In celebration of the Partnership for Patient Care’s (PPC) 15th Anniversary, the Health Care Improvement Foundation (HCIF) is featuring our partners on our website and in our monthly newsletter. As a long-standing collaborator with HCIF, we would like to take this opportunity to highlight the work accomplished by Independence Blue Cross, HCIF, and the region’s health care organizations over the past 15 years through PPC. The intent of these profiles is to give our readers a better understanding of the breadth of work of the Partnership for Patient Care, as well as an introduction to our innovative and valuable partners with whom we we are fortunate to work.
For this month, we are delighted to feature Victor Caraballo, MD, MBA, Vice President of Quality Management, Independence Blue Cross. In his role, Dr. Caraballo is responsible for all activities associated with ensuring health plan compliance with the National Committee for Quality Assurance (NCQA) accreditation standards. Dr. Caraballo is also actively involved in leading Health Equity activities in Independence as well as across many stakeholder organizations. Dr. Caraballo holds both undergraduate and medical degrees from Brown University and holds a Master of Business Administration degree from The Wharton School of the University of Pennsylvania. He is board certified in Emergency Medicine and is a Fellow of the American College of Emergency Physicians.
Dr. Caraballo is a longstanding supporter of HCIF and currently serves on the HCIF Board, Clinical Advisory Committee and is an advisor to our Health Equity Data Strategy, Pennsylvania Urologic Regional Collaborative (PURC), and Partnership for Patient Care programs. We conducted an interview with him to learn more about his experience with the Partnership for Patient Care program:
Independence Blue Cross supports the Partnership for Patient Care (PPC), which is a unique collaboration between a payer and providers to jointly fund quality and patient safety improvement initiatives and has been recognized as a national model. In celebration of 15 years, what do you consider the greatest accomplishments of PPC since its launch in 2006?
The Partnership for Patient Care program, led by HCIF has been so important. The creation of this unique collaboration has been the most impressive feat, in my opinion. Starting with the regional medication safety program and moving on to hospital acquired infections, readmissions, and more recently, Safe Table, the ability to address these challenging issues and create real and lasting change has been invaluable.
In addition to your involvement in PPC, you have supported HCIF’s work by serving on the Board of Directors, the Clinical Advisory Committee, and as a Champion for several programs. What do you think makes HCIF unique?
What makes HCIF unique is that it is a neutral convener, bringing together various stakeholders throughout the healthcare marketplace. But HCIF also understands the market and the intricacies of healthcare, as well as the dynamics of our region. I have been involved in a number of HCIF’s programs over the years and have appreciated its unique ability to maintain neutrality, while helping to solve very complex healthcare challenges in our community.
What have you found most valuable about working with HCIF? What is something you’ve learned through our partnership?
Experiencing the value of building coalitions is really unparalleled. Being able to see this in action and motion over the years has been incredible to witness – it’s very clear that we’re stronger when working collectively. We’re all connected in our healthcare ecosystem and the importance of working across stakeholders has been very instructive. No institution is an island – tackling healthcare problems together shows the power of coalitions.
PPC’s vision statement is “to be the safest region in the country.” As HCIF celebrates its 15th year, what are some of the most significant benefits to participation in PPC?
Collaboration with peers across the region is one of the most significant benefits of the PPC program. Working through this unique coalition allows individual institutions to have a seat at the table to solve real challenges. Peer conversations that are so critical and networking with colleagues are other benefits that comes to mind. The biggest benefit is working together. So much of the healthcare system is interconnected. For example, if you think of our readmissions work – this just isn’t a problem that can be solved working in your own bubble. PPC allows for interchange of ideas and best practices.
As HCIF and Independence Blue Cross turn to/look forward to the next 15 years of PPC, what do you think is the next big frontier in healthcare for the Philadelphia/SEPA region?
The next frontier is about being aware of critical issues such as health equity, and being able to mitigate the drives of health inequity. We need to address health care holistically by evaluating social determinants of health. Many players will need to work together in a way that improves health and accrues to everyone’s benefit.
You’ve been at Independence Blue Cross for19 years. How did you become interested in quality improvement and/or patient safety? How has your background as an Emergency Department physician influenced your interest in quality improvement and/or patient safety?
First, I always wanted to serve an underserved population and working in the emergency department allowed me to do this. What got me interested in quality and safety was my training in emergency medicine. Working in the emergency department (ED) requires a very process-driven and modular approach to care, while also recognizing the importance of treating the individual. Working in the ED allows you the option of reflecting back at the end of the day to see how I could deliver care in a better way.
What has been your personal proudest accomplishment within the quality/patient safety field so far?
There have been a lot of different accomplishments, but problem-solving some very challenging issues tops that list. I am also very proud of my work with the National Committee for Quality Assurance (NCQA), serving on a number of committees. Recently, I have been working to lead Independence Blue Cross’ (IBC) COVID 19 program. COVID has really shone a light on the issues of inequities in healthcare and vaccine access. I am very proud of the leadership IBC is taking to address health equity and integrating this into our quality and safety programs.
What is a quote that inspires you in your work?
