A recent study found that measures of physical function, such as grip strength and gait speed, are strongly associated with hospital readmission risk.
CMOs looking to reduce costly hospital readmissions should pay closer attention to their patients’ physical activity in the hospital.
According to recent research, physical function impairments can help predict the risk of readmission. Addressing them could help healthcare leaders reduce readmissions within 30 days—and the reimbursement penalties of up to 3% that can come from the Centers for Medicare & Medicaid Services for those returning patients.
"If you talk to CFOs, they will tell you that the margins are thin in treating Medicare patients, and it is hard to give back 3% of your reimbursement," says John Romano, acting CMO of Fremont, California-based Washington Health.
ZoomCare is confident that it can make serving Medicare beneficiaries financially sustainable.
While some clinics and physician practices are withdrawing from serving Medicare beneficiaries, Tigard, Oregon-based ZoomCare is doubling down on Medicare services.
The Centers for Medicare & Medicaid Services have been scaling back on reimbursement for Medicare services, most recently implementing a 2.8% reduction in physician reimbursement as part of the 2025 Physician Fee Schedule. Physician reimbursement from Medicare decreased 29% from 2001 to 2024, according to the American Medical Association.
The reimbursement reductions have driven some clinics and physician practices to stop serving Medicare beneficiaries, but ZoomCare is bucking the trend.
The 47-clinic organization launched serving Medicare beneficiaries in December in part because patients demanded it, according to Mark Zeitzer, MD, CMO of ZoomCare.
"As patients aged and entered Medicare, they were frustrated that they could not see us anymore," Zeitzer says. "It was important for us to take on that population and do it in a high-quality, effective, and efficient way."
ZoomCare also took on serving Medicare patients because it strives to work with other healthcare providers in Oregon and Washington, Zeitzer explains.
"Serving Medicare patients fits with our commitment to partnership," Zeitzer says, "we want to work with other healthcare providers."
ZoomCare provides primary care and urgent care. It also has three emergency care clinics and offers specialty care, including dermatology, women's health, mental health, and podiatry.
Investing in technology
In July, the clinic network invested in a new electronic health record, athenaOne, as part of the effort to serve Medicare beneficiaries and to work effectively with other healthcare providers.
"What's important is that our system connects efficiently and effectively with other systems," Zeitzer says. "You cannot operate in a silo."
Additionally, athenaOne is Medicare-certified, which was not the case with the homegrown EHR that ZoomCare had been using since 2006.
"Medicare certification is a difficult and onerous process, so an off-the-shelf solution like athenaOne was helpful to achieve that certification," Zeitzer says. "If we had tried to get Medicare certification with our homegrown EHR, it would have taken about three years."
Making Medicare services financially sustainable
ZoomCare is confident that it can make serving Medicare patients work financially and sustainably, according to Zeitzer.
"Thousands of people age into Medicare every day—it is an important population," Zeitzer says. "These are often complicated patients, but there are many things we can do to prevent problems down the line and maximize their healthy years."
Managing costs is an essential strategy to serve Medicare beneficiaries, Zeitzer explains.
"We believe that by making healthcare easy and accessible we can reduce costs," Zeitzer says. "By being able to see more Medicare patients and being able to maximize preventative services working with Medicare Advantage contracts, we believe we can serve these patients at a low cost in an efficient and effective way."
Access is pivotal, according to Zeitzer.
"If you can get into your provider, your overall health will be better, you will have less side effects, and you will have lower costs," Zeitzer says. "For example, if you can keep hemoglobin A1C scores low and keep Medicare patients who have diabetes healthier, having more frequent touch points with patients helps to make care cheaper."
Centralizing business functions and clinical services is another way ZoomCare is prepared to serve Medicare beneficiaries, Zeitzer explains.
For example, ZoomCare has a centralized team of nurses that process prior authorizations, and there is always a physician on call to answer questions from doctors and advanced practice providers about complicated cases, Zeitzer says.
A recent study found that measures of physical function, such as grip strength and gait speed, are strongly associated with hospital readmission risk.
