Stuck at the Gate

Jim Molpus, for HealthLeaders Magazine , December 13, 2007
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It is two hours past the time my flight was supposed to leave. The Kennedy Airport gate attendant has a glazed, defensive look on her face. An older gentleman with a Southern accent is more upset than most of us, probably because he doesn't fly enough anymore to become dulled by the lack of quality, performance and accountability of airlines today.

We air travelers expect delays--and just pray they don't leave us sleeping in the terminal, our heads propped against a carry-on bag. We expect the gate attendants to be surly. We don't expect anything more to eat than a bag of a dozen stale peanuts. Overall, our expectations of an entire industry have been lowered by nothing more than that industry's own speed-of-sound descent into mediocrity. All we realistically expect of an American domestic airline these days is that the airplane lifts off and lands safely. We hold airlines to that bar, and the airlines make darn sure they do nothing that would be misinterpreted as exceeding it.

In my years covering healthcare, I have heard more than one speaker at a convention compare healthcare to the airlines. Whether it is the use of airline-style process improvement to improve quality, or airline-style crew training as a team-building exercise, they hold up airlines as a model for healthcare to emulate.

I can't think of a worse industry for healthcare to copy.

Emulating the airlines would be an admission that patients are a cattle commodity. Hospitals may look to get their error rate down to something approaching the mechanical reliability of commercial air flight, but they must reduce errors while improving overall customer service, something that the airline industry has spectacularly failed to do.

In this month's cover story, we look at the commitment that hospital boards are now making to the quality of the care their organizations provide. The movement toward board involvement in quality has gained steady momentum recently. My hope is that the conversations that boards are having are not merely about the relative merits of individual quality measurements or programs, but a more global discussion about how high the quality bar of the hospital should be. Measurements and guidelines from national associations and ratings companies are no substitute for the leaders in a boardroom deciding what quality means to that hospital, and what the organization's course toward that bar will be.

I can only hope when board members are setting that quality bar, they will craft a vision of quality that includes the best in not just safety and quality, but also healing, care and friendly customer service. Set the bar higher than the airlines. I don't want to imagine a world where we lower our expectations of healthcare.

Jim Molpus




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