The Health Care Improvement Foundation’s (HCIF) Partner Profiles highlight the efforts of valued and innovative health leaders. Our partners’ work supports HCIF’s vision of healthier communities through equitable, accessible, and quality health care.
As HCIF celebrates Patient Safety Awareness Week (March 12 – March 18) this month, we’re excited to feature one of the longest-standing members of HCIF’s Clinical Advisory Committee, Dr. Charles Wagner of Redeemer Health. Learn more about how he applies patient safety principles to his everyday life, what changes in patient safety he’s witnessed throughout his career, and what he sees as the most important future priorities in patient safety. This conversation has been edited and condensed.
Charles I. Wagner, MD, FACP currently serves as the Medical Adviser for Patient Safety and Quality at Redeemer Health in Meadowbrook, PA. He has practiced gastroenterology in academic and community based settings and has served as the Chief Medical Officer and Patient Safety Officer at Redeemer Health. He is a member of the Clinical Advisory Committee of the Health Care Improvement Foundation and had served on the Board of Directors of the Pennsylvania Health Care Quality Alliance.
As a long-standing member of HCIF’s Clinical Advisory Committee since its inception, you’ve contributed to a number of the Partnership for Patient Care (PPC) programs. During your time as an advisor, in what ways do you think that PPC has helped advance quality and patient safety across the region? What is something you’ve learned through working with our organization?
It’s been a remarkable adventure to serve as an advisor and working in the patient safety space has opened my eyes a lot. There are patient safety principles that we use all the time in our everyday lives that you don’t really think about. Ultimately, though, it comes down to patient safety being a way to help people and prevent problems. The real advantage of HCIF and PPC is that we all want to do the same thing and doing it together has lots of advantages. For example, it combines the work allowing for organizations to share their experiences and move things faster. It also allows for institutions to provide care to their patients in their community through the full spectrum of their experience. Lastly, it allows for common definitions and approaches to be used by everyone.
Early on in my career as Chief Medical Officer, there were numerous requirements from regulatory bodies that wanted hospitals to look at many metrics. We developed a patient scorecard and thus began a big effort to standardize amongst ourselves and try to convince regulatory bodies to use the same indicators so there was common definitions and terminology. That’s also the kind of thing HCIF became useful in. For example, when we first started looking at falls, everyone had different definitions of what constituted a fall and how to respond to it. We adopted a common terminology that was used across the country and could then compare rates better. When you don’t have that common definition, it becomes problematic, and we saw that with COVID-19.
“There are patient safety principles that we use all the time in our everyday lives that you don’t really think about. Ultimately, though, it comes down to patient safety being a way to help people and prevent problems.”
Charles Wagner, MD
HCIF is celebrating Patient Safety Awareness Week from March 12-18, 2023 this year. Given your expertise, work, and advocacy in patient safety, what are some of the most significant changes or evolutions of patient safety that you’ve witnessed during your tenure?
I think that probably the most important factor is we’re now actively talking about and prioritizing Patient Safety. For a long time, we didn’t talk about it, and individually we had been aware of some problems, but we weren’t collectively collaborating or educating about them. The more people that are aware of patient safety, the more attention they can pay to helping prevent future problems.
Another important thing that has occurred is we’ve gotten patients involved in patient safety. By including and empowering them in their care, we’re asking for their help to identify problems. We’re aware that patients are a last step in preventing problems, such as double checking they are the right person to receive a certain surgery, or that they are receiving the correct medication. Patient involvement is crucial to the whole process of patient safety. One of the things [Redeemer] was recognized for years ago was about infection prevention regarding handwashing. We put a sign in every patient’s room that read “Did you ask your caregiver to wash their hands?” This allowed the patient to be an active participant in their care and put staff on notice that they were going to be asked if they washed their hands. Redeemer had such a successful initiative that our work got picked up by the local news and made its way to national news. This initiative helped educate the population about something as simple as handwashing and everyone’s involvement in doing that.
Lastly, it’s important to emphasize that everybody has a role that contributes to and makes up the bigger picture of patient safety. Having everybody involved—everyone from patients, nurses, clinicians, dieticians, cleaning staff—helps reinforce behavior and creates a culture of safety.
Looking ahead, what is something that excites you about where the field of patient safety is headed?
