PI with Purpose

We are now approaching one year until the mandatory accreditation deadline of Sept. 30, 2009. Rather than remind you to get moving on this deadline, it's time we review one basic accreditation requirement: performance improvement.

Performance improvement can go by many names — PI, quality improvement (QI), continuous quality improvement (CQI) and others. Most of us first heard of quality improvement standards when the auto industry adopted them in the '80s, but PI has been a major tenant of accreditation since its inception in health care.

PI is usually one of the first challenges providers face with accreditation because it's something they are unaccustomed to doing. As of this writing, CMS requires that providers track several quality measurements. The first, and, really, most basic measure, is customer satisfaction and complaints. Thus, your accreditor requires that you measure and track this indicator.

When I meet with providers about this accreditation requirement, one of the most common comments is, “We don't need to measure performance improvement. If our customers didn't like us, we wouldn't be in business!”

Unfortunately, that's not really the point. Of course you are in business day after day because you have customers. But if you don't have a formal process of polling and measuring their satisfaction, you are operating on gut reaction and perception. It may not be very clear how satisfied your customers are, how your staff treats them, what you might do to improve, etc.

Are there issues you need to address because you haven't given customers an opportunity to express their satisfaction or concerns in a non-confrontational or anonymous manner?

You might feel anxious about polling your customers, but think about how PI has become part of our daily lives and you will realize that your customers are very used to it. We don't realize how often our customers participate in surveys, receive questionnaires or follow-up phone calls after an appointment, service or interaction. These days, collecting satisfaction information is not an imposition, or even unexpected. And face it, CMS is requiring it now, so you no longer have an option not to!

One main factor to keep in mind is that there is no reason to perform PI just for the sake of meeting a requirement. The goal is to learn and improve your business, services and outcomes.