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Tomaino Arm Care Network

Dr. Tomaino's Blog

Trust, But Verify

November 2nd, 2008
An ongoing "real time" assessment of "how are we doing" is a critical, though too frequently ignored ingredient of "Total Quality Management" initiatives.

Google TQM or Deming for more information....but in brief--Total Quality Management (TQM) is a participative management style that stresses total staff commitment to "customer" satisfaction. It is a holistic approach to managing organizations and replaces top-down management with decentralized customer-driven decision making.

Fundamentally, TQM initiatives ensure a continuous improvement process -- eventually producing results that exceed customer expectations. It is based on the assumption that 90 percent of problems are a result of process, not employees.

So, in a small "Boutique" office, I strive to build processes that faciltate efficiency and responsiveness to my patients. And, if we are not meeting or exceeding expectations, we want to hear about it---so that we can improve. Indeed, that commitment and "nimbleness" is why we think we can deliver our pledge to provide truly remarkable care.

HOWEVER, THAT IS NOT ENOUGH. I must also make good on my pledge to base my care on Evidence-Based Practices---"Best Practices". This is the body of knowlege--the Evidence Base--acquired from what is published in the literature, what I have learned, and continue to learn from colleagues around the country (from meetings, dialogue, inquiry), and from my years of practice experience (See my blog on Chie--the wisdom of experience).

Paradoxically, however, "best practices" may too often reflect merely "practices". They may be outdated, not reliably successful, associated with too high a risk of complication, etc etc. Now--in light of the fact that "Adequate information is critical to optimal decision-making" so too would I add to my emphasis on TQM---a commitment to engaging in authentic dialogue regarding the most likely "outcome(s)" you can expect---both from operative as well as nonoperative care.

You deserve to know!

And so, "Trust, But Verify" reflects a very critical part of my mission to provide the best care. It requires Accountability and Commitment--to scrutinize objective outcomes as well as your perception of how you are doing or how you did.

It must include Responsiveness to your Inquiry. It's why I wear my Blackberry 24/7.


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