Quality and Leadership in Health Care

By Terril H. Hart, M.D.
Experienced Resources
Health Care Executive

My first lesson in quality came, unlabeled as such, from Dr. S, my radiology professor.  Dr. S had trained with the father of pediatric radiology in Pittsburg and then came to be chairman of the department at the children’s hospital where I was training.  So, he didn’t see himself as Professor of Quality.  But he was.  I was a first year resident.

Common practice in those days called for taking a repeat x-ray film if the first try didn’t come out well. Films might be under-exposed or showing fuzziness because of movement.  Dr. S had a rule in his department:  No repeat films allowed.  He took the stance that, “If you have time to do it over, you have time to do it correctly the first time.”

Young and green, I had no idea what deep implications that rule would have for me.  Remembering it now (heck, I never forgot it), I find many resonances with the core values and criteria within the Malcolm Baldrige National Quality Program that can clearly improve health care.

First among Baldrige’s Core Values comes Visionary Leadership.  Dr S knew that he could not efficiently operate a busy hospital radiology department wasting precious time and material on re-work.  He was an early practitioner of Lean.  Simultaneously he was implementing the second Core Value, namely Patient–Focused Excellence.

His decree had another assumption underlying it, that his staff already had the training and experience that allowed them to perform at the level he was demanding.  Guess what?  Organizational and Personal Learning is the very next Baldrige Core Value.  He was training his crew constantly, with occasional shots at trying to help greenhorns like me.  Dr S, I owe you much more than I knew.

That’s also why I think that if leaders with Dr. S’s principles and vision, or better yet, who operate with the Baldrige system, run more of our health organizations, we might have better results.  This space isn’t big enough to relate all the whys, but here are a few. 

Visionary Leadership —  looking ahead. Couldn’t leaders see that the rise of health savings accounts and higher insurance deductibles might impact the demand for services and increase receivables?  Might they have seen that the risks in certain kinds of bonds they issued were too great for their companies to accept?

One other Core Value speaks for itself, namely Focus on Results and Creating Value.  In spite of expending over two trillion dollars for health care annually,  the United States show meager results compared to other developed countries in infant mortality, percentage of the population uninsured and other measures.

Since 2002 nine health care organizations have won the Malcolm Baldrige national Quality Award, informally called the Nobel Prize in organizational excellence.  Reading some of their award applications (www.baldrige.nist.gov), and most importantly their results, reveal that great achievement is possible.  The tools exist, Values and Criteria are clear, fine results occur.  Leadership can spread such performance.  Or not.

Terril H. Hart, M.D. was recently on an interim Chief Operating Officer assignment through Experienced Resources.  Dr. Hart’s experience includes; Pediatrician and Managing Partner, Wayzata Children’s Clinic; Vice President Medical Affairs and Chief Medical Officer, Children’s Hospitals and Clinics of the Twin Cities; Chief Executive Officer, Indian Health Board of Minneapolis.

Preliminary Survey Results

Experienced Resources recently conducted an online survey to identify the specific issues/trends that most challenge health care leaders in the Twin Cities Metro and Greater Minnesota and to determine how they are addressing these issues/trends.

In addition to the online survey Mary Christensen, President, will be meeting with individuals in February and March to gain a deeper understanding of the issues and trends and how leaders in MN health care are addressing them. 

Once the information is compiled we will be sharing the results.

Below are preliminary results for one of the questions in the online survey:

In your opinion, what factors will be most important in the development of a new health care model?

This newsletter is intended to be interactive, and we welcome your input.  If you have suggestions for topics or would like to submit an article, please feel free to send us your thoughts to info@FlexGenER.com.  The goal is to provide content from a wide variety of health care sources including Experienced Resources’ talent and clients.

You are receiving this e-mail to because of your relationship with Experienced Resources, LLC. You may unsubscribe if you no longer wish to receive our e-mails.