NONE OF US STAYS THE SAME
The reality is that, as people, we leak and we stray. We must continuously fill others and ourselves back up and come back to true north. It’s an ongoing process. We recognize that leaking and straying are unfortunate consequences of our being human. Such shortfalls occur even in the midst of carrying out our continuous improvement strategies.

Measurement is vital to accessing organizational performance, including the achievement of results. It helps answer the question—
“How do we know if we are getting better or worse?”
We improve results by looking at the data and if necessary, changing our behavior.
We must ask the high impact questions.
The challenge is to measure the important things.
The result? Should be improvement–continuous improvement–not just collecting a growing list of things to do. After the consistent effort, we should also find that we have a list of things we no longer have to do. Continuous improvement represents a commitment to achieving and producing high-quality service and outcomes, not the avoidance of mistakes and errors.
My dad used to repeat the old saying,
“It ain’t what you don’t know that gets you in trouble. It’s what you know for sure that just ain’t so.”

Generally speaking, it’s our experience that state regulations, including “quality standards” usually end up being mechanisms that work to prevent bad things from happening and are not mechanisms designed to ensure the highest quality.
We support the efforts of CARF and CQL and believe these organizations work to improve the quality of organizational performance. Our interest in quality improvement is to assist providers and organizations to evaluate their actual practices from the model of backward mapping — that is, determine the level of performance sought at the operating level and working backward to put structure and procedures in place that will maintain them.
In looking at quality,
we incorporate stories
and pictures and examples
as well as numbers,
charts, and graphs.
