Attending, questioning, and quality

Health care is just now feeling the effects of many years of neglect of serious attention to quality outcomes. We have many tools available now to change our thinking and to provide techniques to attain excellence in quality, such as Six Sigma and principals from Toyota. However, these techniques will only get us to a minimal level of quality. We need to change our questions, think the impossible, and break out of our old modes of thinking about quality. Zero defects are possible. We only have to take that quantum leap and think in new ways. We are posed on the edge of a quantum leap into new ways of thinking about quality. We will hear much more about nurse-sensitive indicators in the near future. Nurse leaders should change their questions now to attend to new models that will get us closer to the ultimate "impossible thinking" goal of zero defects in nurse-sensitive indicators of quality.