QUALITY
Better quality Texas institutions spread quality improvement
BY KEN ORTOLON In 2002, the Baylor Health Care System (BHCS) in Dallas and The University of Texas M.D. Ander- son Cancer Center in Houston sent several key physicians and other leaders to Salt Lake City to learn quality improvement techniques at Intermountain Healthcare. Intermountain, a large hospital system serving Utah and
Idaho, is a pioneer in applying quality improvement techniques developed for the manufacturing industry to health care. For nearly 20 years, Brent James, MD, chief quality officer for Intermountain, has taught health care leaders from around the country and the world how to use those same techniques. Ronald Walters, MD, associate
vice president for medical opera- tions and informatics at M.D. An- derson, says eight people from his institution, including six phy- sicians, attended Intermountain’s Advanced Training Program in 2002. “We used that as a seed, then built up our own version of the course internally at M.D. Ander- son,” Dr. Walters said. Since 2005, 18 classes completed the M.D. Anderson Clinical Safety and Ef- fectiveness (CS&E) course, based
“Quality
improvement is not just crunching numbers but understanding how to manage change.”
heavily on the Intermountain course. Its success led three oth- er UT System institutions to launch similar programs. Similarly, BHCS officials used their early training at Inter- mountain to create a quality improvement course for physi- cians, other clinicians, and administrators in its multihospital system in the Dallas area. “We decided that if we really wanted to move our organiza- tion forward [in quality improvement], we needed to come up with one of our own courses,” said Cliff Fullerton, MD, vice president for chronic disease and care redesign for BHCS.
BHCS uses the Accelerating Best Care course to train its own leaders in quality improvement and takes the show on the road. It presented the course at rural hospitals across Texas as part of a federally funded research project and in Pennsylvania, as well as at Sentara Healthcare in Norfolk, Va., and to groups of physicians and others in Mexico, Italy, and Honduras. Until now, the BHCS and UT courses targeted physicians, other key clinicians, and administra- tors within those systems and a limited number of outsiders, as space permitted. But UT and BHCS hope to partner with the Texas Medical Association Coun- cil on Health Care Quality to offer a condensed version — perhaps as short as four hours — of their courses to physicians in private practice who may not be able to spend several days away from their practice or afford the more comprehensive courses, such as Intermountain’s, that can cost several thousand dollars. “We have to get some interest- ed people in the small practices or even the larger small practices interested in doing some sort of project,” Dr. Walters said. “It real- ly doesn’t matter what it is. It can be anything that’s important that
they’re having a problem with. And then we need to estab- lish a mechanism to communicate those results and to spread those results across practices.” While discussions of this effort are still in the formative stages, that could involve a TMA-sponsored quality event each year at TexMed, TMA’s annual meeting, he says.
Getting lean
The focus on using industrial practices to improve quality in health care began at Intermountain in the late 1980s after phy-
September 2012 TEXAS MEDICINE 45
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