*** EDIT *** Please read, but do not send the author any more email, look through this entire thred, you'll see we've already sent mesages, and the author has responded in a nice way.


Article about health care, writer brings up the Fiero.

http://durangoherald.com/ar...STS06/702159978/-1/s


Questioning what ‘quality’ means in quality health care

Article Last Updated: Tuesday, February 14, 2012 5:31pm

When I became quality manager at Axis Health System nine months ago, part of my work became helping define standards of “quality.”

As this process got under way, I soon arrived at an understanding that quality was an entity that was somewhat illusive to pin down – especially as it pertains to treating the whole person by way of providing integrated health care, which is somewhat of a novel practice to begin with.

I started asking the question: What is quality health care? I approached patients and providers, community members and family – essentially anyone who’d listen. While I was hoping my inquiry would narrow the definition of quality; the exact opposite occurred. It seemed like I heard a different opinion or perspective each time I asked the question.

Making sense of the wide-ranging response data was the research equivalent of hopping on a rodeo bull in the middle of the ring – after it had been let out of the chute. Throw in the national debate about health care and arriving at a shared definition of “quality” started to seem like setting out to build a colony on Pluto – a proverbial long shot.

So to develop a better understanding of quality within an industrial process (as health care is an industry), I went back to my hometown roots – Detroit. Not literally, but in contemplating the industrial process of automaking, I started to think about the concept of “Quality In – Quality Out.” Measuring outcomes is a big focus of health-care reform. I thought I’d arrived at a potential key point of understanding, so I started thinking about the Pontiac Fiero, produced between 1984 and 1988.

When the Fiero was rolled out, its fiberglass body was much-heralded. Bowling balls were thrown against the car to display its resiliency – the dents magically “popped out” back to form. However, nearly 20 years later, while a neat concept model, few Fieros seem destined to make the Historic Car Registry. Pontiac’s focus on the exterior shell – not the “guts” of this model – appears not to have resulted in long-term quality for the Fiero.

Perhaps Pontiac missed something along the way. Maybe it got entirely caught up with the idea of producing a quality exterior – an outcome – and inadvertently became unfocused on other parts of the process; it seems to have missed some steps.

So what exactly goes into the process of providing health care that makes it effective from the patient’s perspective? What contributes to our knowing that we’re not driving a Fiero home from our last office visit, so to speak? We recently asked this question of 30 AHS staff members and patients. We then took the 10 most common responses and built a Web-based survey to expand this inquiry to patients everywhere. If you’d like to assign importance to parts of health care that ensure quality – from your perspective – please visit www.surveymonkey.com/s/KXDD2RS

I’ll share results of this anonymous, community-based survey next month. Thanks for reading, and I hope to hear from you soon.

Mark White is the director of quality for Axis Health System.

[This message has been edited by CoolBlue87GT (edited 02-16-2012).]

Now that's funny!

(I PM'd the link to one our own PFF health care professionals)

I wrote him a quick e-mail.

Just some tips about the space frame and high standards for safety and innovation, nothing too mean.

I just fired this off to him:

Hi MIke - I just read your article to Quality healthcare in The Durango Herald. If I may offer a suggestion relative to your Fiero analogy, if you want to achieve "quality", you have to understand that there are times that you "don't know what you don't know". Enclosed is a recent picture of my 1986 Fiero that is just getting ready to turn 130,000 miles with the original engine and transmission!
The Fireo embodied lots of cutting edge (at the time) technology in addition to the plastic (not fiberglass) body panels including the mid engine design and space frame construction. Allow me to refer you to Wikipedia:
"Crash SafetyThe Pontiac Fiero, being popularly known as being "made entirely of fiberglass," is wrongly accused of being unsafe in a collision.

The Fiero, with its unique plastic body-on-spaceframe design, helped the Fiero achieve a NHTSA NCAP frontal crash test rating of 5 stars, the highest rating available.

According to Hemmings Motor News, the exceedingly sturdy, 600-pound space frame consisted of roughly 280 separate galvanized and high-strength steel stampings joined by 3,800 welds and, when assembled with the Fiero's mechanicals, was fully driveable without its skin.[5] The Fiero's body panels are purely cosmetic and carry no structural load. The Fiero was the second safest vehicle sold in America from 1984 to 1988, bested by the Volvo 740DL station wagon. "
This alone would imply that the Fiero had a bit more "guts" than you may have thought.
If you want to find out "what you don't know", you may want to check in with over 21,000 owners here: www.fiero.nl
Good Luck with your quality gig.......
Tom Hayes

Odd choice of words.... Fiero and health care? Maybe in relationship to a death panel

I didn't have time earlier, but my message to him was quickly replied to and an apology and explanation offered.

My original e-mail:

