‘Leave the road, take the trails’ said Pythagoras. A road is very useful because it gets us from A to B and if you want to get somewhere quickly then roads are perfect - so why would someone think it is better for you to use a more inefficient way?
I would suggest it’s something that humans need to consciously want to do: to experience the journey. If you’re travelling along the M1 you are unlikely to learn much about the towns and villages that pass by. Taking the country lanes will lengthen your journey but you will gain so much more knowledge and see so much more along the way.
QI Partner Chris Woodgate and I are occasionally asked if we are going to provide all the policies, procedures and documents needed to ‘pass’ QSI. The answer is ‘no’ and there are several reasons for this but one of them is that you will miss out on the journey and, therefore, all the knowledge.
The goal of QSI is not to ‘pass’, the goal is to improve the quality of your department. Long and winding as it might be, in order to succeed in QSI you need to take the trail.
Trails, however, are not without their problems, frustrations, and dead ends. Four years ago, I started mountain biking and there are many parallels with this concept. Before I started mountain biking, I would not have described myself as a cyclist. I had a bike with a basket on the front that I used (and still use) to go into town for shopping. I had rarely done any longer road cycling as I found it really hard work or boring or scary. Cycling got me to my destination, but the journey was certainly not fun.
Mountain biking, on the other hand, was fun, even though it’s still hard and I have to make a special effort to do it. Mountain trails are not as defined as roads and there might be many different trails I could take to reach the same destination. There are sudden drops and small hills to navigate. Often there’s puddles to go through and mud or sand to avoid.
Sometimes I am climbing up a hill wondering why I’m not at home with a biscuit and a cup of tea. The biggest surprise four years on is that I now prefer going uphill to going down - before you call in professional help for me, I will explain. But first…
Over the next six months I am going to be writing Whyfronts, so I am going to do a series based on the five areas (see box) covered by the Quality Standard for Imaging (QSI).
QSI is a series of 29 statements and in order to achieve accreditation you need to show that you have met each standard statement. However, just like in mountain biking you might choose different trails to reach the statement standard. Each department is different so there will not be a set list of documents, audits and SOPs because you will need to discover the most suitable for your department.
Each month I will cover one area and explain what is included in the standard and why it is there. Chris and I are passionate about increasing quality in our radiology departments and we both believe the way to do this is to cover all the areas contained in QSI.
Accreditation is not even the top of the mountain. Even after accreditation there is plenty of work to be done and improvements to be made. A radiology department will continually throw us challenges and problems which need to be solved but by using QSI you will have the tools in your box to bring out to meet these challenges. I hope you will join me on this journey and learn more about QSI in the process.
So why do I prefer going uphill? There are two reasons – the first is that downhills are scary, more accidents happen on the downhills and I feel less in control. Downhills are more unpredictable and, as I get older, I am definitely more accident averse. The second is that as I’ve built up my fitness, I get a great sense of achievement from reaching the top of the hill. It’s hard work but as a cycling friend of mine said to me when I first started, the hill never goes on forever, there is a top. I remember this and it keeps me going.
What he didn’t mention was that when you get to the top all you can see is the next hill to climb!
The five domains for QSI are:
a) Leadership and Management
c) Facilities, Resources and Workforce
d) Patient experience