Becker's Hospital Review

62 CMO / CARE DELIVERY MetroHealth's Dr. Brook Watts on getting to the next generation of quality By Anuja Vaidya B rook Watts, MD, chief quality officer at MetroHealth, has been overseeing the health system's experience initiatives for a year. Here, she discusses provider burn- out, missteps made in measuring healthcare quality and why it's important to acknowl- edge the lived reality of patients. Editor's Note: Responses have been lightly edit- ed for clarity and length. Question: What is your proudest mo- ment/achievement overseeing pa- tient experience for MetroHealth? Dr. Brook Watts: For us, the proudest mo- ment has been figuring out patient experience wasn't something separate from quality and safety. So, we have been working toward re- alizing that the perspective that patients pro- vide can give us a great lens and voice to help to improve the overall care that we provide. One of my favorite moments is engaging the patient and family advisory group as it regards quality and safety. Our patient and family advi- sory council meets monthly, and we have sever- al hundred volunteers who participate in more than 30 committees throughout the hospital. Q: What is the biggest threat to pro- vider experience today? How do you think it can be tackled? BW: We're all pretty aware of the challenges we have with burnout, which is now being reframed as moral injury. It's pretty clear that one of the greatest reasons for that has been the separation of provider experience from patient experience. And we know that health- care is a service that comes from the interac- tions of individuals, the system, science-in- formed practice and a provider. Together, those multiple streams produce healthcare. at is recent work from Paul Batalden, MD, with the Institute for Healthcare Improvement. I don't know if you've seen that beautiful visual of the braided cords of the patient, the system, the science-informed practice and the health- care provider co-producing healthcare as a service. I think it's really powerful because it speaks to burnout and moral injury. We measured healthcare from one dimen- sion. We measured it as though it were a product. [It was] very outcomes-focused. By doing that, we separated the process and the relationship of the providers, the system, the evidence and the patient from each other. And that's the opportunity, and that's how we are going to address provider experience. You can't address patient experience without ad- dressing provider experience and vice versa because we produce healthcare from the pa- tient, the system, science-informed practice and the provider. ey're all together. Q: How is MetroHealth planning to take patient experience to the next level in the next few years? BW: I think we're really working to acknowl- edge relationships, true relationships — trust, respect, kindness, empathy, truth-seeking — are necessary between patients and providers to really create action. To do that, we are start- ing to think more and more about that lived reality of our patients. And really acknowledg- ing that in healthcare one size doesn't fit all. A simplistic way [that we are integrating social determinants of health into care at MetroHealth] is screening patients, [and ask- ing] are things like housing or access to food impacting your ability to care for yourself ? ere was a recent [Journal of the American Medical Association] study that shows that when patients were provided with food, they took their diabetes medications more oen, Why would that be? Well, it's because if you have to choose between buying your food and buying your medications, which do you pick? Food. So when patients were given food, they actually had more income to be able to buy their medications, and their diabetes num- bers got better. We actually have a setup where we can write prescriptions for patients with chronic diseases to be able to go and get food. So healthy food is part of their chronic disease management. Q: In what ways do you think your role will change over the next five years? What excites you most, and what worries you most? BW: What's most exciting is that I really think we can do this: We can get to the next gener- ation of quality that really acknowledges that quality, safety and experience — and that's both provider experience and patient experi- ence — are the same thing. I'm a general internist. I see my colleagues, and there is so much burnout. ey are good people who want to take good care of patients, but a lot of things we've done in the system are getting in the way. And I believe fully that the cure for that, the way forward, is this next generation of quality, where we really think about healthcare as a service co-production. If there is any part of all this that makes me sad is that we have been pushing standards of measurement that really have caused an ar- tificial separation between the experience of providers, the experience of patients by sort of narrowing it down to just one dimension. e reality is that isn't healthcare. It got us in a bad situation, but I think there is a way out. n Trump signs exec order on flu shot development By Mackenzie Bean P resident Donald Trump signed an executive order Sept. 19 to modernize the flu vaccine development process. The order will create a task force to promote new technologies that im- prove vaccine manufacturing and effectiveness. The goal is to reduce the na- tion's reliance on egg-based vaccine production. "Improving the speed of production will enable experts to better match vac- cines to actively circulating viruses, an important piece of making the vaccines more effective," the Trump administration said in a news release. Along with streamlining vaccine production, the executive order also aims to boost Americans' access to seasonal flu vaccine services. n

• Cover