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For her entire career, Juli Maxworthy has been committed to quality and patient safety — first as a clinician and now as a teacher. She spent almost 20 years as an ICU nurse and in other roles in critical care before making the transition to academia. She is now an Associate Professor at the University of San Francisco, teaching in the Executive Leader and Population Health Doctor of Nursing Practice programs. In all of her roles, she has strived to ensure “that every patient gets the same care every time because that’s always been a big piece of who I am. I want to make sure that things are fair and equal.”
Maxworthy encourages her students, and others in the field, to get the Certified Professional in Patient Safety (CPPS) credential. To obtain this credential, professionals must pass an exam demonstrating proficiency in five patient safety domains: Culture, Leadership, Patient Safety Risks and Solutions, Measuring and Improving Performance, and Systems Thinking and Design / Human Factors.
Maxworthy earned this credential at around the same time she began teaching, about ten years ago, and since then, she’s continually gotten recertified. “I’ve kept it up and I’ve kept it up because I see the value in the recertifications,” she said. “Reviewing the expectations for the exam keeps me current in my knowledge of what’s happening because it’s an ever-changing field, which is exciting, but can be a little tricky sometimes to keep up with it.”
There are multiple advantages to the CPPS credential. For graduates starting off, in particular, it can be a boon to their career. “Especially if they’re looking for a new position,” Maxworthy said, “having the CPPS really has been a plus because you talk about it during your interview, you can highlight it as something that you’ve done because you value and you understand how quality and patient safety...should be so intertwined in everything we do, and how the process of improvement takes a village.” Getting the certification also gives health care workers an entrée into conversations they might not otherwise be able to engage in, and “it puts you in company with individuals who are at the top of their game as far as their ability to understand the value of quality and patient safety.”
And of course, as more and more health care leaders and providers acquire this knowledge, the ultimate benefit redounds to patients. “By being part of this community, you are encouraging others to make it a priority for them as well.”
In her classes, Maxworthy teaches about IHI’s 100,000 Lives Campaign, a nationwide initiative launched in January of 2005 to significantly reduce morbidity and mortality in American health care. “[T]he idea of it was so outside the box,” she said. “How Don Berwick and team were able to do what they did at that time is amazing and the fact that we were actually able to show improvements still carries over.” She also assigns her students to take IHI Open School courses, which are accessible free of charge to students. She tells them, “You know, take advantage of the fact that you have an edu email.” Then, once they’ve been exposed to the site, they are aware of the resources there and can continue to take courses even after they’ve completed her class.
The Doctor of Nursing Practice program in which Maxworthy teaches is intended to produce nursing leaders, and many of her students are already accomplished clinicians. It’s highly rewarding to be able to teach people who are already experts in their field but eager to learn all they can about safety. “I’m amazed about how these very, very respected and highly regarded individuals, you put them in a seat and say, ‘You’re a student,’ and they just become these sponges... It's magical to see ...”
In the time since she first became passionate about patient safety, Maxworthy has seen mixed results. “‘To Err Is Human’ came out in ‘99, and we have not made as much progress as I think at that time we thought we would,” she said. She notes that the 100,000 Lives Campaign was a big step in the right direction—it “encouraged people to discuss outcomes without fear of sharing all the family secrets[.]” That made her think that serious change was coming, but it has not come as quickly as she’d hoped.
On the other hand, there has been a sea change in the way safety and quality are viewed. “[W]e have made inroads like the fact that patient safety and quality has just as much space on the board report as the financials,” Maxworthy said. Entities such as the Joint Commission and the Centers for Medicare and Medicaid Services (CMS) now see the value of quality and patient safety. Electronic health records have also contributed to changing the landscape of quality and patient safety. “The language of safety is much more part of our work now,” she said. “And always keeping the idea that patient safety is at the center, the patient’s always at the center of our work...it really does make a difference.”
You may be interested in:
CPPS: Certified Professional in Patient Safety
Patient Safety Essentials Toolkit