By Lori Freeman, MBA
Chief Executive Officer, AMCHP
This issue of Pulse centers on the theme of quality improvement (QI) – an idea that I truly embrace and appreciate.
Quality improvement is one of those concepts that we’ve all been exposed to throughout our lives but sometimes never recognized.
As a young mother-to-be, I remember learning of our pregnancy and immediately launching into a very personal QI effort to be the healthiest I could be while carrying our twin children. I solicited the support of my husband, Dan (aka “leadership”), to help me and be part of the best possible positive outcome for our babies. We created our own personal at-home QI culture. We researched and read everything we possibly could about having a good pregnancy and learning to be new parents (aka “planning”).
My OB/GYN worked with us to ensure we closely monitored the health of the babies and were progressing toward a successful delivery (aka “measuring). Even after the babies were born, we kept up the personal QI culture in our house. Because we were new parents, we developed and tested many, many processes and routines (from feeding prep to napping schedules to bedtime routines to planning regular date nights), and often kept revisiting these “systems” – tweaking them, improving them and repeating the cycle. Over the years, the continuous quality improvement culture in our home has remained, and we’ve tried to instill some CQI values into how our kids view themselves and their roles in the world. It’s been a wonderful tool for teaching our kids about accountability, self-reliance and the overall ability to control your own outcomes with the right support and culture of improvement. QI has worked for us even in the most personal contexts.
During my own business career, I recall having been exposed as a younger professional to QI concepts in a number of differing professional roles. At the Association for the Advancement of Medical Instrumentation, a core focal point of my work was the development of national and international standards for the use of medical devices. In this realm, QI concepts were used frequently related to quality assurance and equipment safety; we viewed product development through a lens of human factors to ensure ease and quality use of medical instrumentation by anyone touching the equipment, from biomedical engineers to health care providers, patients and caregivers. While at the International Test and Evaluation Association, I actively employed Six Sigma in my work related to assessing effectiveness, reliability, interoperability and safety of technology-based military systems and products throughout their life cycle. Six Sigma is a data-driven QI approach for eliminating defects in a process. It can be applied to manufacturing, transactional processes, product development and customer service – to name a few applications. One of the many things I liked about Six Sigma was that, as systems improvement occurred, so did the morale of those working within those systems.
It was not until I reached the National Association of County and City Health Officials (NACCHO) that I experienced how QI could be truly intentional within a nonprofit at the highest management levels. This brilliant approach was spearheaded under the leadership of Bobby Pestronk, NACCHO’s executive director, and led by Grace Gorenflo, a professionally-trained QI expert. NACCHO already had a long history supporting QI with its members, mostly as the public health department accreditation process was being developed and launched. The organization embraced QI so fully that it invested in QI internally to help evolve and improve many of its management processes, product offerings and, at times, entire department structures. In the time I spent at NACCHO, I was involved in at least four intensive QI processes that moved the organization toward greater efficiencies; improved process and understanding; and increased staff morale, engagement and accountability. By the time I departed NACCHO for AMCHP in 2014, I was a self-declared QI advocate and remain so.
I learned so much about QI from my colleague and friend, Grace Gorenflo; her teachings will always stay with me. Grace taught me that there was never one way you had to approach QI. She made sure I understood and could appreciate that not everything was a good candidate for a quality improvement process merely because it represented a challenge or problem to be solved. Sometimes, you have to step back and consider quality planning for the future. And she always taught me that failure was a valid result from QI and nothing to be ashamed of because, after all, QI is continuous.
In this issue of Pulse, you’ll learn how QI is being utilized in various ways across maternal and child health to improve outcomes. You’ll also gain some insight into how we are working at AMCHP to create our own internal QI culture. Please enjoy your reading!