CMOs looking to reduce costly hospital readmissions should pay closer attention to their patients’ physical activity in the hospital.
According to recent research, physical function impairments can help predict the risk of readmission. Addressing them could help healthcare leaders reduce readmissions within 30 days—and the reimbursement penalties of up to 3% that can come from the Centers for Medicare & Medicaid Services for those returning patients.
"If you talk to CFOs, they will tell you that the margins are thin in treating Medicare patients, and it is hard to give back 3% of your reimbursement," says John Romano, acting CMO of Fremont, California-based Washington Health.
The recent research, which was published by the Journal of Hospital Medicine, features a systematic review of 17 studies representing 80,000 patients.
The study includes several key findings:
Patients with chronic obstructive pulmonary disease are 10 times more likely to be readmitted within 30 days if their grip strength is weak, compared to patients with normal grip strength.
Impaired gait speed is one of the strongest predictors of readmission risk among patients undergoing transcatheter aortic valve replacement.
Impairments in daily living activities were associated with a higher number of 30-day hospital readmissions among Medicare beneficiaries with a cancer diagnosis.
Hospitalized patients at least 75 years old with low mobility, such as those limited to their beds, are twice as likely to be readmitted within 30 days, compared to those patients who can walk on their own.
Patients with deficits in instrumental activities of daily living (IADL), such as managing a trip to the grocery store, face higher risk of readmission, according to two studies. One study estimated a 17% higher chance of readmission for patients with any IADL limitations as compared with those with no limitations.
"Functional impairments are robust predictors of hospital readmissions in older adults," the journal article's co-authors wrote. "Routine assessment of physical function during hospitalization can improve risk stratification and may support successful care transitions, particularly in older adults."
Why physical function is linked to readmission risk
Physical function reflects the status of several body systems, the lead author of the journal article says.
"Physical function tells us a lot about the musculoskeletal system and the cardiovascular system as well as a patient's cognitive status and psychosocial well-being," says Erin Thomas, PT, DPT, associate professor of practice at The Ohio State University College of Medicine‘s School of Health and Rehabilitation Sciences. "Physical function gives us a lot of insight, and when physical function is compromised, patients are at higher risk for readmission."
Romano says hospitalization can compromise a patient’s physical function.
"We know that movement and activity both promote health," he says. "Hospitalized patients are inherently at risk of physical decline due to their medical needs and their need for bed rest most of the time. Hospitals are a disruptive environment for rest and recovery. For example, you can get awakened early in the morning for blood draws."
At Washington Health, which includes a 415-bed acute-care hospital, Romano says about 60% of the hospital's patients automatically work with physical therapists. That figure is likely to increase, he says, with the findings of the journal article and other research.
"Now, there are more and more protocols for post-surgical care to optimize early mobility because we know that if patients stay in bed they are not going to get well," he says.
Measuring physical function
Thomas says there are many ways to assess physical function.
"You can look at strength," she says. "You can look at mobility issues such as walking. You can look at how a person is able to handle their activities of daily living such as managing bathing and dressing. The are many opportunities for clinicians and nurses to look at physical function and to think inter-professionally about physical function."
Given the research, Thomas and Romano say, hospital leaders should prioritize assessing physical function during a hospital stay.
"An important finding of our study was the importance of routine measurement of physical function," Thomas says. "In addition, you need to recognize that physical function is like a vital sign. We should be checking physical function early and frequently during a hospitalization. This can help identify patients who are at risk for readmission."
"We want to be able to identify the deficits, then provide the tools for measurement similar to lab tests for diabetes, where you measure the blood sugar," Romano says. "You measure to understand what the problem is initially. Once you identify the problem, you apply modalities to improve it."
Improving transitions of care
Understanding a hospitalized patient's physical function impairments can also improve transitions of care, Thomas and Romano say.
"Knowing about physical function impairments helps us to plan and think about where an individual should go after a hospitalization," Thomas says. "It helps us make sure we are making the right decisions for post-acute care. For some individuals, it may not be safe for them to go home. They might need to go to a skilled nursing facility or a rehab facility."