“A work that aspires, however humbly, to the condition of art should carry its justification in every line. And art itself may be defined as a single-minded attempt to render the highest kind of justice to the visible universe, by bringing to light the truth, manifold and one, underlying its every aspect.”
I have found this to be profound and inspiring – especially the importance of having lofty goals and integrity in your work. Everything you do should be of excellence and accrue to your ultimate goal.
What are some of your favorite hobbies, or things you like to do for fun?
I love music, reading, and cooking Mediterranean-inspired food and Italian cuisine.
What’s something most people don’t know about you?
I am a long-time environmentalist, especially growing up in the 70s. Being a city boy, I always found it important to have a connection to nature. The 1970s were a time when the environmental and climate issues came into national consciousness, and I was especially moved by the commercial showing a Native American man crying due to the mistreatment of nature. I explored the ideas of alternative sources of energy when I was a kid and won an essay contest from the White House with President Jimmy Carter.
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 for a responsive, coordinated health care community that fulfills the needs of patients and consumers to achieve better health.
HCIF is proud to serve as project manager for Go to Know, a campaign to raise awareness about the impact of colorectal cancer on the African American community. Through this program, anyone can request an at-home fecal immunochemical testing kit, or “FIT kit”, to be screened for risk of colorectal cancers.
For this month’s partner profile, we are excited to feature a Go to Know partner, Sara Lomax-Reese. Sara is the President and CEO of WURD Radio, Pennsylvania’s only African-American owned talk radio station, and a longtime advocate for the health of the African-American community.
[Cassidy Tarullo]: How did you become interested in health awareness?
[Sara Lomax-Reese]: My father was a doctor and I remember growing up going to his office in South Philly, and working in his office as a teenager. He ended up having health care centers all over the city of Philadelphia in underserved communities. So, I was exposed at a very early age, seeing not just the science of medicine, but also the art. He was a brilliant, brilliant physician.
When I graduated from journalism school, I started reporting and writing for different newspapers and magazines. My father had stopped practicing and had developed a health care management organization, and the family business was providing managed care services to prisons and jails around the country. My entire family was involved in that business, except for me as a journalist; I was an outlier, because I wasn’t working in the family business. But, I did want to do something that really was meaningful within this journalism avenue. I was living in Atlanta, and I connected with another Black woman who was an editor at the Atlanta Journal Constitution, and the two of us started talking and planning and exploring; we wanted to develop a magazine that would fill a void. Once we started doing the research, we realized that there were no magazines at the time that focused specifically on the Black community from a health perspective. I had this lightbulb moment where I realized that I could still be within the family business, but on my own terms. So, we pitched this idea of starting a consumer-based Black health magazine to my parents, and they were willing to take a chance on it. My co-founder, Valerie Boyd, and I, launched HealthQuest: The Publication of Black Wellness, in 1992. We published that for about 10 years, and it grew from a quarterly magazine that reached about 25,000 people to bimonthly with a national circulation to 500,000 people. It was a real journey, being a media person and developing a media business, but also from a health standpoint, and seeing the racial health disparities that exist. Throughout COVID, everybody has been saying, “Wow, racism exists in healthcare”. Well, we knew it. Anybody who’s been in health care has known that for a very long time. I’ve also learned so much about culturally-specific communications around health and wellness, and figuring out, what are some of the ways to really connect with a Black community with information that can oftentimes be scary and numbing? How do you break through, so you can connect and really help people? How do you spark interest and awareness proactively?
“Health and wellness is so deeply embedded in who I am at this point.”
– Sara Lomax-Reese
I closed the magazine down in January 2002, and it was pretty devastating for me, because I just invested so much of my time and energy in it. But, my father bought WURD in 2002, and at that time, then General Manager, Cody Anderson asked me if I would want to host a weekly show. I started doing a three hour radio show called HealthQuest Live, that was basically a radio version of my magazine. That kept me very connected with health communications and health information. At the same time, I became a yoga teacher, and learned about holistic nutrition. I started doing workshops for Black women, that integrated yoga and holistic nutrition. I did that for a few years, and simultaneously, the radio station was continuing to evolve, though it was struggling financially. I was the only one in my family who had media experience, so even though I was really committed to not being a part of management and media entrepreneurship, I got drawn back in. I became the President and General Manager in 2010, and have been running the station ever since. I wasn’t able to keep the HealthQuest show on air, due to the day-to-day operations of the station, but health and wellness is so deeply embedded in who I am at this point.
[CT]: What accomplishments are you proudest of as the CEO of WURD?
[SLR]: That we’re still alive and kicking and growing. We’ve defied the odds. I think we might actually be the only independently-owned Black talk radio station in the country. Even if we’re not the only, we are one of very few. There’s a reason that there’s not a proliferation of media outlets like ours. It’s very difficult to build and maintain. I’m really proud of the fact that something that my dad ventured into as a community service, has survived. He always thought that it’s important to give the community a voice.
[CT]: What is one thing that you feel like people should know about colorectal cancer?
