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Who's Responsible for Quality?

Cheryl Clark, for HealthLeaders Media, May 13, 2011
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Many in hospital senior leadership have gotten the message about quality. If it’s not happening already, your hospital or health system is about to be judged on it, and ultimately, reimbursed for it.

In response, many hospital leaders have implemented quality programs of varying size and scope. Most have a staff of several clinical workers, coders, and executives. But has a critical executive decision been overlooked in the drive toward quality?

Patrick Falvey, Aurora Health Care’s chief integration officer, has been working in quality for many of his 20 years in the organization. Aurora bolstered its quality improvement back in 2003 under the CMS/Premier Hospital Quality Incentive Demonstration, which ended in 2008. Falvey, who was instrumental in achieving buy-in from the system’s 1,400 employed physicians for the program, perhaps owes his position as chief integration officer at Aurora to some lessons learned from the HQID experience.

“Our quality improvement at the time was known around here as relentless incrementalism,” he jokes, explaining that many organizations came to that program for “one of two reasons, either they knew you were performing well or their CEO volunteered you, which is what happened with us.”

He notes that Aurora—with its 15 hospitals in and around Milwaukee—was below average when benchmarked against Premier’s better-performing organizations. “Our CEO didn’t just sign us up to participate, but he wanted to look at accountability,” says Falvey.

He says at the time, Aurora boasted a well-developed quality improvement team, but the challenge was that the quality team was responsible for the results.

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