"When a patient is discharged, we have a case manager who looks at all of the patient's needs and recommends to the attending physician what to order for the patient's post-hospitalization," Romano says. "Now, because we have measures of physical function, we can apply that same process for the patient's activity needs."
Health systems and hospitals should have social media policies but should avoid limiting protected speech, a legal expert says.
Social media can be a powerful tool for CMOs, other healthcare leaders, and physicians. However, there are pitfalls.
A recent pitfall example is a wrongful termination lawsuit filed in North Carolina by a pharmacist who had complained on LinkedIn about inadequate staffing at her hospital and its corporate parent, HCA Healthcare. The lawsuit claims the pharmacist was fired to silence her and cover up staffing shortages at Mission Hospital in Asheville, North Carolina.
The firing of the pharmacist puts Mission Hospital and HCA Healthcare in legal jeopardy. According to Amanda Hill, JD, founder of Hill Health Law Group, health systems and hospitals should have social media policies, but there are limits to restricting speech on social media platforms.
"There is a fine line in setting rules," Hill says. "That is why you should have your social media policy reviewed by legal counsel. Sometimes, organizations go too far. They say you cannot talk about your pay and workplace conditions. But that is protected speech."
Health systems and hospitals should have social media policies but should avoid limiting protected speech, a legal expert says.
Social media can be a powerful tool for CMOs, other healthcare leaders, and physicians. However, there are pitfalls.
A recent pitfall example is a wrongful termination lawsuit filed in North Carolina by a pharmacist who had complained on LinkedIn about inadequate staffing at her hospital and its corporate parent, HCA Healthcare. The lawsuit claims the pharmacist was fired to silence her and cover up staffing shortages at Mission Hospital in Asheville, North Carolina.
The firing of the pharmacist puts Mission Hospital and HCA Healthcare in legal jeopardy. According to Amanda Hill, JD, founder of Hill Health Law Group, health systems and hospitals should have social media policies, but there are limits to restricting speech on social media platforms.
"There is a fine line in setting rules," Hill says. "That is why you should have your social media policy reviewed by legal counsel. Sometimes, organizations go too far. They say you cannot talk about your pay and workplace conditions. But that is protected speech."
While physicians and other healthcare professionals can air grievances on social media platforms, they should be cautious, Hill explains.
"You need to tread lightly," Hill says. "A lot of physicians get too cavalier with sharing their workplace stories online. There are a lot of eyes and ears on the Internet—people can have a false sense of privacy that things are not going to be screen shot or shared."
Particular care should be taken when airing grievances about patients. Identifying patients on social media without their permission is forbidden by the Health Insurance Portability and Accountability Act.
"Sometimes, doctors think that they are not using a patient's name or date of birth, so posting is not a problem," Hill says. "But there are many ways you can identify a patient in a social media post. … You just need to be cautious when you are talking about patients because if you identify a patient, it can turn into a train wreck."
Physicians and other healthcare professionals should refrain from airing grievances on social media platforms, says Jennifer Khelil, DO, MBA, executive vice president and chief clinical officer at Virtua Health.
"It is not a good idea," Khelil says. "I would never recommend for a physician to air grievances on social media. There are ways of dealing with grievances in a respectful way. People need to remember that anything that is put out on a social media platform is there forever."
Physicians have other options to address grievances such as internal processes at health systems and hospitals, Khelil explains.
"Physicians should use the processes and resources that are available to them to address grievances," Khelil says. "Social media is not the place to do that sort of thing."
How healthcare leaders can leverage social media
However, there are several good uses of social media for CMOs and other healthcare leaders, Hill and Khelil say. For example, social media can be used to provide inspiration.
"If you get on social media as the CMO of a hospital, you can share your heart and where your mission lies," Hill says. "Instead of being seen as sitting in an ivory tower as an administrator, you can go on social media and talk about issues that matter to the community."
