Becker's Hospital Review

25 QUALITY IMPROVEMENT & MEASUREMENT 3 tips for engaging physicians in quality improvement By Mackenzie Bean E ngaging physicians in quality improvement work can help prevent them from feeling a loss of control in medicine, which is often cited as a contributing factor to burnout, two physicians wrote in a blog post for Health Affairs. Lisa Rotenstein, MD, a resident at Boston-based Brigham and Women's Hospital, and Amanda Johnson, MD, a primary care physician at New York City-based NYC Health + Hospitals, argue that methods to promote organiza- tional improvement can therefore also alleviate provider burnout. Three ways hospitals can engage physicians in improvement efforts: 1. Ensure open communication with providers and allow for collaborative decision-making during team huddles. 2. Train physicians in basic improvement methodology to give them the skills to improve their daily work environments. 3. Give physicians time to work on improvement initiatives and measure the associated impact on employees. "Among the many strategies being tested, giving physicians back control over their environments through provision of improvement skills and oppor- tunities to engage in improvement can not only be uniquely empowering but also enhance our systems of care," Drs. Rotenstein and Johnson concluded. n Open communication limits medical errors' adverse effects, study finds By Mackenzie Bean H ealthcare providers should use open communication when disclos- ing medical errors to limit adverse outcomes such as healthcare avoidance or loss of trust among patients, according to a study published in BMJ Quality & Safety. For the study, researchers surveyed 253 Massachusetts patients in 2018 who had experienced a medical error in the past six years. Researchers used six questions to determine whether providers used open communication when sharing these medical errors with respondents. Among individuals who experienced a medical error three to six years ago, 51 percent reported continued emotional effects, such as depression or feelings of betrayal. Fifty-seven percent said they avoided the clinicians or organizations involved in the error, and 67 percent reported a loss of trust in healthcare. Respondents who reported the most open communication demonstrated lower rates of persistent sadness, depression or feeling betrayed. Research- ers also noted a link between open communication and less avoidance of physicians or healthcare organizations. The implementation of communication and resolution programs could help healthcare providers have more open conversations with patients to mitigate these adverse effects, researchers concluded. n Viewpoint: Why hospitals should invest in clinician-led quality improvement By Mackenzie Bean H ospitals can instill more mean- ing in clinicians' work and achieve better quality outcomes by investing in clinician-led improve- ment efforts, one physician leader wrote in an op-ed for STAT. Lara Goitein, MD, ser ves as medical director of clinician-directed perfor- mance improvement at Santa Fe, N.M.- based Christus St. Vincent Regional Medical Center. A few years after Dr. Goitein joined Christus St. Vincent in 2011, the hospital rolled out a clinician-directed performance improvement program that offers front-line clinicians paid protected time to work on quality im- provement projects. Each ser vice line designates a "clinician dyad" to oversee improvement projects, which usually comprises a physician and nurse who don't practice full time. In the program's first four years, clinician dyads finished more than 40 improvement projects at a 92 percent success rate. Over that same period, the hospital's CMS star rating jumped from two stars to five. The projects also led to lower rates of hospital-acquired infections, adverse drug events and sepsis deaths, while boosting clinician morale, according to Dr. Goitein. "Any hospital — not just large, affluent or academic medical centers — can make meaningful investments in clinician-led quality improvement," she wrote. "The greatest challenge is to make the leap of faith in which the or- ganization commits to truly supporting its clinicians' quality priorities." n

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