#MEQAPI – Tweetchat May 31-2018 3:00ET Healthcare Resources

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

If you have been a patient or a healthcare professional in the developing world, the lack of healthcare resources will be familiar to you. On the other hand, if you are from a G7 country, work and live in a major metropolitan area, and don’t venture out much, it may have been somewhat hard to understand what it’s like to sometimes lack basic materials, expertise, and equipment.

However, venture just a little distance into rural America, and you may find some of the most basic resources in short supply, or have intermittent and sporadic availability. From dead=basic supplies like saline fluid, to complex capital-intensive equipment like MRI or PET cameras, lack of resources influence what medical services are available, and to what degree a patient can be supported.

Recent weather events, and ongoing market manipulation have brought resource shortages to the doorstep of even the biggest metropolitan hospitals, though. The disruption of supply chains due to extreme weather events in Puerto Rico, for example, have created shortage of IV Bags, pediatric amino acids, and synthoids.

Resources shortages area only likely to become a more familiar experience over time, due to political instability in offshore manufacturing regions, forced migration, economic shifts, climate change disruption, and a fifteen year human capital hiatus as the larger baby Boomer generation gives way to a smaller Generation X.

This chat topic was initiated by a physician with experience in the developing world, and who sees resource shortages on a daily basis, but her experience has real relevance to all clinicians.

Some areas in which resource shortages manifest, and have significant patient safety and care quality implications:

  • Expertise and human capital
  • Medications
  • Capital equipment
  • Ancillary and logistical equipment
  • Surgical tools and devices
  • Medical consumable materials



  1. Policies: How do national policies, laws, and processes lead to medical resource shortages – which resources are you most worried about?
  2. Equipment: What risks, issues, and missed opportunities relate to medical equipment and device availability. What equipment is most at risk?
  3. Measurement: What measurements will be most effected by medical resource shortages. Which measurements will serve as early warnings?
  4. Environment: What environmental factors influence medical resource availability? How can we mitigate the risk?
  5. People: What people factors cause medical resource availability risks? What effects may medical resource availability have on people?
  6. Materials: What medical materials are most involved in medical resource availability? What is the effect?


MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Accessibility, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.


The Author and Moderator: Matthew is a principal analyst for healthcare improvement at the Washington D.C. based firm of Whitney, Bradley, and Brown (WBB), and is a strategic adviser and board member at the Blue Faery Liver Cancer Association. Matthew is a peer reviewer for the international journal of Knowledge Management Research and Practice, and blogs regularly for Physician’s Weekly.




Published by

Matthew Loxton

Healthcare Analyst using Lean Six Sigma, Knowledge Management, & Organizational Learning to improve healthcare http://linkedin.com/in/mloxton

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