Academic journal article Frontiers of Health Services Management

Building a Quality Future

Academic journal article Frontiers of Health Services Management

Building a Quality Future

Article excerpt


How can healthcare leaders stay ahead of the curve? What can they do to see what the future holds and to secure a place for their employees and their organizations? They must begin doing today what they need to do to survive tomorrow. Furthermore, they must take wise action today or there will be no tomorrow. This article looks into the future and connects it with what we must see and do today.

The article begins with a glimpse of the future and with an exploration of what people really want from health and healthcare. Next, it examines what appear to be inexorable megatrends and healthcare trends that are sweeping through society. This leads us to consider the quality and value imperatives that must be faced to secure a stake in the healthcare delivery. We will discuss a model for managing care for individual patients and small populations by focusing on where patients, populations, and caregivers meetat the front lines of patient care. We conclude with some advice on how to build sustainable organizations by exploiting the inevitable.



"The future ain't what it used to be."

-Yogi Berra

Several years ago, Nissan entered a race with Toyota with a goal to bring a new luxury car to the American market that would capture "high-end" marketshare from the German and the American automotive industry. Nissan's new car was to be called the Infiniti, and its predistribution marketing campaign was remarkable. Nissan did not focus on selling the cars-or "moving metal" as it is sometimes called-focusing instead on building a lifetime relationship with their new car owners.

The material that follows is based on a real Infiniti ad that appeared in nationally distributed magazines. We have recast the original advertisement for Infiniti to read as if it were a print ad for the fictitious, Boston-based WeCareGroup, which, in this made-up scenario, is starting a campaign to increase its marketshare for cardiac services and to build a larger and more loyal customer base. Note: We have added bold text to the following Infiniti advertisement to transform it into a healthcare advertisement for WeCareGroup.

Suppose, today, you made the decision to purchase an Infiniti Q45 luxury sedan or M30 sports coupe [to have cardiac surgery or angioplasty at "WeCareGroup."]

Now race ahead five years in your imagination. Based on our continuing commitment to customer service [your health and your healthcare] . . . this is what those five years of ownership [healthy living] might be like.

In those five years, your Infiniti dealership [your WeCareGroup clinical team] will have contacted you regularly to make certain that your car [CABG or angioplasty] is living up to your expectations and that your ownership experience [quality of life] has remained positive.

Minor service procedures, every repair, all visits to the dealership [visits for any type of minor health problem or for ongoing health maintenance visits to the WeCareGroup]-for whatever reason-will be kept as part of a computerized file, a personal history of your Infiniti [cardiac and overall health].

Should you move from the area or should you require service elsewhere, that file can be called up by any other Infiniti dealer [WeCareGroup center] in the country.

We believe that an Infiniti [a CABG or angioplasty] is not simply an automobile [operation], it is an automobile [operation] and an agreement to provide the highest level of service [quality healthcare] for as long as you own the automobile [live].

The WeCareGroup case is make-believe, yet it has many features that are believable today and are inevitable in the future healthcare marketplace. First, the emphasis is on what people want and need as opposed to what the producer is selling (Deming 1993). Second, the aim is developing lifetime loyalty for services, not merely providing episodic sick care (Jones and Sasser 1995). …

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