The Quality-Cost Connection: How quality managers can stop information overload
The Quality-Cost Connection: How quality managers can stop information overload
Screen out nonessential information
By Patrice Spath
Brown-Spath Associates
Forest Grove, OR
It seems that the biggest problem facing health care quality professionals is not that there is too little progress, but rather too much of it. A typical quality manager in the late 1970s probably felt overwhelmed just processing the latest Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards and newest requirements from Medicare.
Today’s manager must address not only these issues, but also must deal with a full set of additional information arriving from professional associations, consumer-advocacy groups, business coalitions, patient safety organizations, and other state and national groups involved in health care quality initiatives.
It is difficult to cope with the rate of change and growing demands. Quality managers must contend with a large volume of seemingly high priority requirements.
Information technology tools such as the networked desktop workstation, e-mail, and the Internet combined with telephonic means such as the fax, wireless phone, and pager all compete for the quality manager’s attention.
These tools are attaining a greater presence throughout the workplace, increasing not only the amount of information, but also the number of potential correspondents.
It is clear that quality managers face a huge challenge in assimilating all the information coming from various sources. Sorting through, interpreting and distributing the most valuable information to appropriate individuals and groups are never-ending struggles.
It is quite likely that the amount of information will continue to overtake the quality manager’s ability to process it. It may be unrealistic to expect that you’ll ever catch up. Advances in information technology will continue to make information more accessible. That’s why it is important for quality managers to develop efficient habits and techniques for managing all of this information.
Strive for an immediate response
A primary cause of information overload is the lack of a system for handling data as it comes into your office. It is easy to get backlogged if you don’t have a routine method for responding to new information. It’s not the volume of information that’s the problem; it’s our failure to make decisions about what to do with it. Plus, in the back of our minds, there is always a fear that we’ll throw something out and need it later.
This fear paralyzes our ability to effectively manage information. To become more productive, next time you receive information from any source, ask yourself these four questions:
- Do I need to keep it?
- Where do I keep it?
- How long do I keep it?
- How can I find it again?
Try to screen out the nonessential information. Focus on keeping information that helps you or your organization deal with high priority quality issues.
Be ruthless about what you allow yourself to keep. Deal with the information that’s left by determining what each item refers or relates to. This will tell you what file it should go in. To keep the information from getting lost in your files, place a reminder note on your "to do" list, your "projects" list, or on your calendar.
Learn to put paper where it belongs the first time you touch it. Never read something without making a decision or taking action.
If it’s an e-mail that needs responding to, take the time to do it immediately or place the e-mail in a "pending action" folder in your e-mail system. Tear out interesting articles and toss the remainder of the publication.
Once you’ve finished reading, decide where the information goes next. Set aside time in your schedule to read or respond to information (twice a week for 30 minutes, if you can).
Track knowledge-based information
Some of the information that comes across the quality manager’s desk must be shared with other individuals or groups in the organization. Keeping track of these referrals and actions taken can be time-consuming.
With the focus on patient safety, it is important to develop a system to document dissemination of safety related information, including JCAHO sentinel event alerts. Include in your documentation the recipient of the information, the individuals/groups that reviewed the information and all decisions or actions that were taken in response to the information.
The title of the document is entered in column one. The date issued or published and the source (e.g., JCAHO, American Hospital Association, Institute for Safe Medication Practices, American Medical Association, etc.) are documented in the next two columns. The remaining columns are used to record the names of each individual or group to whom the information is sent, date the information was reviewed, and what decisions or actions were taken as a result of the information. In some instances, the information may not be found to be relevant to your organization, and no further action is necessary.
In other instances, the information may be used for improvement purposes, e.g. initiate a process improvement project or conduct a failure mode and effects analysis on a high-risk process. Any and all actions should be documented. Use a paper tracking system such as the paper-based tracking log or design an electronic tracking system with spreadsheet or database software.
Be sure you’ve got a workable strategy for documenting the dissemination and use of patient safety information as well as other quality-related information. At the time of a JCAHO survey, your organization will need to confirm that knowledge-based information is being used to design new processes or modify existing processes.
The quality department receives a lot of information that is important to the success of the organization. In whatever form the information arrives, the department must have a systematic way of processing it and tracking responses. Do you have scores of e-mail messages to read, piles of mail and papers to sort, a six-month-old stack of journals that you haven’t even opened? If so, you are probably suffering from information overload.
It’s time to develop methods for responding to what is most important and discarding information that won’t be needed within the next three months or so. Backlogs are caused not by the volume of information but by not knowing what to do with everything when it is received.
Quality managers must have effective systems for managing this overload as the information age matures.
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