1. How has Dr. James gone about introducing the concepts of Deming’s “total quality management” into the health care environment?
2. How effective has this effort been overall? What has been its measurable impact at IHC?
3. What are the fundamental attitudes toward variability in clinical practices exhibited in this case?
4. How does Intermountain Health Care illustrate the role of the “shadow organization” in clinical CQI? Why has this aspect of the organization undergone so many changes over time?
5. Compare and contrast the CQI effort at IHC with the models of team building in Chapter 6. How would you describe the current stage of team development at the end of the case?
6. How has IHC set itself up to be a learning organization?
7. What have been the contextual variables affecting the implementation of CQI at IHC?
8. IHS provides a wide range of services at its many locations and facilities? What can you learn from their experience about the application of CQI concepts in multisite and diverse organizations?
Dr. Brent James, the Chief Quality Officer and Executive Director at the Institute for Health Care Delivery Research at Intermountain Health Care (IHC), has introduced many of Deming’s “total quality management” concepts into the health care environment. “Make it easy to do it right” became IHC’s slogan for implementing their Clinical Integration care delivery protocols. Clinical Integration is an organizational structure and network of tools (protocols, databases, etc.) that organize the delivery of care at IHC. After getting IHC’s mission right, the next step Dr. James took was to use Deming’s 14 points but retool them for use in health care; specifically, data-driven process management in patient care delivery. Dr. James and Dr. David Burton, IHC’s Vice President for Health Care Delivery Research, developed a strategic plan that grouped IHC’s health...
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