A crucial step along the way in the future of patient safety is understanding our own behavior. It’s important to understand how people think and act in order to anticipate what steps we may need to take in response to actions. The behavioral stuff of how we learn and how we respond, it’s everywhere in our lives. I spent time in the U.S. Public Health Service that provided health service to the U.S. Coast Guard, and from that experience I took away learnings of how the military practiced and completed drills in preparation for problems they may have encountered. I witnessed how everyone on the team had their assigned job and I was able to draw many parallels to the very same concepts of education, practice, and accountability that we carry out in health care.
Along those same lines, another big insight I had occurred when I started at a new institution during my graduate training and found that they were not doing things the same way I did or was taught. I realized that I was inculcated with the behavior and institutional approach of the people that previously taught me and worked with. When I went to another institution that had a different orientation or culture—it wasn’t a matter of who was right or wrong, but rather an opportunity to interface with and learn from each other. That same principle applies to the cross-fertilization that HCIF’s work promotes. As each institution learns about a safety issue or solution, sharing it or exchanging that information in collaboration with someone else has real value to it.
As you reflect on your career of being a health care provider and patient safety expert, how did you become interested in patient safety? What do you think is one of the most compelling or important components of patient safety that the general public might not yet know?
Paired with the landmark report “To Err is Human: Building a Safer Health System” from the Institute of Medicine in 1999, and witnessing things happen in the clinical setting, I realized how important patient safety was. From there and serving as Chief Medical Officer, I was involved in writing our organization’s first Patient Safety plan.
Two of the big tenents of patient safety is communication—we have to make sure we’re talking the same “language”—and education. Additionally, as I shared before, we have to keep in mind the human behaviors behind actions. Knowing how we react and what we do and why is really crucial. It’s important to understand what people are working with and why they’re reacting a certain way when you are educating and training them, especially as it applies to health care. Addressing the components of communication and education can ultimately have a profound impact on the outcomes of care and culture at an organization.
If you are interested in connecting with our partner, you can connect with Dr. Wagner via email at Cwagner@holyredeemer.com.
Something you may not know about Dr. Wagner…
His favorite book is Moby Dick, which he first read in high school and when the movie came out, he saw it fifty-six times while working as an usher in the movies! When reading Moby Dick, Dr. Wagner likes to reflect on what a case study of patient safety the story is. He draws parallels of the actors, actions, and lessons learned in the story to that in health care and appreciates looking at all those aspects of behavior, safety, and leadership in just one story.
Additionally, Dr. Wagner likes to garden as a hobby and form of exercise. With the help from his wife, he sees the everyday tasks of gardening following the same steps of a Plan, Do, Check, Act quality cycle. As he’s shared throughout this profile, he likes to seek and apply patient safety principles to his every day when he can!
Philadelphia, PA – 3.8.23 – The Health Care Improvement Foundation is proud to announce that Kathleen Donohue, RN, BSN, MBA, FAHM, CHCQM, CPPS, NEA-BC has joined its talented Board of Directors. Ms. Donohue is the Director of Quality at Independence Blue Cross, with a background in nursing and clinical leadership. Ms. Donohue has expertise in change management, improving quality and patient safety, as well as leading population health initiatives.
“We are honored to welcome Kathy to our Board,” said Wendy Nickel, President Health Care Improvement Foundation. “We are delighted to continue our longstanding tradition of partnership with Independence Blue Cross and are fortunate that Kathy will serve in that role.”
The Health Care Improvement Foundation (HCIF), hcifonline.org, was founded to support a responsive, coordinated health care delivery system that fulfills the needs of patients and consumers, and achieves better health. Through large-scale collaboration HCIF works with health systems, community based organizations, payors and a variety of other stakeholders to find solutions to complex healthcare challenges, which any one stakeholder could not achieve alone. Since its inception, HCIF has worked with numerous organizations to improve quality of care, health equity, patient safety, and population health issues such as, COVID-19, perinatal care, readmissions, cancer, workplace violence, food insecurity, trauma informed care, and health literacy.
To honor and celebrate Black History Month, HCIF would like to recognize and amplify the work of Black health care professionals in our region. As such, we had the pleasure of interviewing Joanne Craig, M.S., Chief Impact Officer at the Foundation for Delaware County. Joanne also serves on HCIF’s Board of Directors and offers valuable insight to the Board with her unique experience in health care. Read below to learn more about her and the important work she does.
