Introduction
The need for quality management in healthcare facilities is an issue that many stakeholders have been fighting for over the years. According to Arias (2000, p. 87), quality healthcare is one of the major pillars of the economic development within a given country. People should have access to quality and affordable healthcare in order to remain strong and healthy.
In the current society, there are numerous diseases that may affect people of different social classes, and this may reduce their productivity. It is because of this that many stakeholders, including the government and nongovernmental agencies, have been able to come up with ways of improving service delivery at various healthcare institutions within the country.
In the United States, the federal government, in close connection with private non-profit making organisations such as Mayo Clinics, has improved the healthcare standards within the country. Mayo has been using numerous quality management tools in order to improve its service delivery. Currently, the hospital is using ISO 9001 principles to improve the quality of its services.
Background of Mayo Clinic
Mayo Clinic is one of the largest non-profit making private healthcare institutions in the world that offers a wide range of medical services to various people across the country.
In defining Mayo Clinics, Charantimath (2006, p. 78) says, “The Mayo Clinic is the world’s oldest and largest integrated multispecialty group medical practice, combining clinical practice, education, and research at the regional, national, and international levels for the benefit of individuals with routine as well as complex health care needs.”
From this definition, it is clear that The Mayo Clinic offers more than just medical services to the American population.
It is an integrated team of multispecialty medical practitioners who are focused on offering medical services, educating young people interested in joining the medical practice, and maintaining a high level of research in various areas of health.
Founded in 1889 by William Worrall Mayo and his sons, this foundation currently employs over 3,800 physicians, and about 60,000 allied health staffs in various hospitals within the United States and all over the world. It has experienced massive growth over the years to become the largest and one of the most reputable healthcare centres in the world.
As stipulated in their mission statement, Mayo is not just focused on offering quality healthcare to the people, but it is also concerned with finding the best ways of managing some of the emerging health complications by engaging its staffs in research.
With its headquarters in Rochester, Minnesota, Mayo Clinic has become one of the most reliable healthcare institutions in North America. Its efforts in research and development has enabled it become one of the most successful non-profit making healthcare organisations in the entire region.
Quality Management System at Mayo Clinic (Strengths)
At Mayo, the management has always been focused on offering quality healthcare to all the patients who visit the facility with various health complications. When William and his sons started this facility, they were interested in offering quality healthcare services to the American people.
However, this organisation experienced numerous challenges as the field of medicine started experiencing changes due to technological advancements (Donabedian 2003, p. 34). The organisation had to adapt to the emerging technologies in order to maintain the quality service provision to the patients.
The dynamic leadership at this organisation has seen it transform in line with the technological advancement and various other changes in this field to become one of the most reputable organisations in the world.
Always emphasising on quality delivery of healthcare services, this organisation has six attributes of an ideal healthcare delivery system as defined by the Commonwealth Fund which forms its main strength (Charantimath 2006, p. 44).
Information Continuity
Information continuity is one of the most important ingredients of quality healthcare provision within a healthcare facility (Wheeler & Grice 2000, p. 81). At Mayo clinic, all departments are interconnected using personal computers and local area networks that make information transfer very efficient.
Once a client’s information is fed into the system at the reception, all the relevant departments can access the information on demand. Any adjustment made in the information at any of the departments will be reflected in other relevant departments.
This means that the speed and reliability of data transfer has become highly efficient. It has helped improve the quality of services offered within the facility. The information is managed from a central database as shown in the diagram below.
Care Coordination and Transitions
At Mayo, there is a clear system that allows for patient care coordination among various practitioners. There are cases where a patient suffers from multiple health complications that may require practitioners in different fields. The management has developed a system where this cannot be done without any form of strain.
A medical doctor in one department can easily communicate with another doctor in a different area of specialty of the medication that has been offered, and the steps that should be taken to address other complications. Such closely coordinated communication between the practitioners eliminates any possibility of misunderstanding among the doctors.
System Accountability
Mayo Clinics have adopted a total care policy on all the patients who visit their facility as a way of improving the quality of services they deliver. According to Lighter (2011, p. 33), many medical practitioners have worsened the health of their patients through careless acts due to relaxed management systems at the institutions. This is not the case at Mayo Clinic.
At this facility, every medical officer is held accountable for any service rendered, and if any mistake arises from any of the departments visited by the patient, then the officer who offered the service is always held responsible as per the organisation’s policies and principles.
