staff have developed and submitted comments on the Draft Proposal for Regional Health Information Extension Centers and on the Draft Definition of “Meaningful Use” in relationship to the funding of health information technology under the Stimulus Plan. Other ASQ/HCD comments will be submitted as opportunities arise.

In addition, partially in response to testimony from the HELP staff and partially to provide a platform for ASQ’s messaging on Health Reform, the HCD, at the request of its incoming Chair, Dave Eitel, has developed a White Paper on Healthcare Reform (, which calls for legislators’ attention to the following five aspects of healthcare reform that we feel have not been properly or sufficiently addressed thus far.

  1. WASTE REDUCTION – The aggressive use of process improvement tools in all aspects of healthcare (clinical and administrative) must be dramatically increased, incented and monitored using industry-proven tools.
  2. INCENTIVE ALIGNMENT – We have achieved what we have incented in healthcare. All incentives in healthcare for all stakeholders must be aligned with the behaviors, outcomes and processes that we want.
  3. HEALTH INFORMATION TECHNOLOGY (HIT) – As in house-painting, in HIT, preparation is everything! An EMR in an unprepared medical practice is like a Corvette engine in a go-cart! For HIT to work as designed, the environment (physical, socio-technical, and operational) must be properly prepared, again using industry proven tools such as those with which ASQ and HCD members are familiar.
  4. SUSTAINABLE CULTURE CHANGE – Without culture change, there will be no permanency and/or spread of improvements. Therefore, culture change must be effectively addressed.
  5. WORKFORCE EDUCATION AND PREPARATION – We need to be training the healthcare workers of the future to be team-oriented, to be patient-centric, and to be conversant with the principles and tools of continuous and sustainable improvement.

Shortly, we will be asking HCD members and those of other Divisions to help in two ways with our health reform effort:

  1. Volunteer your time as a Quality Improvement Coach in ASQ’s “New Marshall Plan” to bring process improvement skills and learning into medical practices in a community near you. This program is based on a successful program in Michigan and is already underway in two communities in Pennsylvania (Erie and York) under the leadership of Karla Konzel and Dave Eitel from the HCD Leadership Council. For more information, please contact ASQ Board Member, LouAnn Lathrop (
  2. Please send us the details (in A3 format, please) of a successful project you have done in healthcare that has reduced cost, removed waste, improved results, etc. with as much quantification of the results as possible. We will collate these examples and make them available to legislators as tangible evidence of the value of our messaging in these areas. Please contact me ( for more information and the form for submitting this.


Joseph Fortuna, MD
Chair-Elect, ASQ Healthcare Division

Watch our newsletter and the Healthcare Division web site
for more news on our health reform efforts!