Social media was a helpful communication channel during the coronavirus pandemic in a time when there was a lot of misinformation, according to Khelil.
"There were shortages of COVID-19 tests and personal protective equipment," Khelil says. "People were distressed. We created videos that we put on social media to inform the population and let people know how we were handling things such as testing."
During the pandemic, social media enabled Virtua Health to "take the temperature down for our patients," Khelil explains.
"Social media was a way for patients to get information in a modality they felt comfortable with and in a time that was convenient for them. It opened lines of communication," Khelil says. "Using social media, we were able to reach thousands of people and give them information that they were seeking."
Social media is great for CMOs and other healthcare leaders whenever there is something big going on such as an infectious disease outbreak, according to Khelil.
"It is in real time. I can record something, and it can be out to the public in 15 minutes," Khelil says. "Any time there is a health emergency, social media is helpful. We have used social media to communicate with our patients when we have had insurance complexities—we were able to reassure patients that we were still here for them despite the insurance complication."
Social media uses to avoid
CMOs and other healthcare leaders should avoid some uses of social media, Khelil and Hill say.
Leaders should not post anything that would jeopardize patient confidentiality or patient safety, according to Khelil.
"The main thing is to remind leaders that when they are using social media in a professional capacity, they are speaking on behalf of the organization," Khelil says. "Leaders should also partner with the marketing team—it is important to have a collaborative relationship with people who are experts in social media."
CMOs should avoid polarizing topics on social media platforms, Hill explains.
"CMOs and other healthcare leaders should avoid commenting on politics or religion, unless they are comfortable with the backlash," Hill says. "They should stick with the mission of their organization without making it political. The more polarizing you are on social media, the more anger you are going to generate from one side or the other."
Healthcare organizations need to encourage physicians who are struggling with burnout or mental health issues to seek help.
In this episode of HL Shorts, we hear from Thomas Campbell, chief wellness officer at Allegheny Health Network, about ways to reduce the stigma that physicians face for burnout and mental health issues. To view the episode, click on the video below.
There are several opportunities to introduce AI tools into operating rooms.
Up to this point, AI tools are not being widely used during surgical procedures. The technology has made more of a splash in the pre-operative and post-operative settings.
However, Miami Cardiac and Vascular Institute, part of Baptist Health South Florida, is examining ways to introduce AI tools into the operating room. Tom Nguyen, MD, chief medical executive of Miami Cardiac and Vascular Institute, says his surgeons are using an AI tool to generate risk profiles for their patients.
Historically, according to Nguyen, they had risk calculators that could use the patient's age, comorbid conditions, and other factors to determine a risk profile after the patient had surgery.
"Those risk calculators did not take into account the patient's Zip code, the particular surgeon, the time of the surgery, and a host of other factors," Nguyen says. "AI can use machine learning to predict more outcomes."
Risk calculators that use regression analysis to generate risk profiles have been available for more than a decade, but the AI tool that Miami Cardiac and Vascular Institute is using is more powerful, according to Nguyen.
"Unlike regression models," Nguyen says, "AI can add more variables and personalize the predictive risk for each individual patient."
AI has taken hold in the perioperative arena, according to James Blum, MD, chief health information officer at The University of Iowa.
Ahead of surgery, some surgeons are using AI for imaging to look for defects or tumors that have metastasized, Blum says.
"After surgery, there is monitoring in the hospital with predictive algorithms for people suffering deterioration," Blum says. "There is also remote patient monitoring that is being used after sending surgical patients home with algorithms that can show when they are getting into trouble."
AI opportunities in the operating room
In the future, AI will assist surgeons during procedures, according to Blum and Nguyen.
"We have worked with a company that uses AI to make surgeries safer," Blum says. "Essentially, this AI tool monitors things that are going on during an operation and provides feedback."
AI will help anesthesiologists in the operating room as well, Blum explains.
"There are technologies being used in Europe to maintain the blood level of the anesthetic and calculations for individual patients," Blum says, "particularly if an anesthetic is being given as an IV infusion."