Peer Review and Teamwork for High-Value Care
The peer review and teamwork system was introduced at this facility to help promote teamwork and responsibility within various departments. Under this system, practitioners in a specific field have the responsibility to review works of peers in that department with the aim of maintaining the best practice in their field.
Any changes taking place in that specific field would be shared by the members in order to enhance its application within the facility. The focus of this strategy is to offer high value care by improving skills and competencies of the individual members of the staff.
Continuous Innovation
In the current dynamic world, innovation is one of the most important tools that an organisation can use in order to ensure that it offers continuous quality care to its clients (Kelly 2003, p. 45). At Mayo Clinic, the management knows that the only way of achieving its vision is to maintain innovativeness in its service delivery.
This has been made possible by the research unit of this firm. The researchers have been interested to identify the emerging trends in this field of healthcare and to develop mechanisms of dealing with it in order to ensure that this firm remains dynamic. It has come up with new ways of addressing various issues that at the facility in order to maintain superior quality delivery (Lighter &Fair, 2000, p. 44).
Easy Access to Appropriate Care
According to Horch (2003, p. 78), healthcare is one of the basic needs in the modern society, and it should be easily accessible to members of the public. When offering healthcare services, it is necessary to ensure that clients have the capacity to access their information and understand their health conditions as soon as it is determined by the practitioners.
This is one of the factors that Mayo Clinic has been determined to improve its service quality in the market. The Clinic has developed a communication system in all its clinics for easy retrieval of information and reliable communication with the patients.
The above attributes have been considered ideal for a standard healthcare facility such as Mayo Clinic. This has made this healthcare facility one of the most preferred institutions in North America. The above strengths have seen a rise to the Mayo brand in the healthcare sector within this region.
They are considered an integrated team of medical experts who are focused on identifying any health complication, informing their patients about their complication, suggesting ways through which such complications can be addressed, and using the strategy that the patients chooses to address the problem.
This creates a feeling among the patients that at this facility, they have a voice, and can make their own independent choices about how they should be treated based on their personal preferences. This strength has helped this firm expand its operations beyond the United States.
It has also made it easy for it to raise funds from the well wishers who have now trusted it as one of the leading healthcare provider in North America. In most of its campaigns, this firm has received massive support from the public, not just because of the fact that it is a non-profit making healthcare facility, but also because of the quality of care it offers (Lighter & Fair 2004, p. 67).
The management of Mayo Clinic knows that its strengths in offering quality healthcare largely relies on its ability to retain highly qualified and motivated team of experts who are specialised in various fields. Although this is a non-profit making organisation, maintaining this kind of staff needs a strategy that would help in making them comfortable so that they do not consider quitting the facility.
This can only be achieved through good remuneration. Mayo Clinic is one of the best paying private hospitals to various health experts.
The working environment is positively designed to promote integration, socialisation and teamwork among all the employees, creating a community where everyone has an emotional attachment with other members of the organisation. This has helped minimise the rate of employees’ turnover, the fact that has helped it to retain its highly qualified staff.
Using Principles in ISO 9001 to Improve Quality of Services at Mayo Clinic
From the discussion above, it is clear that Mayo Clinic is one of the best non-profit making private healthcare firms in service delivery within North America. The firm has been determined to embrace the best practice principles in the industry in order to match or even exceed the quality of healthcare offered at some of the best hospitals in the world.
The management of this facility has been benchmarking its services with that of the leading hospitals in the world such as John Hopkins Hospital and Cleveland Clinic (Lloyd 2004, p. 44). In 2010, CNN, one of the leading news agencies in the world, ranked it as the third best healthcare facility in the world in overall medical treatment and quality services to its clients.
Despite this success, it is a fact that this facility needs to maintain continuous improvement in order to maintain its glorious position as one of the leading healthcare facility in the world. Although this firm is ISO certified, it needs to give more focus to the principles of ISO 9001:2008 as it seeks to improve on its quality of service in the market.
There are nine principles that will help Mayo Clinic to advance its current systems, and find ways of expanding its capacity to offer improved services to all the patients that visit the facility. The principles of ISO 900:2008 that have been applied by Mayo Clinic include the following.
Customer focus
This is the first principle of ISO 9001:2008 that Mayo Clinic has been using to improve the quality of services offered to its customers. Mayo Clinic clearly understands that all other healthcare facilities in the regions where it operates are competitors. For this reason, it has always found ways of attracting customers to its facility. To achieve this, it has taken a customer-centric approach in its management.
