Words (might) get in the way

Note: This brief post is not meant to simply state a problem; it is meant to start a dialogue about how we can learn to talk about quality improvement in healthcare in ways that are welcoming and inviting to all. In an upcoming post, I will ask some parent and patient partners to help “flip” the discussion and write about their quality improvement observations in words that resonate with them. Let me know if you want to participate!

This post was inspired in part by a twitter Exchange about the words we use in talking about quality improvement (and healthcare in general) with the ever-thoughtful patient leader David Gilbert. That exchange prompted me to think about the words and concepts we use in quality improvement, and the extent to which they can make quality improvement activities less accessible—and enjoyable—to patients and their families. And we need patients and families to be equal partners—and indeed leaders—in healthcare quality improvement. It’s their system and needs to meet their needs and support outcomes that matter to them. What a bonus it would be if we all had more fun together working on it!

Jargon can be a barrier, but so too can poor explanations of data, measures, methods, and the reason that we do things the way we do. As someone who has been immersed in quality improvement for most of my career, I admit to using jargon—and less than thorough explanations—from time-to-time. I would also argue there is a place for some of the words that we use some of the time. But we simply need to do better when we are talking with parents, patients, and even each other. We need to find the right balance to help ensure that all are on equal footing and able to contribute.

To get this conversation started (because I’m the first to admit that I don’t know how patients and parents really feel about this!) I recently asked a couple of ImproveCareNow patient and parent partners what makes the language—and methods—of QI confusing or frustrating to them. I am sharing their responses are below to get others thinking; I learned from their comments and I hope you do too:

From parent partners:

“When I first started this journey I had no idea what QI was. The lingo is intimidating. Maybe [need] a 101 on this is what QI is, this is what we look at/measure, this is what it means to you.” –Annette Kulzer

“This is a topic I actually think about quite often. I feel like I am responsible to lead the Patient and Family Advisory Council at Children’s Mercy Hospital in a way that directly reflects the mission of our local center while utilizing the standards set out by ICN. Yet, often I find myself struggling to feel well-versed in the process of QI. I love that you speak consistent language across all roles within our network. While the ‘jargon’ can feel so new and unique, I would rather be immersed in it and asked to rise to the challenge of understanding than to be separated by vocabulary. That said, I think improvement is always possible!  Ultimately, I keep going back to the idea of constant exposure and personal experience. I often find learning to be much more meaningful when it directly informs the work I am doing. So, to learn the QI process in a session at a Community Conference is much different than using a specific example from my center and applying the QI process to that specific example.”—Jamie Hicks

From a patient leader:

“…I know that a lot of our Patient Advisory Council members know they are working towards better outcomes, but I do not think they all know about all the data that goes into it beyond what they see. It's hard to explain because of the jargon used in QI, but also if the kids feel they are making a difference, its hard throwing in an explanation of QI on top of the complexity of ICN and networks when they are satisfied as is.” –Alex Jofriet

I’d love to hear more feedback from parents and patients in the comments section. Let’s keep this (jargon-free) conversation going…and stay tuned for the follow-up post!