Becker's Hospital Review

24 CLINICAL LEADERSHIP MSU Health Care's CMO on the biggest barrier to sustained quality improvement By Erica Cerutti B urnout and disengagement among clinicians remain one of the biggest barriers to sustained improvements in quality and patient safety, according to Mark Smith, MD, chief medical officer of East Lansing, Mich.-based MSU Health Care. Dr. Smith, who stepped into the role in February, said addressing workforce wellness and engagement will be central to advancing clinical quality across the organization. As CMO, he oversees quality, safety, risk management and clinical alignment across MSU Health Care's academic faculty practice. e focus reflects a growing recognition across healthcare that clinician well-being is a critical driver of quality and patient safety. Research has linked clinician burnout to higher rates of medical errors, lower patient satisfaction and worse outcomes. In an interview with Becker's, Dr. Smith discussed how MSU Health Care is approaching team culture, clinician recruitment and the operational changes needed to support continuous improvement in quality and safety. Editor's note: Responses have been lightly edited for length and clarity. Question: You stepped into the CMO role in February with oversight of quality, safety, risk management and clinical alignment. Looking ahead to early 2027, what's one specific improvement you'd like MSU Health Care to be able to point to that would signal meaningful progress under your leadership? Mark Smith: Any time you start a new position, you're in assessment mode. I don't want to make any drastic changes until I understand the landscape — what works, what doesn't and what do we need to enhance. In general, from what I've learned in the first month that I've been here, is that we really have an opportunity to take each clinical service, flatten it down and make it about the patient and community needs. We have two medical schools and a nursing school at MSU, and every school has its own way of doing that clinical service. So there's an opportunity to collaborate together, put the patient in the center and say, let's provide a primary care clinical service, for example, that supports our community need, supports the market need and supports access. We need to put the patient in front of the needs of the individual colleges and look at it holistically. Q: Part of your role is also fostering stronger collaboration across physicians, nurses and other members of the care team. What strategies are you planning to put in place to strengthen that collaboration, particularly as care delivery becomes more complex and multidisciplinary? MS: It's about the team. A good team needs to have a strong culture of trust. You need to know that your teammate is doing the job they were supposed to do, and doing that to the best of their ability. at means that you don't get in the business of that other person's job, right? You stay in your lane, and you do your job. And that trust factor needs to be built. We have a lot of opportunities related to having those folks coordinate care so they're not doing duplicative work or embracing technology so that the work is easier or more efficient. Administration needs to support the team in that way, but the team itself needs to also develop that culture of safety and trust. It's okay to question why we do things. It's OK to say, 'Stop the line. I don't understand this. I'm afraid there's a patient safety issue.' at culture needs to be developed so that people really trust that we're heading all in the same direction. ey also need to understand that they're part of a team that is bringing a bigger value proposition for that patient. In other words, each individual team member has a role, but that role along with all the other roles of the jobs that people do in combination have exponential value for the patient. Q: Every health system is under pressure to advance quality and safety while managing workforce and financial constraints. What do you see as the single biggest barrier to sustaining continuous quality and patient safety improvement right now — and how are you working to address it at MSU Health Care? MS: is is not just germane to MSU health care. It's burnout and it's a lack of wellness in folks' jobs that leads them to want to make a move. Or they're not as engaged as they could be. at's probably one of the biggest opportunities for us to address. Pay is only one part of that. Everyone's focused on how much does my job pay me? But there are many other aspects that can disengage folks, including culture, the type of working relationship you have with your colleagues, or even how far you are away from work and the area that you live. It all contributes to your overall wellness. As administrators, within what we can control, we need to focus on making it easier for everyone to do their job — decreasing administrative burden, and helping them understand that we're developing a continuous change and processes that provide meaningful change. We need to embrace technology to make our jobs easier. Q: A recurring challenge we hear from clinical leaders is that recruiting specialists has become especially difficult — that it increasingly feels like a race to the top, where top-tier talent flows to the systems that can offer the most compensation. How does MSU Health Care navigate this? Beyond pay, what differentiators have proven most effective in attracting or retaining top clinical talent? MS: Pay is definitely a big part of it. Fortunately or unfortunately, we have something called "fair market value" that keeps us whole related to how much we can offer in the markets that we have. We try to stay within the ranges that are accurate for the area we're recruiting in, but in some clinical services, you just can't find people and you do end up having to pay a bit more. But there are other qualities of a job that make that job attractive. Culture, I'll go back to. Luckily, MSU Health has an academic faculty practice, so we can offer an academic relationship with a clinical relationship with a research relationship. All three entities of that job can have different [full- time equivalent] fractions, meaning someone may want to focus more on research and do less clinical. We can play with those in a way that makes sense for them and also aligns with what our institution needs. at allows us to be a little creative. We also have to understand what people are looking for before we go down the pathway of, "Here's our job offer." Do you want to work in a rural area? Do you want to work in an urban area? Do you want to live on a lake? All of these things are important from a wellness perspective and you want to understand which things you can deliver on. And if you can't, you just have to be honest with people. You don't want to portray something that you can't deliver on. It's difficult, but I think culture and designing a job that people really want to come to, and an environment where they feel part of an enterprise that's doing good for patients and their community, is crucial. n

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