It focuses on ways through which its clients can be offered customised quality healthcare whenever they visit the facility (McLaughlin, Johnson & Sollecito 2012, p. 77).
This involves active engagement of the clients when offering them care in order to ensure that they get the service in the manner they consider appropriate. Every client is always treated as a unique entity with unique needs. This way, the firm has been able to develop a personal relationship with clients who visit the facility.
Leadership
Leadership is the second principle that Mayo Clinic has used in order to improve the quality of its service delivery to the clients. As stated previously, this facility has a responsibility of managing its top doctors in a manner that would convince them to remain loyal to the firm. This can only be achieved through effective leadership (Mohanty, 2008, p. 56).
The management unit has embraced transformational leadership characteristics in order to maintain high moral and loyalty of every member of the organisation. The leaders have developed best approaches of positively challenging the current capacity of its workers with the view of making them reinvent themselves into better service providers in their respective field.
The management realizes that it has a responsibility of making every employee feel valued within the firm. It is only through this that employees will feel committed to the firm and develop a responsibility of coming up with new approaches of undertaking their duties. The managers at Mayo appreciates that their position is meant to offer service to the employees.
They seek to offer guidance in case of challenging factors in the environment, and in all the cases, they ensure that they integrate easily with all the employees of different ranks within the organisation (Geisler, Krabbendam & Schuring, 2003, p. 66). There is an open communication system at Mayo Clinic as shown in the model below.
Involvement of people
One of the basic principles of ISO 9001:2008 used at Mayo Clinic is the need for involvement of people in undertaking various tasks and in making decisions. According to Morfaw (2009, p. 97), every human being has his or her worth that makes him or her special over the rest. The problem is that in most of the cases, some people are always belittled to the extent that they feel useless.
The management at Mayo Clinic appreciates the fact that the firm can only become innovative if people are involved actively in the development of plans and in their execution. Creativity and innovation is not a preserve for the top managers, the intelligent staff or any other special groups within an organisation.
It is a natural force that comes out of a person irrespective of the position held or academic excellences when faced with new challenges in the workplace (Okeyo & Adelhardt 2003, p. 78).
By involving every member of the organisation in decision making, the management of Mayo Clinic has given them the opportunity to be creative in their respective fields in order to come up with superior ways of addressing various issues in the workplace. This has helped in improving the quality of services that are offered in this organisation at various levels.
Process approach
The process approach is another principle of ISO 9001:2008 that Mayo Clinic has been using to improve the quality of its services. Success and failure are two possibilities that an organisation can experience when dealing with various issues in its normal operations. One of the factors that separate failure from success is the approach that is taken in the process of undertaking a specific activity.
Many organisations have failed to implement good plans because they used wrong approaches. Deciding on the best approach to use will involve embracing technology and innovativeness whenever it is necessary. Oleske (2009, p. 96) advises that it is important to ensure that the management devolves decision making to the departments.
At Mayo Clinic, each departmental heads has a plan that is always followed when implementing various policies within their departments based on their local needs. This hospital has been focused on choosing the process approach when implementing new policies (Sollecito & Johnson 2013, p. 89).
System approach to management
The principle of system approach to management has gained popularity in many successful organisations around the world, and Mayo Clinic is one of the firms that have actively used this principle in their operations. According to Spath (2009, p. 78), an organisation is a system of people with different skills, experience, knowledge, and talents.
All these factors define an organisation and the approach it takes when addressing various activities in the market. System approach to the management is a principle in ISO 9001:2008 that emphasises on the need to involve other members of the organisation in the management process.
At Mayo Clinic, before coming up with a decision on how different tasks should be undertaken, the responsible managers always make efforts to understand the ideas of other people, especially those that are directly involved in the implementation of some of these policies are very important. They always form part of the management system, especially in decision making.
Their views are regarded as important when making decisions that will affect them or their tasks. This not only motivates them, but also ensures that the approach taken is the most practical one. This approach has helped this giant organisation to devolve some of the operational and tactical plans to departmental levels in order to help find local solutions to local problems at these facilities.
Continual improvement
Continual improvement is probably one of the most important principles in the ISO 9001:2008 that Mayo Clinic has emphasised on at all its departments. According to Stamatis (1996, p. 63), success should not be considered a destination because it is a process that has no end.
