The Quest for Error-Free Care
The Suffolk University Chapter of the Institute for Healthcare Improvement (IHI) recently sponsored a panel discussion with three of Boston’s health care leaders: Dr. Judith Melin, chief quality and safety officer at Lahey Hospital and Medical Center; Mary Cramer, associate chief quality & safety officer at Mass General Hospital and a Sawyer Business School MBA; and Professor Elizabeth Turner, a nurse-attorney whose practice focuses on health care law. Turner is a graduate of the Suffolk Law School as well as a teacher in Suffolk’s Master of Healthcare Administration program.
In a free-ranging discussion, the panelists talked about trends in the industry, patient safety, how the patient experience has improved over the decades, job-hunting advice, and many other subjects. It was the marquee event of the year for the recently reconstituted Suffolk chapter of the IHI, whose mission is to improve health and health care worldwide.
Here are some important takeaways from this informative event:
When the moderator asked the panelists about how they ended up in their current positions, Melin told a story:
“In our waiting room, we had long rows of chairs like a bus station or an airport. People wouldn’t sit next to each other, which meant we were wasting an enormous amount of chairs. So one night, I rearranged them to be in groups of three. The next day, everyone was using a chair and there was nobody standing against the wall.”
After that, the heads of other departments asked her to rethink other waiting rooms. Then she was asked to help standardize all the exam rooms so that, for example, doctors would always know which drawer held the tongue depressors no matter what room they were in.
“You know how it feels when your doctor can’t find anything?” asked Melin. “You’re not sure your doctor knows enough medicine to practice. If you standardize all the drawers, you get beyond that hurdle as a clinician, and the patient has a sense of comfort.”
The panelists were also asked what specific initiatives their organizations have been taking to improve patient safety. Mary Cramer responded:
“The ultimate objective at MGH is to be sure the right patient gets the right care at the right time. That is far easier said than done given the constraints of the system and the demands on that system. So the core work we do is in the emergency department, given the wait times that are involved there. The point is to understand the root causes across the continuum.”
Another area she and her team focus on is patient experience, looking at the root causes in a systematic way.
“What can we do to improve the processes on which the clinical care relies and on which the patient’s experience depends?” asked Cramer. “We try to get very granular but at the same time keep it as broad as possible.”
A member of the audience asked the panelists about consumerism in healthcare. Professor Turner offered her insight:
“When it comes to playing a role in their own health care, people are comfortable with the passive kinds of things: writing questions down, carrying lists of prescriptions. But they are reluctant to take on more participatory roles, like asking providers to wash their hands.”
Turner said it’s hard to know why that is.
“Maybe we’re not understanding patients’ abilities. Or maybe we’re putting too much on them. Or providers don’t understand what we expect patients to do. All of this is important, but it goes with everything we talked about tonight: patient care is a work in progress.”
Expert advice
“The importance of this event was that students learned about quality improvement in healthcare organizations,” said Professor Mona Al-Amin, faculty adviser to the IHI group. “They also got to ask questions about the field. And they got to learn about career choices and what skills they might need.”
At the end of the evening, the Suffolk IHI Chapter presented its Quality Champion award to Mary Cramer for all her efforts at improving patient care.
Al-Amin sees the award as an important aspect of what the IHI does.
“The hope is that, over time, health care professionals in the Boston area will recognize that the IHI chapter at Suffolk acknowledges those who make an impact on patient safety,” she said.