Just finished reading a review of Chef Geoff's restaurant chain in the August issue of Washingtonian Magazine. OK, I'm a little behind in my reading, but this caught my eye as demonstrating successful use of basic quality tools and techniques, including some principles from ISO 9001.
Owner, Geoff Tracy opened a restaurant in DC and managed everything himself. This was successful, so he opened another, and another, and another. He soon realized, however, that he could no longer manage everything himself and that without effective management, things didn't always go well. Enter brother Chris, a numbers guy. Together, they established 800 standards that are measured at each restaurant. (Wine by the glass dated to ensure freshness, dishwasher at correct temp, email to new employees before first day of work, etc.). All this is part of a perhaps obsessive attention to detail that rolls up to weekly, monthly, and annual reports on each restaurant. Tracey is quoted as saying, "Consistency is a lot harder than it looks. It might just be the hardest thing of all to achieve." There are 70 training courses for employees, with cash rewards for those doing well on the tests.
All of this will sound familiar to quality professionals, but it's unusual in the restaurant business. Marriott hotels has a similar but shorter list of quality metrics. (Trivia question of the day: How many hotels does Marriott own? Answer next time.)
Chef Geoff has a mission statement: "Great Food, Libation, and Merriment." His 800 metrics describe in excruciating detail what that means for every employee. Note that there is nothing about gourmet dining or cheap eats. Just a promise of great food/wine, and that you'll have a good time eating there. And they do that every time at every restaurant. Geoff is also quoted as saying, "I don't think measuring is what differentiates us. . . . we share that information with our managers in a way that is actionable." Sounds like my kind of place. They even have outside auditors, tho they're not registered to ISO. At least not yet.
So what's this have to do with healthcare? Healthcare as an industry needs this approach. Here's what it might look like:
1. A clear mission statement, linked to identifiable customers and their needs.
2. Weekly metrics to the CEO from key processes, with actionable items for improvement.
3. Consistency in service everywhere. How about 70 in-house training programs, with cash awards for effective learning by employees.
4. Call buttons answered within three minutes. If this restaurant can serve a cocktail within three minutes of the order, surely we can answer the call button in that time, every time.
In short, healthcare needs to define some standards, measure performance against those, and develop action plans for noted deficiencies. Note that it's not enough to say that "we'll meet this goal 90% of the time." The quality professional will ask what happened the other 10% and what are you doing about it. Take a page from Lexus automobiles, "The relentless pursuit of perfection."
In defense of the healthcare industry today, there are too many metrics that are imposed externally and have little to do with the quality of care. Even for some that are relevant, the task of measuring compliance is more expensive than providing the service. (Think, giving an aspirin within 30 minutes of an ER visit for chest pain.)
Some hospitals are adopting ISO 9001 as a management system, and there are consulting companies to help them with that effort. Still, dramatic change will require something that doesn't exist today--price competition for healthcare services. There is just so much business in "eating out" in the DC area. Chef Geoff is pursuing a subset of those diners and aggressively assessing the quality of his efforts with the aim of constant improvement. He will do well. Now, what about healthcare?