The Essentials of QI Leadership: A Conversation with Dr. Eric Howell, Part 2

My last blog post, featuring my Q and A with Dr. Eric Howell, Division Director, Collaborative Inpatient Medicine Service (CIMS) at Johns Hopkins Bayview Medical Center in Baltimore, MD, and SHM’s Senior Physician Advisor, focused on his early days in Quality Improvement (QI) and advice for training in QI. This next post discusses the Center’s role within SHM and how hospitalists can become involved in quality improvement.

How did you get involved in The Center, and can you explain your role in The Center today?

It was a lot of luck, good timing and being prepared. I’ve been in The Center for two years. Before that, I was involved with a number of The Center’s successful QI projects. I was reasonably well known in the Project BOOST (SHM’s program for improving care transitions) community. Along with Mark Williams and Jeff Greenwald, I was one of the original three who pitched Project BOOST to the Hartford Foundation. I knew Greg Maynard, the physician advisor to The Center prior to me. When he took on a new role, because the team knew of my experience in QI, I was someone in the right place at the right time.

As The Center’s physician advisor, I feel like my role is a dream job. I get to work with a bunch of terrific people. When I visit SHM, I am among people who think they can change the world. And they do. People like Jenna Goldstein, Director of The Center, and Kristin Scott, Director, Business Development, and Kevin Vuernick, Senior Project Manager in The Center, and numerous others do a tremendous amount of work to make the world a better place.

I also interact with folks like Jeff Schnipper and others, who are outside of SHM, but are linked to the organization through their passion for QI. The SHM staff are wonderful staff, but lack physicians, outside of Larry Wellikson SHM’s CEO. So I add the perspective of a physician to many of the projects. I identify hot topics and things that are sun setting. I partner with people that seem genuine and have our interests in heart. As a physician, I can help weed out some of the sales pitches that don’t ring as true as others.

You mentioned RADEO (SHM’s program for opioid prescription management) and IPASS (SHM’s program to improve care handoffs). Can you discuss some of the current hot topics The Center is working on, or how you start up of these projects?

MARQUIS (SHM’s medication reconciliation program) and Jeff Schnipper came to SHM because of previous interactions with The Center. They know we provide high value and seek us out to partner with them. The same thing with BOOST. The Center often looks to partner with funders that have some similar core values and visions. Once we begin a relationship with a funder, we go out to the quality community and find out who is interested in what we have available, whether it is opioid prescribing practices or VTE prevention.

We try to make sure all of our projects are mission-focused. We never take money for the sake of taking money, whether it’s a partner from outside or industry. We try to find the intersection of the circle of the Venn diagram where our mission overlaps with a funder, and also with our ability to make change in the hospital.

Can you help SHM members understand how they can get involved with The Center?

I would suggest using The Center to become involved with projects and their participants. I-PASS (handoffs), RADEO (opioid prescription management) and MARQUIS 2 (the second iteration of SHM’s medication reconciliation mentored implementation program) are all part of The Center. I had one of my junior QI docs – someone who was interested in QI – become a mentor, and a more junior doctor became a site lead for MARQUIS 2.

Within SHM, there are many entry points for obtaining skills, including Leadership Academy or the Quality & Safety Educators Academy (QSEA). There are also practical ways to get involved, such as mentoring through MARQUIS 2 or IPASS. The nice thing about mentors is that they are not official; you can go to your CQO, CNO, or CMO – or whoever you think has the skills to help make you better – and partner with them as well. Everyone likes people who are dedicated and ready to help.

The Center seems unique to SHM; do other societies have anything similar? Why do you think that is?

I’m not aware of any societies who have something like The Center, with an extensive focus on QI and member training. I think other societies and physicians are fairly siloed and often don’t see the interface of the various siloes within the hospital or across the hospital. Hospitalists are everywhere – from the ER to the ICU to transitioning patients outside the hospital. We get to see patients across a complex system more so than our colleagues do, and we see how broken that system is. I think because we are constantly operating in a broken system, and we see it every day. We are the ones trying to fix it.

Hospitalists are so interested in QI, because we are used to showing our value more than other specialties. We are lucky, in that we have two revenue streams. We have our billing and we also frequently get significant revenue from the hospital. We have to show our value. Showing value is important for you, our members, and our society. We get our physicians to care about quality improvement in addition to efficiency. We come to our society saying we’d like ways to make our hospital to run better to show value. Can you give us the skills to do that? And SHM has stepped up to the plate.

Any final words?

QI is leadership with mentors, using data and dashboards. SHM has a lot of offerings to assist. All it takes is a knock on the door.

Jordan Messler

Jordan is a hospitalist at Morton Plant Hospitalists in Clearwater, Florida. He currently chairs SHM’s Quality and Patient Safety Committee. In addition, he’s been active in several SHM mentoring programs, most recently with Project BOOST and Glycemic Control. He went to medical school at University of South Florida, in Tampa, and completed his residency at Emory University.

He recognizes the challenges of working in a hospital that lines the intracostal waterways of a spring break mecca. Requests that if you want to be selected as a mentored site, you will have a similar location with palm trees and coastline nearby. He tries to find time to sit on the beach with his family to escape the hospital’s miasma. While there, he looks forward to reading about the history of hospitals/medicine, and how it relates to quality (Anti-UpToDate reading material). But inevitably will get a five year old dumping sand on him, and then has to explain why she is buried up to her neck.

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