Partner Profile: A Conversation with Scott Cowan, MD, FACS

April 12, 2024

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.

We are pleased to feature Dr. Scott Cowan of Jefferson Health to share more about his reflections on patient safety and quality improvement as we look back on Patient Safety Awareness Week (March 10 – 16). Dr. Cowan is a Professor of Surgery and the Vice Chair of Surgery Quality and Safety at Thomas Jefferson University Hospital, as well as the Enterprise Lead of Surgery Quality and Safety at Jefferson Health. 

Dr. Cowan is the Vice Chair of HCIF’s Clinical Advisory Committee as well as serving as a member of the PENNJ-SOS Steering Committee.

You specialize in thoracic surgery – when did you first become interested in being a surgeon? And how did you expand your interest into quality and patient safety?  

After graduating from college in 1989, I took a position as an organ procurement technician with The Pittsburgh Transplant Foundation in Pittsburgh, PA. In this role, I had the privilege of working with Dr. Thomas Starzl, a pioneer in the field of organ transplantation, who fueled my interest in becoming a surgeon. My conversations and interactions with Dr. Starzl opened my eyes to what a surgeon can do for patients.

After training, I had the pleasure of working as an academic thoracic surgeon for approximately 13 years. My experiences as a junior attending provided insight into the importance of creating strong systems within our health care institutions that, if built correctly, could lead to harm reduction and improve patient outcomes. As an attending surgeon, I also had the privilege of serving on multiple hospital quality and safety committees and in 2013 I was appointed Vice Chair for Quality for the Department of Surgery at Thomas Jefferson University Hospital. Over the next decade, I served as the Medical Director for Quality and Safety at TJUH Inc. and Medical Director for Enterprise Risk for Jefferson Health. In order to develop a strong foundation in health care quality and safety, I completed a Master’s Degree at the Jefferson School of Population Health in 2018. These experiences have provided excellent insight into many facets of quality and safety and served to prepare me for my current position as Enterprise Lead, Surgery Quality and Safety for Jefferson Health. 

One of the roles of HCIF’s Clinical Advisory Committee is to identify and address Southeastern Pennsylvania’s quality and patient safety priorities. As a well-versed quality and patient safety professional, what do you see as some of the biggest challenges ahead or shifts occurring in this field? Are there any specific regional priorities that you and Jefferson Health are focusing on?

Health care is constantly evolving and a strong commitment to implementing and improving programs that benefit patients and raise the level of care is a necessity. When I was training, the average length of stay for a patient who underwent a lung resection was 5-7 days. Presently at Jefferson, with minimally invasive techniques, the length of stay has been reduced to 1.5 days and many patients are discharged just one day after their procedure. This is one of the many pathways and protocols that are evidence based which have led to exceptional outcomes in many non-complex and complex procedures.

An opportunity that lies ahead relates to safely integrating artificial intelligence (AI) into daily workflows. AI will play an important role in quality and safety and will need to be leveraged to further optimize patient care. In the realm of equity and inclusion, one of many areas that Jefferson is focusing on pertains to post-discharge transitions in care. Jefferson is working to expand and strengthen the continuity of care, particularly in patients with substance abuse and/or mental health disorders who have challenges with regards to accessing necessary resources.

Health care is constantly evolving and a strong commitment to implementing and improving programs that benefit patients and raise the level of care is a necessity.

Given your dual role as a practicing surgeon and quality and patient safety leader, what is one key thing you’d like the public, or someone not in healthcare, to understand about patient safety and the role it serves in our communities and the healthcare system as a whole?

Safety and quality need to be the number one priority when providing care to our patients. Although much work has been done in this area, there are still opportunities for improvement. Mandatory public reporting has had a positive impact on quality and safety, however, health care institutions need to focus on further enhancing systems and workflows to make it easy for our providers to do the right thing and hard to do the wrong thing. Jefferson is on the cutting edge of quality and safety improvement as demonstrated by the development of a robust Serious Safety Evaluation System, a structured event report review process,  and many additional programs focused on harm reduction in our hospitals.

As a longstanding partner of HCIF who has participated in several PPC programs over the years, what do you think makes HCIF unique and what have you found most valuable about working with HCIF?

I had the pleasure of working closely with HCIF when I served as President of the Pennsylvania National Surgical Quality Improvement Program Consortium (PANC). PANC partnered with HCIF on PENNJ-SOS, a grant-supported initiative aimed at reducing postoperative opioid prescribing in patients who have undergone surgical procedures in our hospitals. HCIF was instrumental in developing resources for our clinicians including patient information brochures, a podcast series, and an enhanced NSQIP data collection process to better understand postoperative prescribing patterns and the impact of opioids and anti-anxiety medication on patient outcomes. Our hospitals are making great strides in using multimodal therapies and in setting expectations for our patients in terms of using non-opioid modalities to help reduce opioid use during the recovery period.

Reflecting on your own career, what has been one of the proudest moments or greatest accomplishments of your career thus far?

In 2020, I was fortunate to co-lead the expansion of the Jefferson Enterprise peer support program known as R.I.S.E. (Resilience In Stressful Events). The aim of the program is to provide psychological first aid and emotional support to employees who are having difficulty coping after an adverse workplace-related event has occurred. Currently, over 1,300 encounters have taken place. These encounters involve peers who check on the well-being of employees involved in stressful events and provide support and resources when necessary. I am an active RISE team member and work with a dedicated group of volunteers across the enterprise who care deeply about the well-being of their colleagues.

To get to know Dr. Cowan a bit more, he shared the following:  He is inspired by the quote – “Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.”  – Atul Gwande. His true source of joy is my family. As hobbies, he enjoys growing grapes and reading biographies about individuals who have made a major impact upon the world.

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