How do you define excellence? What is quality?
I usually play a little game of word association with myself when I am
asked to define a word. If I can figure out what words I associate with
it I can have a better grasp of what my definition of the word is. The
word that is associated with excellence most often for me is
consistency; followed by completeness.
Either fortunately or
unfortunately depending on the bias with which you view the question,
I find that those words also play into my definition of quality. When
speaking of a resident’s performance we question if they are
competent. Most of the residents I work with are competent in their
patient care; they are good at what they do. But then there are those
two or three residents that are truly excellent at what they do – and
the key thing that differentiates the two is that the latter residents are
consistent in the good performance and completeness of their work.
If I am applying the term to a program, such as a Center for
Excellence, the same criteria appear. It is the consistent performance
of the right things at the right time in the right manner over and over
again. That is also true of quality – it is doing the right thing over and
over again.
How do you apply these terms to clinical practice?
My aim at every patient encounter is to do the right thing for the right
reason based on the latest information available to me. This allows
me to treat each patient I encounter the same – consistency. By
reviewing the chart for the preventive measures needed at every office
visit I am sure that I am being complete in my assessment. When
combined consistency and completeness provide my patients with
excellence and quality in their medical care.
How do you
activities?
apply
these
terms
to
teaching/educational
When I am preparing a lecture for the residents or students I begin
with a literature search for the latest articles on the subject I am
teaching. After reviewing the articles I prepare the presentation with
detail to the format I am presenting it in. Often I will mix formats in
one lecture to provide some stimulation in the learning process. I
think the detail put into preparing the same way each time and
utilizing all of the resources available to me I am able to provide
consistent results for the learners. When teaching at the bedside the
approach is obviously a little different since there is little time to
prepare beforehand for what may present at that interaction. For this
reason I try to keep up with all the latest developments for the “big”
things we see such as diabetes mellitus or hypertension. By keeping
myself up to date with the information I can provide quality
information to the resident or student.
How do you apply these terms to leadership?
Application here is a little difficult to describe. Excellence in leadership
is again linked with consistency in my definition. I think that a leader
must be consistent in their expectations for performance however they
must also be consistent in their approach to the members of the team.
Keeping the team current with the expectations of the project they are
working on as well as any developments within the project makes a
leader consistent in their approach.
Good communication and
information help maintain the quality and integrity of the team.
Is one easier to describe than the other? Why do you think this
is true?
Actually I find them both a bit difficult to describe especially if I try to
separate the concepts. I think much of what we do in education and
learning is interdependent. One term or concept will rely on another
to fully complete its meaning or scope. I find the same to be true of
excellence and quality.
I find it difficult to think of something or
someone being excellent if they aren’t quality; the same is true for
finding something to be quality is difficult to perceive without it being
excellent.
What role does assessment play in your definition?
In the definition of these terms I think the assessment is purely
personal. To each of us given these questions our assessment will be
different as to the meaning. I am sure that there are those who will
quantify these two qualities in order to describe them and for their
assessment that is correct. However, in my frame of reference, it is
difficult to assign the term excellence, or quality for that matter, and
have it be the same for each person. When determining excellence or
quality we utilize our personal history to reflect and make comparisons
before assigning the words.