What drove you to pursue a career in health care?
I came into the healthcare space in more of a supportive role. I developed community-based programming that created supportive resources. I then started working in maternal and child health and discovered that the Black infant mortality rate in Chester City was worse than in third world countries. Black children were dying at an unconscionable rate. I found myself in a position where I was able to work within the community and begin to address the high and disparate rates of Black infant mortality and high Black maternal morality so maternal and birth outcomes could be improved. I have spent the better part of my career working in Delaware County and seen firsthand when people struggle to find and access resources and services. In Delaware County for example, there are a lot of folks that do not speak English as their first language and/or are undocumented. I want to make sure all people know where, how, and when to connect to resources.
What are some of your favorite parts of your role?
I do a lot of work in advocacy and policy to make sure “upstream” changes are made. I love the work to achieve health equity and working with all kinds of folks. I always try to keep an ear close to the ground as I want to amplify, raise, and elevate voices. I enjoy being able to do this work because it’s fulfilling to me when policy changes occur, a health concern gets resolved or people’s needs are met.
What has been the most rewarding part about serving on HCIF’s Board of Directors?
Being in this space with HCIF and having the opportunity to listen and learn. Serving on the HCIF Board of Directors is a great connection to the work that I’m doing. Additionally, being on the other side of health care, I know that I can carry the messages and voices from the folks who are receiving services and make sure those people are represented in Board meetings.
What excites you most about the future of health care?
The opportunities and the possibilities. Health care practitioners recognize that they can only do but so much. Early on, when I was teaching health literacy I used to say that you need to be a partner in your own good health. It’s a collaboration and partnership. The best health care practitioner is one working in partnership with their patient, listening, educating them, and being available to them so they can make informed decisions.
What is a recent memorable experience you have had as a healthcare professional?
Hearing from those that we serve. When I’ve worked with an individual or family, you spend a good length of time with folks. When the child gets older, they may age out of the program. I’m always grateful to have that mom, grandmother, or other family member express their thanks and talk about how they have benefited from the program.
When you’re not busy working to improve the lives of others, what do you like to do?
I’m a trained florist. I love to garden, decorate, and make floral arrangements.
For this month’s Board Profile, HCIF had the pleasure of interviewing Stephanie Zarus, Pharm.D. Stephanie is the Managing Director of Healthcare Innovation for Avancer Group, Inc. and the outgoing Governance Committee Chair of HCIF’s Board of Directors. Her career in pharmacy and health care has helped thousands of patients access affordable and quality medication. Stephanie’s knowledge, expertise, and wit has guided her throughout her career and made her an inspiration for all who come in contact with her. She will be missed on our Board of Directors, but her impact will last for years to come. Read below to learn more about her.
Tell me about your professional history and your work experience.
I am a pharmacist by training, who has always leaned toward administration over clinical practice. In the early 1990’s, I was part of the founding team who started Hospice Pharmacia/ excelleRx, a technology-based medication management company. We focused initially on improving the cost and care and service for terminally ill patients in hospice programs. We were among the first pharmacists to push the envelope enabling patient “care without walls”. Meaning that medication could be accessed for patients wherever the patient was, without the barriers caused by having to procure and submit a paper prescription. Our mission was to ensure that every person in our care could access the medication they needed, when they needed it, at home or in a health care facility.
As a company founder, I was fortunate to be involved in setting the organization’s mission and vision. Over time, I had a hand in building teams, selling services, formalizing operations and insuring performance improvement. It was the experiences I had in performance improvement and quality controls that lead me to crossing paths with other quality experts who served on HCIF’s board. In 2006, I was invited to serve on HCIF’s Board for the first time. I have been fortunate to serve on the board for two full terms. My interest continues to be on health care quality, though HCIF has broadened my understanding and interests into the many nuanced areas that inform quality and care.
What drove you to pursue a career in healthcare?
I have old school parents who are the sweetest, most lovable, and wonderful people in the world. They instilled in their children that the world is our oyster. College is a choice if we can get in, pay for it, do well, and have a job at the end. I thought my dream was to write children’s books. What materialized for me happened when I met a pharmacy professor on the West Philadelphia campus of the Philadelphia College of Pharmacy and Science (now part of St. Joe’s). He took me for a tour, told me about the school, gave me a stethoscope, and handed me an application. He convinced me that my interest in science would be a good fit and that a pharmacy profession welcomed women. Ultimately what drove me to pursue a career in healthcare was my interest in science and the promise of a career.
