Four M's

I spent some time at the 13th Annual Meeting of Becker's Hospital Review conference in Chicago last week.  I was honored to serve on a panel with three other leaders in healthcare quality and safety to talk about some of the challenges of keeping Quality Improvement and Patient Safety top of mind with everything that is going on within the healthcare industry right now.  I mentioned the most recent Hospital Flash Report from the consulting firm Kaufman Hall which showed that hospitals have been struggling with negative operating margins for over a year!  Health care organizations have had to deal with declining reimbursement rates at a time when labor and capital costs have signficantly increased.  And in case you haven't heard it, we are in the midst of a national nursing shortage, which will likely not end for the forseeable future.  In other words, keeping our "eyes on the prize" of quality and safety can be a bit of a challenge.

As I was preparing for the session, I came across an online post that I thought made an important point about something that I had learned a while ago but had apparently forgot.  Lean/Six Sigma manufacturing has something called the "four M's".  The key to ensuring quality in manufacturing starts with achieving optimal conditions with machinery, materials, manpower, and methods (somewhere along the line, someone added two additional M's - measurement and Mother Nature or milieu, but I will stick with the original four).  

The important point here is that the first step in assuring quality is to optimize these four foundational conditions.  Workers (manpower) have to have the right knowledge and skills, as well as the the requisite amount of motivation and morale.  They also have to have the right equipment (machinery) and resources (materials) to be able to do their jobs effectively.  Finally, they have to be using the right processes (methods).  If any of these four areas are not optimized, quality will not be optimized either.

As I thought about this, I can't help to go back to where we are in healthcare today.  Our frontline providers are faced with supply shortages, inadequate staffing, and an exceedingly high level of burnout.  So, right there we are not optimized in at least three of the four M's!  As we think about trying to improve quality and safety in the healthcare setting, we absolutely have to address these issues.  It's clear we have a lot of work ahead of us!