When I first started working in quality, I found myself surprised by how many staff did not follow quality measures. "But they know what they are supposed to do," I would say. In response, I would be told that I needed to lower my expectations for people. Quality Floor At the very bottom of quality care is what I refer to as the quality floor. This is the very minimum staff need to do to achieve quality goals. They fill out the audit forms, complete the history and physical, check the box, and do what they think they are supposed to do. In this case, the quality bar is set so low that it is easy for any staff member to step over it. No outcomes are measured, no follow-through occurs, no patient followup occurs, no analysis of results occurs. Mediocrity There are other quality departments and organizations that set their quality goals at what "passing" is for a quality indicator. The passing point maybe 50% patient satisfaction, 60% of audits completed, r
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