In the health system of the future, there are multiple opportunities for clinical care improvement and reform such as patient safety and quality improvement.
Editor's note: This article is based on a recent chief medical officer roundtable discussion. The full report, Clinical Care: Opportunities for Improvement and Reform, is available as a free download.
Clinical care is a hotbed of innovation in the healthcare sector. There are not only opportunities for improvement and reform, but also a shift in the delivery of care from the inpatient setting to the outpatient setting.
Quality improvement and boosting patient safety are primary objectives for clinical leaders, says Julian Schink, MD, chief medical officer of Boca Raton, Florida-based Cancer Treatment Centers of America. "This is our day-to-day job. This is our No. 1 priority: quality and safety within our workspace. I look at it as three spheres. There are the tools that make it easier for us to be safe and practice quality medicine. There are the incentives to practice quality medicine. Then there are the barriers."
At healthcare organizations, establishing a just culture is foundational for patient safety, says Sarah Garber, MD, chief medical officer of the Swedish Medical Center Ballard Campus in Seattle.
"Part of a just culture is reporting problems. Physicians and other caregivers need to be able to report on themselves, and they need to feel that they will be supported by colleagues and the organization. We are all human and we all make mistakes—we all need to be able to step back together to acknowledge that. If caregivers feel that they can raise their hands in the moment and say, 'I see a problem,' that would be a huge opportunity and a place to improve before bad things happen to patients," she says.
With the rapid expansion of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic, healthcare leaders need to be cognizant of patient safety and quality challenges, says Joe Kimura, MD, MPH, chief medical officer of Newton, Massachusetts–based Atrius Health.
"We do need to understand where telemedicine strategies could raise patient safety or quality of care issues. The recent Science publication highlighting racial bias in risk stratification algorithms shows where unintended care disparities may be propagated as we funnel more and more care through digital platforms. For the broad use of telehealth during the COVID-19 pandemic, there are questions about the quality of communication and the interaction between clinicians and patients. While it may seem natural and easy, it may take people time to learn how to best use this mode of care appropriately," he says.
The ongoing shift of care delivery from the inpatient setting to the outpatient setting also raises patient safety concerns. Patient ownership of care is a significant factor in outpatient care safety, says Donald Whiting, MD, chief medical officer of Pittsburgh-based Allegheny Health Network. "In the outpatient setting, safety is much more about the patient and their family's ownership of safety. You aren't watching them as inpatients, and patients are just starting to really want to own their own health, particularly the younger generation."
View the complete HealthLeaders CMO Roundtable report Clinical Care: Opportunities for Improvement and Reform.
Christopher Cheney is the senior clinical care editor at HealthLeaders.