In the future, the da Vinci robot will likely have AI features that could make it a better assistant to the surgeon, according to Blum.
Nguyen is bullish on the future of AI tools in the operating room, particularly in robotics.
"Just as with automated driving, you could have AI do almost automated procedures," Nguyen says. "There have been studies to use AI to watch an operation then alert the surgeon not to take a certain action or alert the surgeon that they are doing something out of sequence."
One of Nguyen's responsibilities is looking for opportunities to improve operational efficiency, which could be a near-term application of AI at Baptist Health South Florida.
"We are working with some companies that have AI technology that will help us understand our current operational efficiency, understand where the gaps are, and help guide us to become more efficient," Nyugen says.
Miami Cardiac and Vascular Institute is exploring AI technology that could manage the counting of supplies in the operating room, where every single sponge and needle must be accounted for. The concern is that an object could be inadvertently left inside a patient.
"Those counts are done by people," Nguyen says. "Every time you rely on a person, you are subject to variability and subject to inaccuracy."
According to Nguyen, there is a piece of AI technology that involves using a camera that takes pictures of all the needles and counts them. In complex cases that can have as many as 300 needles, the technology can be a big help.
"If your count is wrong, you must go around the room and try to find the missing needles," Nguyen says. "You may have to take an X-ray to make sure you did not leave a needle in the patient's body."
Nguyen is excited about AI, and he believes it will transform medicine.
"We need to approach it with cautious optimism," Nguyen says. "We need to have components in place to ensure that AI does not spiral out of control."
Considerations for AI adoption in the surgical realm
When adopting AI tools in the surgical setting, healthcare organizations must make sure that patient information is secure, according to Nguyen.
"In using AI, you use many data points for each patient," Nguyen says. "Something we are very cognizant of and have committees adjudicate is how we use patient information."
Additionally, healthcare organizations should not impose AI tools on their surgeons, Blum explains.
"You need to understand your surgeons' needs, and you need to understand their pain points," Blum says. "You should avoid finding a tool, acquiring it, then telling surgeons to use it."
Healthcare organizations should find an AI solution and pair it with a surgeon champion, according to Blum.
"The best way to adopt AI technology in the surgical field is to have the right technology with the right surgeon," Blum says, "who can then champion that technology throughout the organization."
The new chief clinical officer of Virtua Health shares her best practices for creating residency programs.
Jennifer Khelil, DO, MBA, led the creation of residency programs at Virtua Health before becoming the health system's chief clinical officer.
Khelil was promoted to executive vice president and chief clinical officer of Virtua early this month. She had served as CMO of the health system since 2019 and was previously vice president of medical affairs starting in 2013.
Virtua has added several residency programs to the institution over the past five years, including residencies in family medicine, internal medicine, obstetrics and gynecology, surgery, and psychiatry. The health system has a fellowship program in cardiology and will be adding an anesthesiology residency program.
The southern New Jersey health system has quadrupled the size of its residency programs over the past five years.
Jennifer Khelil, DO, MBA, led the creation of residency programs at Virtua Health before becoming the health system's chief clinical officer.
Khelil was promoted to executive vice president and chief clinical officer of Virtua early this month. She had served as CMO of the health system since 2019 and was previously vice president of medical affairs starting in 2013.
Virtua has added several residency programs to the institution over the past five years, including residencies in family medicine, internal medicine, obstetrics and gynecology, surgery, and psychiatry. The health system has a fellowship program in cardiology and will be adding an anesthesiology residency program.
"Part of running a successful academic institution is having faculty engagement and having faculty who are excited about teaching," Khelil says.
When Virtua started the process of launching residency programs, there was some push-back from physicians, according to Khelil.
"We had some faculty who were concerned about what it meant for them and how it would affect the day-to-day care of patients," Khelil says. "We had to provide some education, and we had to give them the resources they needed."
In particular, physicians wanted training on how to educate residents, so the health system introduced faculty development tools and education.
"We taught our physicians how to teach and how to give good feedback," Khelil says. "Part of a resident's program is that they receive monthly evaluations. So, we trained our physicians on how to evaluate a resident."
