“Health care was missed by the industrial revolution,” said Steve Swensen, MD, director of quality at Mayo Clinic.

But it is under way at Mayo Clinic. Mayo looks good in the Dartmouth Atlas of Health Care, which ranks hospitals on quality, but its leaders do not seem too happy about that. A panel of Mayo executives discussed Mayo’s initiative to systematically improve quality.

What it takes:

• Infrastructure
• Leadership and Culture
• Systems Engineering

Some bullets on infrastructure needed to drive quality:

• Integration

Integration across entities: As a patient moves from one part of organization to another, the hand-off should be seamless.
Integration within entities: Staff should be motivated to provide patient-centered care, not increase their own revenues. (Mayo physicians are salaried.)

• Measuring Quality

Mayo wants to move away from process measures to more meaningful measures, such as “was the diagnosis correct?” and “Can we diagnosis, treatment started and recovery under way within a week?”

What systems are there to capture quality information on a timely and regular basis? How to get quality data within nine days after end of the month, for example?

• Electronic Medical Records

EMRs needs to be integrated across the inpatient and outpatient environments–and eventually personal health records as well.
Use EMR “alerts” to prompt needed actions.

• Education

Mayo established Quality Academy to educate staff about process improvement.
Recent decision to put Quality Academy under College of Medicine to integrate into the system, the residency and nursing training programs.

• Simulation Center

Staff members are required to demonstrate competency in placing central lines in simulation center, for example.