From Data to Diamonds: A Deep Dive into Quality

In a world where healthcare systems strive to be more patient-centered, data-driven, and outcome-focused, quality improvement has become an art as much as a science. When done right, it can transform organizations, empower healthcare professionals, and, most importantly, save and improve the lives of the very people at the heart of it all: the patients. The integration of patient data analysis in hospitals has become crucial in this transformation, allowing for more precise patient analytics and informed decision-making.

Recently, we had the pleasure of hosting a conversation with an industry veteran, Tannasia (aka T) Gonzalez, MBA who serves as the Deputy Chief Quality Officer at the Jewish Board of Family and Children's Services . She has more than 20 years of experience as a continuous improvement analyst, using data and kaizen principles to optimize patient (or client) outcomes. Over the course of our talk, T. delved into her team's approach to "small data," the challenges of driving a culture of quality, and how organizations can mine for their own "diamonds" by focusing on what matters most to enhance patient experience.

Below is a deep dive into some of the key lessons and best practices that emerged from our conversation.

The Evolving Landscape of Healthcare Quality

When T. first started her career, the notion of "quality improvement" in healthcare primarily revolved around meeting certain regulatory benchmarks and ensuring services were compliant with basic standards. Over the years, however, the emphasis has shifted toward a more holistic approach: reducing variation, improving patient experience, adopting evidence-based practices, and using actionable data in a proactive rather than reactive way.

At the Jewish Board, T. and her team have embraced this transformation by integrating clinical performance analytics into daily decision-making. Through dashboards and scorecards, her department tracks a wide range of metrics—everything from mental health outcomes and social service utilization to daily operational processes. While capturing large datasets has become commonplace, the real trick is in knowing how to translate "big data" into actionable insights through data-driven decision-making.

The Concept of "Small Data"

A term T. championed during our conversation was "small data." She explained that this process goes beyond just counting the number of visits, procedures, or service interactions. It's about identifying the exact clients, patients, or members who need targeted interventions. By doing so, quality improvement teams can help shape a culture that prioritizes personalizing care, rather than simply recording it.

T. recounted her experience overseeing an HIV/AIDS clinic in a large Manhattan-based health center. In that setting, the organization already had a proprietary database that captured the unique metrics associated with HIV/AIDS care, from regular lab work to medication adherence rates. Armed with these data points, T. and her team created a centrally accessible system that showed the status of each metric, down to the level of individual providers and patients.

For instance, if a provider's retention rate (number of patients who had at least one visit in the last 12 months) fell below the target, the system generated a list of patients who were overdue for appointments. The provider could then focus on those specific individuals, reach out to them personally, and troubleshoot barriers to care (like transportation, stigma, or misunderstanding of treatment plans).

This approach of pinpointing exactly where the problem lies—rather than making broad, sweeping changes—helped the clinic improve several key performance indicators by 50% or more. That's the essence of small data: letting the numbers lead you to real humans whose lives can be changed for the better. This method of data improvement has proven to be a powerful tool in driving patient experience trends and achieving patient experience goals.

Walking in the Patient's Shoes

Data alone, T. pointed out, cannot paint the full picture. Sometimes, you need to physically step into your patient's or client's journey to grasp their experiences—pain points and all. This approach is crucial for gathering valuable patient experience statistics.

One of the most powerful initiatives T. led at her HIV/AIDS clinic was called "Walking in Patient Shoes." Over a two-week period, quality improvement staff asked each patient for permission to accompany them through their entire clinic visit. This allowed the QI team to observe and record every step:

1. Check-in Process: Was it intuitive, or did patients struggle with paperwork?
2. Wait Times: Were patients left in the waiting area with insufficient information?
3. Care Environment: Did they feel comfortable and respected while speaking with clinical staff?
4. Follow-up: Were next steps clearly communicated once the appointment was over?

What emerged from this exercise was an immediate insight into barriers the data had not previously revealed. For instance, many patients complained about difficulties getting through on the phone. Staff discovered that voicemails weren't being returned promptly or that call routing was confusing, leaving patients frustrated. This had a direct impact on retention and adherence.

Armed with this "customer voice," T. and her team spearheaded improvements:

• They centralized the call center so that every incoming patient call could be monitored, and call response times could be tracked.
• They also recommended that doctors block off a specific window each day to return phone calls.

These changes may sound straightforward, yet they had a transformative impact on patient satisfaction and retention in care. Another discovery from the "Walking in Patient Shoes" initiative was that many patients were unaware of the clinic's walk-in policy. Through a "Did You Know?" campaign, staff posted informational flyers and explained to patients that they could come in for urgent appointments without a scheduled time. This eliminated a crucial barrier, and again, retention metrics began to rise.