Virtua achieved faculty engagement once physicians began interacting with residents, Khelil explains.
"We got wonderful feedback," Khelil says. "The faculty got excited. Having young people in the institution with inquisitive attitudes brings a level of excitement."
The health system has developed a robust faculty, which is not only interested in teaching but also clinical research, according to Khelil.
"We have brought many research opportunities into the organization, including clinical trials and device trials," Khelil says. "We have partnered with industry partners to bring cutting-edge advances to our organization."
An essential element of successful residency programs is recruiting the right residents, Khelil explains.
"When we recruit our residency class, we look for residents who will fit into our culture," Khelil says. "We want residents who are just as excited and just as interested in engaging in clinical learning and research as our faculty."
Virtua is particularly interested in recruiting resident candidates from New Jersey.
"If you grew up in New Jersey and you train in New Jersey, you tend to stay in New Jersey after your training," Khelil says. "Every state is facing a shortage of healthcare workers, so if we can select individuals from this geographic region and train them, and they stay in the state, that benefits everyone in New Jersey."
Jennifer Khelil, DO, MBA, is chief clinical officer of Virtua Health. Photo courtesy of Virtua Health.
Leading strategic growth
In addition to building residency programs, Khelil was involved in leading strategic growth initiatives before becoming chief clinical officer.
"When you talk about strategic growth, you are really talking about partnering with your community and meeting your community where it needs to be met," Khelil says.
One of the first strategic growth initiatives Khelil helped to lead was an effort to increase patient access to services.
"That included putting practices in remote areas of our counties that did not have access to primary care," Khelil says. "That included pulling specialists into those practices, so that patients did not have to drive 45 minutes to see a specialist."
Another strategic growth initiative was stepping up efforts to address social determinants of health, according to Khelil.
"We have an area that is a food desert—those patients do not have access to healthy food," Khelil says. "We have put programs in place to address that need."
Those programs include a mobile farmers market and a mobile grocery store, since part of the patient population does not have a supermarket in their general vicinity.
"Those patients are going to small corner stores that do not have fresh produce or fresh meats," Khelil says. "The mobile farmers market goes out to areas in the community that do not have access to fresh produce or meat."
"We have a grocery store on wheels," Khelil says. "We took a New Jersey transit bus and retrofitted it as a grocery store. We can drive into any parking lot or drive down to any street and allow people to shop for healthier foods, including fruit and vegetables."
Nutritionists are paired with the mobile farmers market and the mobile grocery store, so they can advise people on how to prepare healthy meals.
Supporting physician services
Khelil has been involved in efforts to support physician services at Virtua.
"At Virtua, physician services come down to our medical staff," Khelil says. "We must provide resources to the medical staff so they can come in every day and do their jobs."
A primary area where the health system has been providing resources to physicians has been to address clinician burnout, according to Khelil.
"The past few years in healthcare have been rough on our providers," Khelil says. "They have had stresses that we had never seen before—the coronavirus pandemic stressed the workforce for not only nurses but also physicians."
The first step was to ask physicians about the challenges they were facing.
"The doctors told us that they loved taking care of patients and loved being at the bedside, but there was other noise that was weighing on them," Khelil says. "Doctors were burdened with the electronic medical record, the patient message in-box, and other touch points that impacted their day and pulled them away from the bedside."
To help physicians cope with the electronic medical record and documentation burdens, Virtua adopted an ambient listening AI tool.
"Instead of having to leave the bedside and sit down for 20 minutes to compose a note, the clinician can leave the bedside and already have the structure of a note in place," Khelil says. "They can edit the note. They can add to the note or delete information from the note. It speeds up the process, so our clinicians are spending more face-to-face time with our patients."
Physicians at the health system receive as many as 100 patient in-box messages per day that need to be answered, according to Khelil.
"We addressed the patient message in-box," Khelil says. "We put processes in place, and we put people in place who could offload some of the patient messages."