quote Dear Mark White I recently read your article "Questioning what 'quality' means in quality health care" and found the representation of your example featuring the Pontiac Fiero to be off base. The Fiero did receive a poor reputation for quality, but not for the reason you specified. In the 1984 model year, the 2.5 liter engine installed in the cars were susceptible to fires if the owner was not attentive to the oil level/cleanliness. A recall was issued and the problem fixed for the remaining years. However, despite this effort, the Fiero would be characterized by this flaw. The plastic body that you refer to in your article is actually one of the ground breaking features on the car. The Fiero was one of the first mass production vehicles to use what is referred to as space frame technology. A space frame is the preferred method of most of today's car, and I can assure you that your car most likely follows a similar architecture. The body of the Fiero was revolutionary becuase up to this point, most cars relied on the outer body panels for structural rigidity; in fact cars up until just recently featured a bottom chassis that other pieces bolted onto, creating multiple weak points. The space frame is a solid object that makes up the chassis, hood and truck surround, any side pillars, and the roof structure. In 1984, this system granted the Fiero a safety standard better than any car without airbags, and second best among cars with airbags (the Fiero had none). Furthermore, this bold on exterior meant that the exterior was a lower quality than the interior or "guts". The plastic panels that make up the car tend to fade and weather similar to their metal counterparts, but since they provide little or no structural rigidity, they are allowed to be flexible instead of rigid, and affordable instead of expensive. I'm not arguing with the overall basis of your article, I feel that your example still lends itself to your cause, but only because you created the example around a car that carries little public knowledge. I hope this e-mail convinces you to change your opinion about the Fiero, and perhaps cause you to pause before using an example that you don't fully understand. Also, please understand that this e-mail is written out of the consideration of knowledge, not out of indignation Thank you for your time, Paul ******

His response:

quote Mr. [Blob] I very much appreciate your willingness to share your perspectives/insight regarding the Pontiac Fiero. Although my reference to the model was not intended to “throw the car under the bus” so to speak, I readily admit the context of the article did not capture and/or accurately represent the full picture of this unique car or the people who made it for that matter. As a Detroit native, I have friends and family members who have been and continue to be members of the UAW. I fully expect to catch my share of grief regarding this reference! J To this end, the knowledge you’ve shared is invaluable. As a result, I will be more thoughtful of the innovative aspects of this groundbreaking vehicle moving forward. Again, thanks for reading and sharing your timely correspondence. Regards, Mark White

I briefly thanked him for responding and he added that he received another e-mail and was wondering if he could make an apology to our group. So on his behalf, he is sorry and does realize his mistake and hopes that there is no offense taken as it was not his intent.

From my conversation with him he seems like a really understanding and knowledgeable guy that simply posted this without intending any harm. With that, he doesn't need any further information, I feel like he has better things to do.

Thanks

This one was drivable--and driven--as is, (no doors) to AAFO's 2010 Fiero Roundup in San Antonio. Can't remember for sure, but I "Think" this was a far West Texas car. Maybe driven from El Paso.

quote Originally posted by Renegade blob: I didn't have time earlier, but my message to him was quickly replied to and an apology and explanation offered. My original e-mail: I briefly thanked him for responding and he added that he received another e-mail and was wondering if he could make an apology to our group. So on his behalf, he is sorry and does realize his mistake and hopes that there is no offense taken as it was not his intent. From my conversation with him he seems like a really understanding and knowledgeable guy that simply posted this without intending any harm. With that, he doesn't need any further information, I feel like he has better things to do. Thanks

Cool, sounds like he's a nice guy. I agree, he doesn't need anymore hounding from us.

I don't know anything about the guy, but appreciate the apology, and the way that he handled it. And besides, he did have some truth to his article when doing the comparison.

Tony

I appreciated the quick response as well. Perhaps we can help him out by completing his survey here:

http://www.surveymonkey.com/s/KXDD2RS

Maybe he should have used the MR2 for his analogy. Talk about not withstanding the test of time...!

An additional response from him:

quote Mr. [blob] I appreciate the opportunity to clarify the intent of the article with Forum members. I sincerely appreciate the correspondence and I’m pleased to hear that so many Fiero’s are still rolling and continue to be held in high regard by so many folks. My assumption @ the long-term quality of the model was clearly under-informed and I will offer a formal retraction in next month’s column. Thank you! Mark White

[This message has been edited by Renegade blob (edited 02-15-2012).]

Fiero and Healthcare? Come on, juxtapose? The author needs to use a better a example to make his point clear. I'm not sure you can use any make of car here with healthcare. Maybe try using the word "mortuary" and healthcare. If you don't have a good healthcare package you're D.O.A.

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"Friends don't let their friends drive stock."

I certainly hope that the author is successful in his efforts to develop a healthcare organization that it as successful as the Fiero was and continues to be.

What a joke.

No one on this forum let's anything get buy. Good read, thanks

Well I'm glad he came clean on this matter. Now I'll put away the butcher knives.

Spoon

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"Kilgore Trout once wrote a short story which was a dialogue between two pieces of yeast. They were discussing the possible purposes of life as they ate sugar and suffocated in their own excrement. Because of their limited intelligence, they never came close to guessing that they were making champagne." - Kurt Vonnegut

Darn, I read the artical and fired off an email to him also.. then read the rest of the post and see I'm not alone..

Guess he got the message....! Way to go guys...

He'd appreciate it if no more e-mails came. He has been extremely cooperative in all this, and he and I have actually shared some friendly correspondence today. But it's nice to see that everybody is this passionate about this, lol. He'll even be posting a retraction in the next column.

quote Originally posted by Spoon: Well I'm glad he came clean on this matter. Now I'll put away the butcher knives. Spoon

Now that's funny right there, hehe.

That's awesome.

He was just trying to make a point about the focus on the external structure of the Fiero being RELATIVELY over-emphasized compared to the internals.

He took it REALLY well, what you guys updated him on.
Regarding the ACTUAL intent of his article, he is EXACTLY on track.

People keep talking about health care "quality". He is actually trying to get MEANINGFUL measures that are important to people, so he can focus the efforts to improve things.

That's a better way to do it than to have a bunch of "experts" on a panel define quality.


If you want to take the time to fill out the survey, you actually can have a little part in being part of MEANINGFUL improvement.

From a thread here. The driver is looking at his car shortly after the crash. A below-the-knee cast is a pretty good outcome if you ask me.

Jonathan