Overcoming Resistance to Change

While quality improvement teams might be excited by metrics, dashboards, and new methodologies, frontline clinicians and staff often have their own priorities and workflows. Resistance to change is natural, and T. noted that her strategy to tackle these objections is twofold:

1. Find a Champion – Identify at least one staff member or leader within the clinical department who already embraces the change. It could be the medical director or a highly respected physician. Let them serve as a spokesperson and mentor for the rest of the team. Hearing the case for change from a respected peer rather than an external data analyst can make all the difference.
2. Communicate Non-Punitively – Emphasize that dashboards and metrics are not there to punish or single people out. They exist to highlight opportunities, standardize best practices, and, ultimately, provide better patient care. Celebrating small wins, according to T., is essential to building trust and enthusiasm for improvement projects.

At the HIV/AIDS clinic, some providers initially pushed back, arguing that patient relationships couldn't be reduced to numbers. However, once they saw how a colleague's personal touches—such as a caring word, a shoulder pat, or a simple follow-up call—dramatically improved retention rates, they were eager to adapt. Data confirmed that these human interventions actually worked. In essence, the numbers validated the power of empathy.

Building a Culture of Continuous Improvement

Quality improvement can often stumble when organizations treat it as a one-time project rather than an ongoing practice. T. believes deeply in training staff at all levels in Lean Six Sigma methodologies, from entry-level personnel to department heads. She encourages everyone—particularly those who seldom see themselves as "leaders"—to think critically about how to enhance the patient experience.

Front-desk staff, T. pointed out, are a perfect example. They are often overlooked but serve as the gateway to any clinic or hospital. As the first point of contact for patients, they have a front-row seat to everyday challenges. By involving front-desk staff in brainstorming sessions and giving them simple tools to track issues (like a basic spreadsheet of how many complaints or compliments come in about wait times), leadership can glean valuable insights on where to direct improvement efforts.

This approach fosters a continuous improvement platform where every team member contributes to data analysis adaptability collaboration. By establishing feedback loops and implementing robust data validation processes, organizations can ensure that the information collected is both accurate and actionable. This focus on employee engagement is crucial for measuring continuous improvement success and developing effective performance improvement plans.

Putting It All Together

The phrase "from data to diamonds" is apt because data, like raw diamonds, need refining. It is only by sifting through, analyzing, and polishing that we uncover the precious insights needed to drive real, human-centered change. Here are key takeaways from T.'s experiences:

1. Define Excellence – Start by articulating what good looks like for your organization. Identify key performance indicators (KPIs) aligned with evidence-based practices, including metrics like Net Promoter Score and Customer Satisfaction Scores. Consider incorporating industry-standard metrics such as Overall Equipment Effectiveness, First Pass Yield, Cost of Poor Quality, and Defect Rate to provide a comprehensive view of performance.
2. Embrace Small Data – Use dashboards and scorecards not just to collect big numbers, but to drill down to the individual who needs help. This involves a combination of descriptive analysis, prescriptive analysis, and predictive analysis to gain a comprehensive understanding of patient needs and drive improvement over time.
3. Engage Champions – Team up with well-respected clinicians or staff who can help build buy-in and spread best practices organically. This approach can significantly boost employee engagement in continuous improvement efforts.
4. Listen to the Patient Voice – Conduct "Walking in Patient Shoes" sessions or similar real-world observations to see where gaps exist. No spreadsheet can replicate that kind of first-hand insight. These exercises can provide valuable patient experience board ideas and help in collecting meaningful patient experience statistics.
5. Foster a Culture of Continuous Improvement – Encourage everyone from senior leaders to front-desk staff to adopt a mindset of "quality never stops." Provide the training and resources needed to evolve as a united team, focusing on process improvement and implementing changes based on data-driven insights. Consider implementing Cycle Time Reduction initiatives to streamline processes and improve efficiency.

Conclusion

Quality improvement in healthcare is a relentless journey of learning and adaptation. While large datasets and advanced analytics platforms are critical tools, they must be paired with empathy, direct feedback from patients, and a culture that embraces change. As Tannasia (aka T) Gonzalez, MBA so aptly demonstrated, even a small data point—like a single patient's unanswered voicemail—can open the door to transformative system-wide improvements.

Organizations that commit to an ongoing conversation between data, patients, and staff stand the best chance of turning raw information into the brilliant "diamonds" of improved clinical outcomes, seamless experiences, and flourishing communities. By setting measurable objectives and consistently monitoring progress, healthcare providers can ensure that their efforts lead to tangible improvements in efficiency data and overall patient care.

That blend of compassion and precision lies at the heart of healthcare's future—and it's how we turn data into true diamonds of care.