A systemic health care quality service program

This article describes a systemic quality service program implemented in a community hospital as an initial component of a total quality approach. The program interventions are based on consumer research and principles that have been effective in producing organizational change and enhancing worker performance. The description of the program is organized around six change and performance-enhancement principles: (1) establishing the importance of the performance, (2) specifying the expected performance, (3) ensuring the ability to carry out the performance, (4) accurately measuring the performance, (5) providing consequences, and (6) addressing systemic blocks to effective performance. Evaluative data are presented, indicating enhanced performance in the critical areas of documented resolutions to problems and reduced response time to problems.