HQPS members also serve as leaders in national efforts to define and improve care transitions including the American Board of Internal Medicine’s Stepping up to the Plate program, and Hartford’s Safe Steps.
HQPS: New Horizons, New Leadership
By Janet Nagamine, MD
It is an honor to serve as the new chair for SHM’s Health Quality and Patient Safety (HQPS) Committee. Dr. Halasyamani has done a tremendous job of developing the committee and getting current initiatives under way. We will continue to support current initiatives with a emphasis on strengthening the relationships and alliances with partner organizations and hospitals so we can take our work from project-level initiatives to system-level initiatives.
System-Level Improvement
I am often asked by hospital administrators in all types of hospital settings, “How do I get physicians on board and engaged as a partner in our quality and safety initiatives?” My response is that many hospitalist physicians are already active members and leaders of committees and initiatives. Some hospitalists would like to be more involved but find little time because most hospitals lack an infrastructure conducive to making this happen.
Hospitals are our “office,” and we are invested in how well the hospital operates. Although it is common for hospitalists to participate on numerous committees, we often lack formal titles or ties to the Quality Department or formal organizational structure. The traditional hospital structure worked better when our role was limited to the occasional P&T committees or peer review, but our level of involvement has evolved into a much larger scope. We are now integrally involved in The Joint Commission Patient Safety Goals, Core Indicators, Pay For Performance, Get with the Guidelines, Rapid Response Teams, Glycemic Control and VTE Prophylaxis initiatives—to name a few.
It is hard to make a significant impact when you rely solely on volunteer committee time to do the work on major initiatives like medication reconciliation, which crosses many department lines. While I wholeheartedly believe it is our professional responsibility to take interest in and volunteer on committees, the scope of the work to be done makes this model unsustainable. hospitalists spend long hours (often 12 hours a day) taking care of acutely ill patients, which leaves little time to develop initiatives, attend meetings, and implement the work of major quality and safety efforts. Yet they are still very involved.
Alignment and support at the organizational level are critical to physician engagement and success in quality improvement and patient safety efforts. Many hospitalists spend numerous hours trying to get initiatives off the ground, only to hit a stumbling block and not succeed. Experiences such as these will certainly affect their willingness to participate in future initiatives. While most hospital administrators and staff find that hospitalists have greatly improved the work environment, we can find better ways to create opportunities for system-level improvement. TH