Continuous success is what should be regarded as a true success because any missteps that a successful firm makes would lead to a failure that may wipe away past successes. With this in mind, Mayo Clinic has maintained continuous improvement in its service delivery in order to retain its prestigious position as one of the best hospitals in the world.
All the good strategies that this firm uses have been under continuous improvement to enable it offer even better services. If this firm was ranked third in 2010 among the best hospitals, it means that there are other areas that it should improve on in order to become the best.
Continual quality improvement that has been embraced by Mayo Clinic may be a challenging task, especially when a firm believes that it has exploited some of the best imaginable strategies.
However, Steiger (2001, p. 68) says that there is always a way of improving the best, and the only difficult task is to identify how this should be done. This should be a continual process as shown in the diagram below, and the management at Mayo Clinic has been determined to apply it in order to improve its customers’ experience whenever they visit the facility.
Factual approach to decision making
Factual approach to decision making has been another popular principle of ISO 9001:2008 that Mayo Clinic has been using to enhance its ability to offer quality products. Some policies can appear very attractive on a piece of paper, but when it comes to implementation, they may become impractical. This is one of the reasons why some firms fail to achieve their objectives in the market.
When the plan lacks the factual information, or practicality, then it will remain a plan that cannot be implemented (Wan & Connell 2003, p. 56). This simply means that the plan will be useless to the organisation, and all the resources that were used in its development will be a waste.
The management at Mayo Clinic acknowledges the importance of ensuring that its decision making process is based on factual information. Care has always been taken to ensure that only the practical plans based on the factual information from the field are developed. This means that decision making should not be a preserve of the top executives.
The main role of the top executive when planning for operational and tactical plans would be to ensure that the operational and tactical plans are in line with the strategic plans of the firm.
If they realise that a section of the plan does not work within the strategic objectives of the organisation, they should give advices on how to make adjustments in order to realise the desired goals. As Kelly (2003, p. 75) notes, this will help in coming up with practical and realistic plans that can easily be implemented by respective departments.
Mutually beneficial supplier relationships
This is the last principle of ISO 9001:2008 that Mayo Clinic has actively used to improve the quality of its products. The research by Charantimath (2006, p. 32) shows that one of the major challenges that firms face in the current market is the increasing strength of the suppliers.
Dealing with a strong supplier may be a serious challenge to a firm, especially if the supplier controls a major share of the market for the supplies. Such a supplier may set terms which are unfriendly to the firm as a way of gaining quick success before the industry is invaded by other players.
Mayo Clinic has found ways of developing a mutually beneficial relationship with all its suppliers in order to ensure that it is able to get all the needed products at friendly terms. To achieve this, the firm has always created a partnership with these suppliers.
It strives to make these suppliers feel that they are in a form of relationship where they need each other’s support. This way, their suppliers always view them as partners that need their protection, other than customers that should be exploited. Through this strategy, this firm has been able to deliver its products to the clients at reduced prices.
Previous Quality Management Tools at Mayo Clinic
The above nine principles are very vital for Mayo Clinic when implementing ISO 9001:2008 in its management strategies. This does not mean that other strategies that this firm was using previously will be discarded when implementing the above recommendations. Some of the strategies that this firm was using before included Six Sigma.
Although some scholars claim that Six Sigma is a complicated quality management strategy that is gradually being outdated, it still remains to be one of the important tools that should not be ignored by the management. At Mayo, this has been an important quality management tool for many years. This tool could probably provide the answer to the question on how to improve the current best practices within this firm.
Mayo Clinic has also found the Commonwealth Fund Commission to be an important quality management tool that has helped it remain competitive in the market. The six principles that have enabled this firm become strong in the market, as discussed on the section above, were based on the best practices as defined by the Commonwealth Fund Commission.
Other important principles that this firm has been using in the past include John Ovretveit’s Principles, which the firm has since reduced its application within its system preferring to emphasise on ISO 9001:2008.
Conclusion
Quality management in the field of healthcare has become one of the most important tasks that define the success of a firm. Mayo Clinic has realised that it has a responsibility to its clients to offer quality healthcare to all the patients. To achieve this, the organisation has been using the industry’s best practice in order to ensure that its services meet the industry standards.
It has been determined to employ some of the important quality measures in its management system. The Commonwealth Fund Commission principles on quality management have been one of the major quality management tools used by the firm in the past. However, the firm must now fully implement the principles of ISO 9001:2008 in order to achieve even greater success in this competitive industry.
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