SHM Leader Urges Quality Improvement Activism

VANCOUVER, B.C. — Hospitalist-driven initiatives in quality improvement are at the core of several programs underway at the Society of Hospital Medicine, according to Dr. Larry Wellikson, the society's CEO.

Speaking at the annual Canadian Hospitalist Conference, Dr. Wellikson urged hospitalists to take advantage of these tools and the opportunities that quality improvement offers them to change the status quo in health care.

“Look at performance improvement as part of your DNA, as part of your job, as the gift and the differentiator that you bring to the marketplace, he advised. “It isn't that [others don't] care about quality or performance—it's just that you have the opportunity to seize this, own this, and be the agents of change.”

Quality improvement isn't something you do at the end of the day or “a bunch of people running around with clipboards satisfying some regulations that will grow from 10 to 20 to 100,” he said. Leading the drive for quality improvement is an opportunity to shake up the status quo.

Hospital care is “virtually the only industry where you pay exactly the same thing whether you get the worst care or the best care,” he observed. Moreover, limited measurement of quality outcomes makes it difficult to compare the caliber of care across hospitals.

Hospitalists are in the best position to drive these initiatives. Unlike staff physicians, hospitalists “are owners, not renters,” he said. Hospitalists know their institutions inside and out. They often have more clout to effect change. Further, hospitalists are intrinsically involved in overarching issues, such as drug safety and patient education.

The many guidelines for standards of care that have been written are merely an initial step in quality improvement, he said. The key is how to implement them.

To address implementation needs, the SHM has brought together multidisciplinary groups of experts to create virtual resource rooms on its Web site (www.hospitalmedicine.org

In addition, because tools are best used by skilled physicians, the society offers at its annual and chapter meetings training in how to conduct quality improvement projects, a skill not typically taught as part of medical education, Dr. Wellikson noted.

SHM also has defined core competencies for hospital care and secured funding to pursue implementation projects, in which trained hospitalist leaders mentor other hospitalists conducting projects to improve quality outcomes.

One such project at a University of California, San Diego, hospital nearly doubled the rate of adequate prophylaxis for venous thromboembolism and reduced the annual number of venous thromboembolic events from 50 to 4.

SHM also is leading efforts to set standards for transitions of care at hospital admission and discharge.

The society's long-term strategy for quality improvement emphasizes teamwork and efforts to bring together allied health professionals, Dr. Wellikson explained at the conference, which was sponsored by the University of British Columbia.

“We need to move toward a world where health care is a team sport,” Dr. Wellikson said. Empowering nurses, pharmacists, and other professionals can have benefits all around.

'Look at performance improvement as… the gift or the differentiator that you bring to the marketplace.' DR. WELLIKSON

VANCOUVER, B.C. — Hospitalist-driven initiatives in quality improvement are at the core of several programs underway at the Society of Hospital Medicine, according to Dr. Larry Wellikson, the society's CEO.

Speaking at the annual Canadian Hospitalist Conference, Dr. Wellikson urged hospitalists to take advantage of these tools and the opportunities that quality improvement offers them to change the status quo in health care.

“Look at performance improvement as part of your DNA, as part of your job, as the gift and the differentiator that you bring to the marketplace, he advised. “It isn't that [others don't] care about quality or performance—it's just that you have the opportunity to seize this, own this, and be the agents of change.”

Quality improvement isn't something you do at the end of the day or “a bunch of people running around with clipboards satisfying some regulations that will grow from 10 to 20 to 100,” he said. Leading the drive for quality improvement is an opportunity to shake up the status quo.

Hospital care is “virtually the only industry where you pay exactly the same thing whether you get the worst care or the best care,” he observed. Moreover, limited measurement of quality outcomes makes it difficult to compare the caliber of care across hospitals.

Hospitalists are in the best position to drive these initiatives. Unlike staff physicians, hospitalists “are owners, not renters,” he said. Hospitalists know their institutions inside and out. They often have more clout to effect change. Further, hospitalists are intrinsically involved in overarching issues, such as drug safety and patient education.

