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The Continuous Evolution of Leading Quality Improvement

Why It Matters

“Quality leaders can be catalysts for improving patient outcomes tied to quality, patient safety, and patient experience.” 

The Continuous Evolution of Leading Quality Improvement

James Moses, MD, MPH, is keenly aware that the world of health care is ever evolving. During a recent interview with the Institute for Healthcare Improvement (IHI), the Chief Quality, Safety, and Experience Officer of Corewell Health (Grand Rapids, Michigan, USA) listed some of the many challenges faced by health care leaders in recent years: COVID, financial pressures, health equity, and artificial intelligence (AI) just for starters.

“We’re not living in a static world,” he said. This has meant chief quality officers (CQOs) like him have had to “constantly develop expertise and skills we didn’t have when he started.”

Moses cited the potentially transformative power of AI as an example. “I think AI can be a tool to uplift quality and patient safety outcomes,” he said. He pointed to AI’s potential to meaningfully address broken and unnecessarily burdensome workflow processes that contribute to clinician burnout.

“When I do a shift as a pediatrician and admit even one patient,” he explained, “I deal with probably 30-plus workarounds to do that admission safely.” Using AI to safely streamline those processes “would get clinicians back to the bedside, which is where we need to be,” Moses said.

His enthusiasm is clear, but Moses is also humble about how much there is to learn. “I’m excited about [AI’s potential],” he said, “but am I an AI expert? No. Do I have to dive in and try to fully understand to the best of my personal abilities how AI can be both a solution but also a risk for an organization? I do. That’s my responsibility.”

“We are at a unique moment in health care,” he continued. “We have to learn how to harness AI and do it in a safe way.” He added, “I think the chief quality officers nationally have a major role to play in making sure that we leverage AI for good.”

Quality Leaders as Catalysts

Moses is enthusiastic about the range of important roles and responsibilities quality leaders like chief quality officers have in a health care organization or system. “Quality leaders can be catalysts for improving patient outcomes tied to quality, patient safety, and patient experience,” he remarked. He added that it is crucial for CQOs to partner with other leaders across an organization to reach shared goals.

Not all organizations have CQOs, but the role has become more common in the last decade or so. As faculty for the Institute for Healthcare Improvement (IHI) Chief Quality Officer Professional Development Program, “We see leadership teams across all of health care recognizing the utility of having someone who’s an expert in quality and patient safety as well as patient experience,” Moses noted. “I think more health care leadership teams are identifying chief quality officers as helpful to their mission.”

Moses remarked that the improvement expertise of quality leaders can be especially helpful as organizations plan for and respond to change within their institutions and in their health care environment. “Improvement capability is one of the engines of change and transformation,” Moses noted. To engage in efforts to improve at scale, “You can't have only two or three individuals who are experts trying to go to 21 different sites,” he explained. “I've always believed that improvement is best done by local leaders championing with their teams’ specific initiatives that are relevant to them.” With his guidance, Corewell Health has invested in building the quality improvement (QI) capability and capacity of staff across their organization.

For Corewell Health, investing in their improvement infrastructure has meant engaging IHI to “train the trainers” on QI and to leverage IHI Open School courses to expand their asynchronous learning opportunities. These efforts have been especially helpful as Corewell has been managing the changes and opportunities brought by a merger two years ago. They have found that having a shared understanding of their goals and how to meet them has been invaluable.

“It’s important when different cultures come together that they have a common language,” Moses said. “Focusing on quality, safety, and patient experience can bring disparate cultures within a merger and acquisition or a rapid growth situation together and give us our true north, our common purpose. We all agree we shouldn’t be harming patients.”

Alongside the many challenges of their merger, Corewell Health also valued the opportunities it offered. “We have best practices from all our regions,” Moses noted. “How can we in quality be the catalyst of bringing those together and then supporting spread and scale? That can only happen by building out improvement capability for the whole organization.”

Addressing Health Equity: The Quality Leader’s Role

Moses began his quality career at Boston Medical Center (Boston, Massachusetts, USA), an organization known for addressing health disparities, so he is not new to thinking of health equity and quality improvement as intertwined. He is clear that quality leaders are essential to any team effort to address health equity. “We understand quality measurement. We understand measurement for improvement, and we can play a meaningful role within the clinical arena specifically to help address gaps,” he stated.

He is also clear about the need for quality leaders to be intentional about designing improvement so that all patients benefit from the interventions tested and implemented. Instead of assuming all improvement reaches all patients, “We need to ask ourselves how we need to modify our quality improvement methodology to embed an equity lens,” Moses stated.

Though he recognizes the challenges, Moses is motivated, rather than daunted, by the need to embed equity into quality and how he sees quality leaders and equity leaders coming together at the behest of more health care executives. “It’s been an amazing transformation that we’ve seen in all health care, an awakening,” he described. “It's one of the more exciting things that has happened in health care in the last few years. We obviously have a lot of work ahead of us, but I’m glad that we’re at least recognizing the need. Now we have to figure it out.”

Photo by Francisco J. Villena | Unsplash

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Join an informational call with faculty for the Chief Quality Officer Professional Development Program (United States) on Tuesday, June 11, 2024, at 1:00 PM ET. Register now to secure your spot.

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