Academia de Operaciones
Sistemas de Calidad
Dr. Miguel Angel Moreno Miguez
Falls Church General Hospital
Founded in 1968, the Falls Church General Hospital (FCGH) is a privately-owned 6l5-patient bed
facility in the incorporated township of Falls Church, Virginia. Falls Church is four miles from downtown
Washington, D.C., and is surrounded by the counties of Arlington, Fairfax, and Alexandria, Virginia, all
affluent urban/suburban communities with a highly-educated population composed largely of
employees of the U.S. government and high-tech engineering firms. Falls Church General Hospital,
with 895 employees, provides a broad range of healthcare services, including drug/alcohol abuse
wards, emergency rooms, x-ray and laboratory facilities, maternity wards, intensive- and cardiac-
care units, and outpatient facilities. In January 1990, the hospital began a series of ads in The
Washington Post highlighting its concerned doctors and nurses, its friendly support staff, and its overall
philosophy that its employees care about their work and their patients.
The Issue of Assessing Quality Healthcare
Quality healthcare is a goal all hospitals profess, but few have developed comprehensive and
scientific means of asking customers to judge the quality of care they receive. A tremendous amount
of effort has been devoted to assessing the clinical quality of hospital care; books, journals, and
papers on the topic abound. The problem, however, is that past efforts to measure hospital quality
have largely ignored the perceptions of customers--the patients, physicians, and payers. Instead of
formally considering customer judgments of quality, the healthcare industry has focused almost
entirely on internal quality assessments made by the health professionals who operate the system. In
effect, a system for improving healthcare has been created that all but ignores the voice of the
customer.
The board of FCGH believes that all hospitals need to make the transformation from the current
practice of attempting to ensure quality to measuring and improving the quality of care from both the
external, customer perspective and the internal, provider perspective. Fueled by concerns in recent
years about costs and medical practice variation and by the demand for greater social
accountability, there is an emerging demand by patients and payers that quality healthcare be
provided at best value.
As board president, Dr. Irwin Greenberg recently stated at the annual FCGH meeting
"As the prices people pay in the future for given levels of service become more
similar, hospitals will be distinguished largely on the basis of their quality and
value as assessed by customers. We must have accurate information about
how our customers, not just the healthcare professionals who work here, judge
the quality of care in this institution. Many hospitals already have some
methods for measuring patient satisfaction. A recent survey of more than two
hundred hospitals showed that two-thirds routinely conduct patient satisfaction
surveys. Typically, the surveys are distributed at discharge to patients who are
free to respond or not. The main value of such surveys is to gain quick
knowledge of problems experienced by patients, many of whom often fill out
