Soft Quality

An activity falls into the category of "soft quality" when the way it is designed or carried out creates the perception of action without challenging status quo. Soft quality became very popular in health care in the 1980s when hospitals were struggling to find ways to meet the new regulatory requirement for the existence of quality programs without making waves inside their buildings. Leaders learned that activities of soft quality allowed them to appease surveyors without having to go through the pain of promoting change.

While anything can become a form of soft quality, the most common activities that fall into this category are mass education, the creation of new forms, discipline of the frontline workforce and committee meetings. A provider could tell surveyors that it had held 87 mandatory inservices, created 70 new forms, disciplined 214 employees and held 162 committee meetings since their last visit and the surveyors would generally go away happy without ever asking the critical question of what difference it made.

Soft quality gave birth to a general perception in health care that as long as we have lots of activity going on we must be accomplishing something. If the surveyors had asked the critical question, they would have found that eighty percent or more of those improvement activities in many settings yielded no value-adding improvement for the patient or the organization. It simply created a great show. It is currently estimated that health care spends about forty cents (or more) of every dollar it earns on administrative functions that serve no purpose. A significant percentage of that money is spent on activities of soft quality.

For far too many healthcare providers, patient satisfaction is a form of soft quality. They send out the surveys, collect the data, aggregate the data and look at the data. Yet, that data never or rarely contributes to the creation of value-adding change. Providers who cherry pick their questions to ensure good data engage in the worst form of soft quality.

Providers who accept soft quality in their patient satisfaction systems are their own greatest victims. A healthy and robust patient satisfaction system is health care's gateway into the minds and perceptions of its constituents. When done wisely, it becomes a powerful business tool for understanding your strengths, weakness, threats and opportunities.