The many guidelines for standards of care that have been written are merely an initial step in quality improvement, he said. The key is how to implement them.

To address implementation needs, the SHM has brought together multidisciplinary groups of experts to create virtual resource rooms on its Web site (www.hospitalmedicine.org

In addition, because tools are best used by skilled physicians, the society offers at its annual and chapter meetings training in how to conduct quality improvement projects, a skill not typically taught as part of medical education, Dr. Wellikson noted.

SHM also has defined core competencies for hospital care and secured funding to pursue implementation projects, in which trained hospitalist leaders mentor other hospitalists conducting projects to improve quality outcomes.

One such project at a University of California, San Diego, hospital nearly doubled the rate of adequate prophylaxis for venous thromboembolism and reduced the annual number of venous thromboembolic events from 50 to 4.

SHM also is leading efforts to set standards for transitions of care at hospital admission and discharge.

The society's long-term strategy for quality improvement emphasizes teamwork and efforts to bring together allied health professionals, Dr. Wellikson explained at the conference, which was sponsored by the University of British Columbia.

“We need to move toward a world where health care is a team sport,” Dr. Wellikson said. Empowering nurses, pharmacists, and other professionals can have benefits all around.

'Look at performance improvement as… the gift or the differentiator that you bring to the marketplace.' DR. WELLIKSON

VANCOUVER, B.C. — Hospitalist-driven initiatives in quality improvement are at the core of several programs underway at the Society of Hospital Medicine, according to Dr. Larry Wellikson, the society's CEO.

Speaking at the annual Canadian Hospitalist Conference, Dr. Wellikson urged hospitalists to take advantage of these tools and the opportunities that quality improvement offers them to change the status quo in health care.

“Look at performance improvement as part of your DNA, as part of your job, as the gift and the differentiator that you bring to the marketplace, he advised. “It isn't that [others don't] care about quality or performance—it's just that you have the opportunity to seize this, own this, and be the agents of change.”

Quality improvement isn't something you do at the end of the day or “a bunch of people running around with clipboards satisfying some regulations that will grow from 10 to 20 to 100,” he said. Leading the drive for quality improvement is an opportunity to shake up the status quo.

Hospital care is “virtually the only industry where you pay exactly the same thing whether you get the worst care or the best care,” he observed. Moreover, limited measurement of quality outcomes makes it difficult to compare the caliber of care across hospitals.

Hospitalists are in the best position to drive these initiatives. Unlike staff physicians, hospitalists “are owners, not renters,” he said. Hospitalists know their institutions inside and out. They often have more clout to effect change. Further, hospitalists are intrinsically involved in overarching issues, such as drug safety and patient education.

The many guidelines for standards of care that have been written are merely an initial step in quality improvement, he said. The key is how to implement them.

To address implementation needs, the SHM has brought together multidisciplinary groups of experts to create virtual resource rooms on its Web site (www.hospitalmedicine.org

In addition, because tools are best used by skilled physicians, the society offers at its annual and chapter meetings training in how to conduct quality improvement projects, a skill not typically taught as part of medical education, Dr. Wellikson noted.

SHM also has defined core competencies for hospital care and secured funding to pursue implementation projects, in which trained hospitalist leaders mentor other hospitalists conducting projects to improve quality outcomes.

One such project at a University of California, San Diego, hospital nearly doubled the rate of adequate prophylaxis for venous thromboembolism and reduced the annual number of venous thromboembolic events from 50 to 4.

SHM also is leading efforts to set standards for transitions of care at hospital admission and discharge.

The society's long-term strategy for quality improvement emphasizes teamwork and efforts to bring together allied health professionals, Dr. Wellikson explained at the conference, which was sponsored by the University of British Columbia.

“We need to move toward a world where health care is a team sport,” Dr. Wellikson said. Empowering nurses, pharmacists, and other professionals can have benefits all around.

'Look at performance improvement as… the gift or the differentiator that you bring to the marketplace.' DR. WELLIKSON