Perfection in Healthcare

There is a useful mental tool in Quality Improvement (QI), in which one conjures up what the perfect situation would be in order to identify gaps between the desired and the actual situations. This is not to say that we think we are going to get perfection, but it’s a very useful way to find things to fix to get us closer to what we want.

There are three theoretical levels of perfection: what we have in the real world, what we could achieve in theory, and what in a perfect universe would be the archetype of what we are doing.

Last things first: The idea of an archetype dates back at least to Aristotle and Plato, and involves the idea that everything (presumably including medical policies, processes, and technologies), has an ideal, perfect, and universal form. These forms are unachievable in the real world of man, but serve as the archetype and exemplar towards which we can strive. Somewhat romantic, but fun to think of what perfection in another universe of forms might look like.

The last range in the perfection scale is where we actually live most of the time, but wish to escape. The place where we sometimes forget what the objective was because we are up to our necks in conflicting demands, mistakes, and things that waste our time.

Between the exalted realm of Platonic archetypes and the undesirable reality of what we typically have, QI poses a more practical, but still distant and largely unavailable level of perfection. This is the Theoretical Capacity, and is an expression of what a process could theoretically yield if everything was running at 100% performance and there were no defects. This is the level of perfection that will be the topic of the next few #MEQAPI chats.

As a mental exercise, we are going to imagine what perfection in the QI sense would look like if it existed in our facility. What does the perfect patient look like? What does the perfect ED look like? What does the perfect medical training look like? … and in what ways do they differ from what we actually wound up with?

For example, what characteristics would the perfect patient have?

Would they show up on time for appointments? What does the perfect patient bring with them? What did they think about before they came to the appointment? How does the perfect patient convey the information to their HCP?

Hope to see you soon during the #MEQAPI chats, and hear your thoughts on perfection in healthcare!