The Broader Issue of Quality

This post was contributed by Seth Hardy, MD, member of the ACR Commission on Economics.

hardy_seth_92016_cropI recently joined a friend, who is also a board member of a hospital where I was on staff for seven years, for dinner.  This hospital is a typical community hospital in a small city; it enjoys a local monopoly as they are the only civilian hospital in the city and have little competition in the county.  My friend shared a concern regarding “the focus at board meetings on the publicly reported quality metrics and those needed for reimbursement, not the broader issue of quality.”  As quality is one of the four competitive priorities discussed previously, let’s consider its importance at a community hospital.

Quality is perhaps the most important competitive priority in a community hospital, as it is the one over which a hospital has the most control. Its impact, when proactively appreciated, extends beyond setting the base threshold for payment by insurance companies.

Quality can also be a strong source of innovation and shape a self-informed, sustainable culture.  Like ethical behavior, quality can establish a behavioral expectation, one set by top leadership and perpetually reinforced throughout a system.

A board or CEO cannot expect staff to deliver quality care or innovate when he or she does not set a high standard.  Hospital leaders must know what quality looks like, both in theory and as manifest within their institution, in order to communicate this priority.  Unfortunately, knowledge of quality may be a major blind spot among hospital leaders today who frequently do not possess a strong diverse clinical background.

Of all the medical specialties, radiology and its clinical internship, orient providers with a strong, diverse clinical experience.  Our training travels from obstetrics to the critically ill nonagenarian and from ER to OR.  Unlike many hospital administrators today, we know where poor quality lurks at our institutions.

Through the lens of our specialty, we can perceive quality as the absence of patients bouncing back to our CT and MRI scanners.  We also know how to leverage technology and information systems to improve quality and to innovate.

Sharing that knowledge, and working within a culture that champions it at a high level, is critical to the competitive ability of our partner hospitals and sustainability of our practices.

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