The National Association for Healthcare Quality (NAHQ) is leading a week-long campaign to highlight the healthcare quality field. The NAHQ is a professional association for people who are healthcare quality professionals, including physicians, nurses, quality officers, and so on. They offer professional designation in quality improvement.
Dr. Deirdre McCaughey joined W21C and the University of Calgary as Associate Professor in the Department of Community Health Sciences at the Cumming School of Medicine in July 2017. On September 19, she participated in a panel hosted by the National Association for Healthcare Quality (NAHQ), titled “Insights into the Future of Healthcare Quality.” NAHQ shared the panel discussion as a webinar for Quality Improvement week, October 15-21, 2017. While the discussion mainly focused on the U.S. context, Dr. McCaughey’s participation signals how Canadian institutions, including the University of Calgary, are beginning to increase their focus on health care quality improvement.
W21C: What was the premise of the panel?
Dr. McCaughey (DM): The panel included a variety of expertise across the spectrum of quality improvement. At the time of the invitation, I was the Inaugural Program Director for Graduate Programs in Healthcare Quality & Safety (HQS) at the University of Alabama at Birmingham (UAB). I developed that programme, which led to UAB being among the first of 12 institutions across North America to offer a master’s program in healthcare quality.
Graduate programs in HQS have to identify what competencies its students should be equipped with when they graduate so that they are effective quality improvement professionals. The NAHQ panel sought to prepare health care quality professionals for future success by discussing how the role of the quality improvement professional is changing.
W21C: What perspective did you bring to the diverse panel?
DM: In addition to my experience as the inaugural HQS program director at UAB, I also conduct research in quality improvement (QI). When organizations identify, for example, an access problem, how do they go about fixing it? I work with health care systems to identify quality improvement opportunities—sometimes this is driven by adverse events, and sometimes it’s the result of organizations being proactive about quality improvement. My experience in research with health care organizations provides me with practical, solutions-orientated perspectives to QI.
W21C: How is the role of the quality improvement professional changing?
DM: In the last decade, graduate programmes in health care quality and safety have emerged. It started with certificate programmes, similar to what is being offered here at W21C, and today there are 12 universities across North America that offer master’s degree in health care quality and safety. These institutions are the first-movers, and they’re setting the standard for the competencies with which students graduate. Overall, it’s a very new, emergent field of education to be in.
I think that this is signalling, and also creating momentum, for a broader change in health systems from quality assurance—which was mainly a retroactive approach to specific events—to quality improvement, the proactive systems-orientated approach to improving quality. For example, In the United States, health systems are looking at ways of improving quality outcomes that are tied to the Centres for Medicare and Medicaid Services (CMS) value-based purchasing program. This means that, for example, in the Medicare program, instead of paying a flat fee for a service, quality outcomes—such as safe and effective care—are attached to that reimbursement amount. Institutions and care providers are seeing the value in being proactive about quality improvement, so we move from being reactive to an incident to being proactive in pursuit of the the Institute for Healthcare Improvement’s Triple Aim of health care. The Triple Aim seek to improve health through excellent patient care experience, reduced per capita costs of health care, and improvement in the health of the population.
W21C: The panel was focused on the US context, but what opportunities for education on health care quality are available at W21C and in Canada?
DM: W21C offers a comprehensive certificate program in patient safety and quality management, which is available to a wide range of providers and administrators. In this program, now in its eighth year, there is a practicum component where students conduct a quality improvement project in a health care setting. There are also two universities in Canada that currently offer masters programs in this field, including the University of Toronto and Queen’s University.
W21C: What do you view as the significance of health care quality improvement as a field?
DM: I began my health care career as a physical therapist in Manitoba. As a care provider, I have passion for great outcomes for care providers, and for patients and their families. As a quality improvement researcher, much of my work focuses on safety, safety culture, and how people think about safety in health care. In order to optimize outcomes for patients, organizations need to optimize the care provider team. When organizations care for their care provider teams, individual providers are healthy, excited, and engaged and able to spend their time delivering health care effectively. The genesis of all my research comes from being a physical therapist and caring for patients, so I have a vested interest in working to improve how organizations look after care provider teams so that they can do their best for their patients.
People usually become care providers in order to help people, they have that innate “helping” desire. Looking at the processes of health care delivery is therefore incredibly important. If there are adverse outcomes and sub-optimal care, those may be the result of broken processes. So, it’s crucial that we research and offer solutions that are based on system-level factors in order to improve and support the overall system of care, which then improves health care quality for patients, providers, families, and family care providers.
The other speakers on the panel included: Dr. Jeffrey DiLisi, the Senior Vice President and Chief Medical Officer at the Virginia Hospital Center; Jodi Eisenberg, the senior director of accreditation education programs for Vizient, Inc.; Pat Merryweather, who works with patients, families, and caregivers on improving the outcomes, processes, and costs of care; Dr. Maria Shirey, the Editor-in-Chief of the Journal for Healthcare Quality with a background in nursing and hospital administration; and Stephanie Mercado, NAHQ CEO and Executive Director.