Becker's Clinical Quality & Infection Control

51 QUALITY IMPROVEMENT & MEASUREMENT 10 executives on quality improvement measures deserving more attention By Cailey Gleeson and Georgina Gonzalez T he COVID-19 pandemic has caused quality leaders to seek innovative solutions to not only maintain but reinvigorate quality efforts. is spring, on the heels of the omicron surge, many hospitals had more bandwidth to refo- cus efforts on quality improvement work. is compilation features guidance from leaders at 10 systems who shared insights with Becker's via email in late April and early May. Question: What is one quality improvement effort that deserves more attention and why? Cathy Duquette, PhD, RN. Chief Nursing Executive and Executive Vice President of Quality and Safety at Lifespan (Prov- idence, R.I.): One of the key drivers to top clinical quality and patient experience outcomes is full team member engage- ment in local quality improvement efforts. e COVID-19 pandemic created staffing and care challenges that made it difficult to maintain our focus on engaging our front-line team members in these import- ant efforts. As we emerge from the peak hospitalization demands of COVID-19 and as staffing moves toward stabilization, we are working to reengage with our front- line team members in owning, leading and driving changes needed to address patient experience and quality improvement oppor- tunities. One of our top priorities right now is improving the patient experience. We are focusing on bedside shi reports and other efforts that were unable to be sustained during the pandemic. Peter Silver, MD. Chief Quality Officer of Northwell Health (New Hyde Park, N.Y.): Although the inpatient surge from COVID-19 has passed, one thing that was clear from seeing which patients became so critically ill from COVID-19 was the in- equity in care delivery to minority patients in our communities. e issue, then, that deserves our most immediate attention is trying to eradicate these health inequities in every aspect of healthcare delivery. One notable component of this is the high rate of maternal mortality among Black women. Reducing this mortality rate by identifying and treating women at risk has become a major focus of Northwell's quality efforts going forward. We announced the launch of Northwell's Center for Maternal Health April 5, which will take a 360-degree approach to improving maternal health, working throughout the continuum of care and in the community to address health conditions that can occur from preconcep- tion through the first year aer delivery, as well as social determinants that raise the risk of those problems among Black women. Graham Snyder, MD. Medical Director of Infection Prevention and Hospital Epidemiology at UPMC (Pittsburgh): We are renewing our efforts to reduce central line-associated bloodstream infections. National surveillance has demonstrated a rise in CLABSI rates with the emergence of COVID-19. Due to the collective stress of a pandemic, disruptions to healthcare deliv- ery and healthcare workers' personal lives, and compounded by widespread staffing shortages, it has been more difficult than ever to maintain attention and diligence to infection prevention measures in every mo- ment of care. At UPMC, we are reempha- sizing evidence-based CLABSI reduction measures to push this healthcare-associated infection toward zero. Fritz François, MD. Executive Vice Pres- ident and Vice Dean, Chief of Hospital Operations at NYU Langone Health (New York City): e acuity of the patients who presented during the pandemic underscored the importance of maintaining quality standards and the need to address health inequities. With the launch of its Institute of Excellence in Health Equity, NYU Langone Health has extended its commitment to quality improvement and has been actively applying a health equity lens to those efforts to ensure excellent outcomes across patient populations. Lisa Maragakis, MD. Senior Director of Infection Prevention at Johns Hopkins Health System (Baltimore): One quality improvement effort that deserves renewed attention is prevention of central line-asso- ciated bloodstream infections. CLABSI is associated with patient harm through in- creased morbidity and mortality. It also pro- longs patients' length of hospital stays and increases healthcare costs. Aer a decade of improvement, CLABSI rates in the U.S. rose sharply, by about 30 percent, during the pandemic, according to the CDC. ere are likely several reasons for this including high patient volumes, increased patient acuity and intensive care utilization, disruptions to normal workflows, and burnout and high turnover among healthcare personnel. We need a back-to-the-basics approach that emphasizes the evidence-based best practices for CLABSI prevention. At Johns Hopkins Medicine, we are utilizing a mul- tidisciplinary team approach with well-de- fined CLABSI prevention roles to regain lost ground and reinvigorate CLABSI preven- tion to protect our patients from harm. Matthew Miller, DO. Associate Chief Quality Officer at Cleveland Clinic: e COVID-19 pandemic has highlighted the unfortunate, long-standing disparities in healthcare. ere are systemic changes that must be made in our delivery of care to achieve health equity. ere is no true qual- ity improvement without ensuring that our care is delivered equitably. Cleveland Clinic continues to shine the light on opportuni- ties for improvement around health equity — to identify disparities, map out the root cause(s) and design care interventions that reduce and eliminate disparities. Daniel Roth, MD. Executive Vice Presi- dent and Chief Clinical Officer at Trinity Health (Livonia, Mich.): An effort that deserves particular attention in American healthcare is the importance of health equity. At Trinity Health, we are exploring how we can proactively identify how our patients' social needs limit their ability to achieve health goals, and how we can con- nect the dots to address those needs. We are committed to this work so we better enable everyone to achieve their optimal health no matter their race, ethnicity, or socioeco- nomic status. Jeffrey Boord, MD. Chief Quality and Safety Officer at Parkview Health (Fort Wayne, Ind.): e experience of the pan- demic has highlighted the urgent need to focus on the safety and well-being of our workforce. Healthcare personnel bore the brunt of workforce-related injury and illness during the pandemic. Alongside the rise in COVID-19, the entire country saw an in- crease in incidents of incivility and violence directed at healthcare workers. According to the Bureau of Labor Statistics, the healthcare and social assistance sector saw a 40 percent increase in total injury and

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