What is something you’ve learned being a part of the HCIF Board of Directors?
So many things. I continue to learn about the depth of public health needs in our region and how these needs are addressed (for better or worse) in the clinical care systems available. I continue to learn how our systems improve clinical quality, whether through access barriers, informed care, literacy or minimizing/mitigating a cadre of other risks factors. I also respect the process HCIF uses. By convening people from different institutions, organizations, and health backgrounds HCIF can facilitate the exploration of a health issue and generate a resolution that incorporates system changes while keeping a focus on the needs of the people who are seeking improved health.
What has been the most rewarding part about serving on HCIF’s Board of Directors?
For me, the people. They’re kind, gifted, and willing to help you see health in different ways. HCIF has an excellent staff, and the board leadership is diverse and experienced. Together, the team is dedicated, driven, and smart.
What excites you most about the future of health care?
There is so much space for technology in health care. Everything from improving our use of artificial intelligence in diagnosing and prospective analysis regarding patient response, to the use of targeted molecular interventions. We have barely begun to dream of ways to use machine learning in health care. Even with the excitement of technology, preserving the human touch in health care remains the most important to me.
What worries you about the future of health care?
The cost of care and the need for our systems to commercialize people’s health, is a primary concern. We are scheduling appointments and providing care around billing codes. How do we move away from this? I am also concerned about the degree of anger in our region. Gun violence is a life threat in our region. There is a cultural problem when people turn to killing one another. How does the health system consider violence and aggression as a risk factor and how can we mitigate this?
When you’re not busy working to improve the lives of others, what do you like to do?
I like to bring people together. I organize events, do photography, participate in book clubs, do yoga, bike, ski, garden, and travel all over. I did just get back from the ultimate bucket list trip—cooking school in Italy! I do a lot of cooking because I love to host. Anything that keeps me learning and engaged with other people, building a strong community and giving back is where you will find me.
November was Men’s Health Awareness Month which is a time dedicated to bringing awareness to a wide range of men’s health issues. One of HCIF’s clinical improvement initiatives – Pennsylvania Urologic Regional Collaborative (PURC) – is specifically focused on supporting urology practices in advancing the quality of diagnosis and care for men with prostate cancer.
Prostate cancer is the most common non-skin cancer in men in the U.S., and the 4th most common tumor diagnosed worldwide. In the United States, 1 in 8 men will be diagnosed with prostate cancer in his lifetime. Sadly, disparities permeate the diagnosis, treatment and outcomes related to prostate cancer. For Black men, 1 in 6 will develop prostate cancer and are more than twice as likely to die from the disease. Even though this type of cancer is common, it is a treatable and manageable disease, especially when caught in its earliest stages. The overall five-year survival rate for prostate cancer is 98 percent which means a man diagnosed with prostate cancer has a 98 percent chance of being alive five years later!
“Prostate cancer is a serious condition, but it is rarely an emergency. Patients should not be pressured into a quick treatment decision. It is crucial that patient education is emphasized, and shared decision making is embraced.”
-Dr. Serge Ginzburg, MD – Albert Einstein Medical Center
To identify prostate cancer early, it’s important for patients to discuss screening options with their doctors. Key factors to consider in coordination with your doctor are age, race, and family history – all of which can impact the likelihood of developing prostate cancer. In most cases, prostate cancer is a slow-growing disease and there is time to gather information, consider all options, and make a plan following diagnosis.
“The critical element of prostate cancer screening is not only identifying the presence of malignancy, but also tailoring management to a patient’s specific type of cancer thereby personalizing individual care for patients.”
-Dr. Jay Raman, MD, FACS – Penn State Health Milton S. Hershey Medical Center
“Management of prostate cancer is certainly not “one size fits all.” There are so many factors to consider when choosing the best treatment options for patients, including disease severity, likelihood of cancer control, a patient’s overall health, and the effects of any treatments on a patient’s lifestyle.”