Good communication between a hospital's administrative team and the clinical staff is pivotal, this CMO says.
Holly Hill-Reinert, MD, is not only the inaugural CMO of her hospital but also is serving as a CMO for the first time.
Hill-Reinert assumed the role of CMO at WVU Medicine Jackson General Hospital in November. Prior to taking on her new role, she was chief of staff at Jackson General Hospital Morad-Hughes Health Center, which focuses on primary care. Hill-Reinert's clinical background includes working as an internist, pediatrician, and hospitalist.
Hill-Reinert has a strong set of goals as an inaugural CMO.
"Obviously, quality care and safety are of utmost concern," Hill-Reinert says. "We must have physician involvement as the cornerstone of those efforts."
"One of my priorities is to advocate for the staff at our institution," Hill-Reinert says. "I would like to assist in improving communication and camaraderie as well as bolster excellence."
In particular, Hill-Reinert wants to improve communication between the hospital's administration and clinical staff.
"I do not agree with the us-versus-them dynamic of administration and clinical staff," Hill-Reinert says. "The hospital will function better if we collaborate and share information."
To improve communication, Hill-Reinert, who participates in the senior administrative team's meetings every other week, is playing the role of liaison between the administrators and clinical staff as well as convenor.
"I bring information back to the medical staff," Hill-Reinert says. "I am trying to get physicians and other providers energized and more involved in the committees that we have."
Boosting care quality
Efforts to promote care quality are two-fold, according to Hill-Reinert.
"First, you must enhance the patient experience and patients' perception of the quality of care that they are receiving," Hill-Reinert says. "At the end of the day, when patients fill out surveys, they make the call on the level of their experience."
"Second, you must provide patient-centered care and evidence-based medicine as well as measure your quality metrics," Hill-Reinert says. "Part of this effort is continually educating your staff and training them to drive quality improvement."
The hospital's nursing staff and a regional group at WVU Medicine play a key role in monitoring quality metrics.
"We follow many metrics such as length of stay, days on antibiotics, central line infections, and catheter infections," Hill-Reinert says.
A CMO is an essential player in efforts to promote care quality, Hill-Reinert explains.
"I need to engage the physicians and get them involved in the peer review committee as well as the processes that we are working on and trying to improve," Hill-Reinert says. "Just being cognizant of what we are doing is important."
Bolstering patient safety
Engaging the frontline staff is essential to promote patient safety, according to Hill-Reinert.
"The most important aspect of patient safety is accountability and ownership across the frontline staff, including nursing, phlebotomy, imaging, and the providers," Hill-Reinert says.
The hospital is working on new ways to hold staff accountable for patient safety events.
"We have stood up a peer review committee," Hill-Reinert says. "We also have a new system called Origami for filing patient safety events or complaints. These reports come back to me if they involve any of our providers."
Origami is a web-based program that any staff member can go into and type in a patient's information. Then, the system will present a form to detail a patient safety event. Reports of medical errors are forwarded to Hill-Reinert, a root-cause analysis is conducted, and the hospital's peer review committee decides whether there was a deviation from care quality. The response to a medical error depends on the severity of a patient safety event.
A CMO plays a central role in promoting patient safety, Hill-Reinert says.
"I can lead staff training and encourage them to practice safely," Hill-Reinert says. "I can make sure that we are thorough and try to hold people accountable."
Keys to hospitalist success
Hill-Reinert has several years of experience working as a hospitalist, and successful hospitalists have several characteristics, according to Hill-Reinert.
"You must have the right physicians," Hill-Reinert says. "They must be responsible, good communicators with patients and the care team, and good with time management. They should not only be timely with their care but also mindful of documentation and other providers."
Hospitalists should have incentives such as safety bonuses, which energizes them to provide better care, Hill-Reinert says. It is crucial for hospitalists to stay up to date on the latest care standards and emerging treatments.
"When we start medical school, one of the first things we are told is that staying up to date is like drinking from a fire hose, and that never stops," Hill-Reinert says. "You must learn how to manage staying current."
