The Maturity Continuum in QAPI
Recently I read The 7 Habits of Highly Effective People. I use that word loosely because you don't just “read” this book. Author Stephen R. Covey challenges you immediately to “try to stand apart from yourself. Try to project your consciousness upward into a corner of the room and see yourself, in your mind's eye, reading. Can you look at yourself as though you were someone else?” Someone else? Someone else's shoes? Consider someone else? It is not as easy as you think.
Early in this book I was captivated by a simple lesson, well before even beginning the study of the 7 Habits. It is called “The Maturity Continuum.” In my position I am frequently evaluating and re-evaluating systems and their effectiveness which includes whether clinicians are equipped to be successful and whether the system itself works. In “The 3 Cs of Skin and Wound Care” I emphasize the importance of investing in the clinician and their Competence, Confidence and the program's Continuous QA. “The Maturity Continuum” concept immediately gave me “a new level of thinking” as Covey would say. How could I improve upon what I feel is a very strong and effective method of teaching and achieving successful skin and wound care programs?
First I had to take a hard look at ... drum roll….myself! Covey writes, “'Inside-out means to start with self; even more fundamentally, to start with the most inside part of self-with your paradigms, your character, and your motives.” He says a new level of thinking exists in the “inside-out” approach.
“Inside-out is a process---a continuing process of renewal based on the natural laws that govern human growth and progress. It's an upward spiral of growth that leads to progressively higher forms of responsible independence and effective interdependence,” he writes.
That was a light bulb moment! If this isn't a very sophisticated “human” definition of QAPI I don't know what is!
“The Maturity Continuum” is the process of moving individuals from dependence to independence to interdependence. In my reflection, I found that I am way bogged down on getting from dependence (Competence-“the paradigm of You”) to independence (Confidence-“the paradigm of I”).
Ultimately the goal of interdependence (Continuous QA-“the paradigm of We”) is really what I should be striving for. A whole bunch of competent, confident INDIVIDUALS will not equate to a successful skin and wound care program. BUT a whole bunch of competent, confident team mates who are continuously complimenting each other's strengths and compensating for each other's weakness WILL. They are interdependent. And you will know this is working and effective by applying the process of Quality Assurance and Performance Improvement. After all, you are looking at the whole AND its parts to ensure Quality thus effective interdependence. As Covey explains, with interdependence “we can do it; we can cooperate, we can combine our talents and abilities and create something greater together.”
Obviously this is just an example of how “The Maturity Continuum” can be applied to one system. I have always appreciated how human behavior affects moving from point A to point Z but now I feel renewed in my quest of continuously advancing and not settling on performance and expectation; not someone else's human behavior but my own! I'm starting “inside-out”.
Tara Roberts, PT, is the Vice President of Rehabilitation and Wound Care Services at Nexion Health.