Globally, healthcare leaders are increasingly looking to embed the principles of continuous improvement in their organizations. Empowering staff to deliver safe, high-quality, reliable care can provide a step-change in results. In this article, we summarize the twelve key findings from our new global report examining how healthcare leaders can build and sustain a culture of continuous improvement in healthcare.
Continuous improvement is a systematic, sustainable approach to enhancing the quality of care and outcomes for patients. Building a continuous improvement culture is not a turnaround project or a quick fix but a journey which never really ends, requiring commitment, investment and persistence. To understand this journey, we interviewed 20 senior health system leaders from organisations across North America, Europe, Middle East, Asia and Australia on their experiences of trying to bring about an improvement culture.
The goal of continuous improvement is 'operational excellence' - establishing a way of working which delivers improvements in care quality and safety by the everyday use of continuous improvement techniques. Continuous improvement is driven and owned by frontline staff, reinforced by specialised, ongoing training and supported by the entire organisation - starting with the board and the chief executive and permeating everywhere from the finance and HR departments to the IT team.
It has to be underpinned by the right leadership behaviours. Autocratic management is toxic to improvement, while those who constantly seek ways to unleash the creativity and skill of their colleagues have a chance to succeed. Leaders who include, support, mentor and ask questions of their team rather than issue instructions are the people who can make this happen. Everyone needs to understand how they are expected to behave.
This is a culture shift towards a new philosophy of being a self-analytical, self-critical, learning organisation which empowers frontline staff to identify the root causes of problems in systems and processes and to develop the solutions.
This article distils the key points from the interviews with our healthcare leaders, looking first at implementing, and then at sustaining, a culture of continuous improvement.
This sort of deep culture change can be challenging, but the ultimate return is far greater than any isolated improvement project. The success of the organisations we interviewed demonstrates the huge global potential for continuous improvement in pursuit of operational excellence in healthcare.
What distinguishes these institutions is long-term commitment and a desire to end the vicious cycle of short-term gains followed by a relapse into old ways. They have made improvement part of daily work, and supported staff with on-the-job coaching to develop the skills and confidence to challenge the status quo.
The rigor and discipline required should be seen as an enabler, not a straitjacket, helping to channel the passion of healthcare professionals into practical solutions that meet the challenge of 21st-century healthcare to irrevocably raise quality and reduce costs over the decades to come.
For further information on this report, or to discuss our global experience in building a sustainable culture of continuous improvement, please contact:
Gordon Burrill, Partner and Global Operational Excellence co-lead, KPMG Canada (gburrill@kpmg.ca)
Jason Parker, Partner and Global Operational Excellence co-lead, KPMG in the UK (jason.parker@kpmg.co.uk)
Dr. Ed Fitzgerald, Global Healthcare Executive, KPMG International (edward.fitzgerald@kpmg.co.uk)