Dr. Adam Reese, MD – Temple University Lewis Katz School of Medicine
Launched in 2015, PURC currently brings together 13 urology practices and 170 physicians from across the Mid-Atlantic region (Pennsylvania, New Jersey, Virginia, and Washington, DC) to discuss trends and advances in prostate cancer, identify opportunities for improvement and collaboration, and analyze clinical registry data from over 20,000 cases. As a result of this collaborative, active surveillance of patients has increased, post biopsy ER visits and hospital admissions have decreased, and overall biopsy complications have decreased for patients of PURC practice sites.
“The changes made by the collaborative have been amazing, with our active surveillance rates above the national average and our rapid adoption of the transperineal prostate biopsy technique.”
-Dr. Andres Correa, MD – Fox Chase Cancer Center
To read more from the physicians quoted above, please check out a few of PURC’s Partner Profiles:
The Health Care Improvement Foundation’s (HCIF) Partner Profiles highlight the efforts of valued and innovative health leaders. Our partners’ work supports HCIF’s vision of healthier communities through equitable, accessible, and quality health care.
In recognition of November being Men’s Health Awareness Month, HCIF is pleased to feature Dr. Andres Correa, MD, Urologic Oncologist and Assistant Professor of Surgery at Fox Chase Cancer Center. Dr. Correa completed his Urologic Surgery residency at the University of Pittsburgh Medical Center and Fellowship at Fox Chase Cancer Center. Originally from Cali, Colombia, Dr. Correa completed his undergraduate degree at the University of Pittsburgh, Pennsylvania, and earned his medical school degree at the University of Maryland School of Medicine in Baltimore, Maryland.
Dr. Correa has been a member of the PURC collaborative since starting in May of 2020 and since has been an active participant in the biopsy working group. Within the collaborative, Dr. Correa has explored the impact of the COVID-19 lockdown on prostate cancer care across minority populations. As Chair of the biopsy working group, he has championed the adoption of the transperineal prostate biopsy approach, including the development of education resources for collaborative members, and closely tracking practice patterns and outcomes
What led you to urology? What interests you most about urology?
I chose to pursue urology because of the great mentors I had while in medical school in Maryland. I was captured by their unassuming demeanor and easy-going attitude while at the same time tackling complex health conditions. As I progressed through my urology training, I became interested in the management of urological cancers. I was intrigued by the wide spectrum of management strategies for each condition, ranging from observation in some patients to invasive procedures in others.
What is one thing you think people should know about providing prostate cancer care?
The main thing I would like people to know about the treatment of prostate cancer is how important it is to individualize the management strategy for each patient. Prostate cancer treatment has the potential to impact several domains of the patient’s life and without discussing important social factors, the consequences can be significant. An in-depth discussion about the patient’s employment status, dependents under his care, future employment, or financial plans are crucial to limit the impact of the treatment strategy on their livelihood.
“Prostate cancer treatment has the potential to impact several domains of the patient’s life and without discussing important social factors, the consequences can be significant.”
-DR. CORREA
If you could motivate people in your field to tackle one issue or address one challenge, what would it be?
The expansion of treatment options for patients with prostate cancer has also opened the window to increasing financial toxicity. As we move forward with adopting novel therapeutics, we also need to the cognizant of the downstream financial impact these therapies are having on our patients. It is well recognized that financial toxicity leads to an increase in mental health conditions and potentially inferior oncological outcomes as patients are tasked with choosing health over other life necessities.
What have you found most valuable about working with HCIF? What is something you’ve learned from our partnership?
I have been involved in the HCIF partnership since 2020, starting as a member of the prostate biopsy working group. It has been an amazing experience to share ideas within the collaborative and identify potential barriers to achieving our quality metrics. The changes made by the collaborative have been amazing, with our active surveillance rates above the national average and our rapid adoption of the transperineal prostate biopsy technique.
What’s a quote that inspires you in your work?
“Most of the successful people I’ve known are the ones that do more listening than talking” – Bernard M. Baruch. I believe that in the world of medicine, listening is a skill set that I work on daily to make sure I am providing the best care for patients. That means taking time to listen to their stories, their concerns, and their future plans. Only by active listening can you have a patient be a partner in their care.
What are some of your favorite hobbies or things you like to do for fun?
I like spending time with my two sons Mateo (8) and Nico (4). They are very active kids, so we spend a lot of time outdoors playing around. I also like to travel and get to experience new cultures.