[SLR]: That it’s highly preventable. That you can survive. When you’re working multiple jobs, or under a lot of stress – you’re not sleeping well, you’re not eating well, and there’s all of these things that could potentially be indicators of a problem or a disease state. But you are so busy and so distracted, that you just chalk it up to, “Well, you know, I’m just tired”. I think that really cultivating mindfulness and awareness about your physical and emotional and mental wellbeing is super important.
[CT]: What have you learned so far by participating in the FIT Kit distribution program that has surprised you?
[SLR]: I don’t know if this surprised me, but I appreciate the fact that we have major partners at the table who are co-creating something that could have a real impact on the Black community. And I appreciate the fact that we have the commitment, willingness, creativity, and interest to figure it out, because it’s not easy. There are a lot of moving parts and complexities, and I appreciate the fact that everyone is willing to try, and to put in the work to put something together that we’re going to learn a lot from. It’s all hands on deck, and I appreciate that.
[CT]: If you could motivate people to tackle one issue or address one challenge in health, what would it be?
[SLR]: I remember when I was doing the magazine, I asked my father, “Dad, what’s the number one health issue facing the Black community,”, and he said, “Poverty”. I really think that until we can come up with strategies to create more equality, more access to financial resources and education, this continues. People get trapped into these cycles of disenfranchisement, and it becomes generational. Figuring out ways to create access and opportunity for people who have been left out and locked out is super important.
“It’s literally a matter of life and death that we share information in ways that are accessible and culturally specific.”
– Sara Lomax-Reese
[CT]: Why do you feel that it’s important for media outlets like WURD to promote health topics to the community?
[SLR]: There’s a lot of history with Black people in the health care system, that has been very damaging and exploitative. So, I think that it’s very important to have outlets that people Black people trust to have their best interests at heart, and know that they’re not being taken advantage of. Because we suffer disproportionately from just about every disease state that exists, it’s literally a matter of life and death that we share information in ways that are accessible and culturally specific.
[CT]: What is a quote that inspires you?
[SLR]: I have three.
If I didn’t define myself for myself, I would be crunched into other people’s fantasies for me and eaten alive. – Audre Lorde
To be a Negro in this country and to be relatively conscious is to be in a rage almost all the time. – James Baldwin
Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. – Marianne Williamson
[CT]: Lastly, we’d like to ask some fun questions about you outside of your professional life – what are some of your favorite hobbies, things you like to do for fun, favorite places you’ve visited?
[SLR]: I love hanging out with my friends – I have an amazing group of girlfriends. I love yoga and meditation, eating out, reading books, watching movies, and traveling. I want to travel to Bali. I studied abroad in college in Paris, and that was amazing – I love Paris. I traveled to South Africa, and that was an amazing trip too.
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 for a responsive,
coordinated health care community that fulfills the needs of patients and
consumers to achieve better health.
In recognition of one of HCIF’s Partnership for Patient Care signature programs, Safe Table, that is continuing in 2021 with renewed funding, we are excited to feature our partner, Barbara G. Rebold, RN, BSN, MS, CPHQ, LSSYB, Director of Engagement and Improvement at ECRI.
Barbara G. Rebold, RN, BSN, MS, CPHQ, serves as co-lead and facilitator for HCIF’s Partnership for Patient Care (PPC) Safe Table program, which began in 2017. A unique program that focuses on regional collaboration, the PPC Safe Table is facilitated by ECRI Institute Patient Safety Organization and provides a legally protected environment for hospital Patient Safety Officers to discuss actual patient safety events and to share solutions and best practices. In an unprecedented year when many meetings had to be converted to a virtual format, Safe Table attendees expressed the high value of the program to themselves and their organizations as well as their continued engagement with the program. We are pleased to feature Ms. Rebold in recognition of the PPC Safe Table continuing in 2021 with representation from 12 hospitals in the Southeast PA region.
How did you become interested in quality improvement
and/or patient safety?
became interested in quality improvement in the early 1980’s, during my first
nursing management job. Quality improvement allowed me to advance the healthcare
goals that I had been passionate about since my time in nursing school.
ECRI Patient Safety Organization and HCIF
have been working together with regional Patient Safety Officers for the past
four years supporting the Partnership for Patient Care (PPC) Safe Table program.
What do you consider the greatest benefits and accomplishments of the PPC Safe
Table so far?
I think the greatest accomplishment of the program is meeting the need of the PSO community by creating a protected space to improve patient safety together. While the Safe Table meetings started slowly with two per year, they have since increased to five per year at the encouragement of the participants.
What are your greatest accomplishments
within your field so far and what do you see as the most important priority in
I am most proud of my continued quality improvement work and my commitment to understanding the different issues in multiple settings.
have been certified in healthcare quality; this allows me to take the broad
view of what we need to do to improve patient care and keep patients safe. I
have worked in quality in multiple settings such as the hospital, behavioral
health, ambulatory care, and managed care. ECRI awarded me the Patient Centered
Award, which validated my commitment to patients.
think the most important priority is creating a culture of safety in every
healthcare organization. This culture shift enables everyone, from leadership
to the frontlines, to approach every problem with a patient-centric solution.
In addition to your work with the PPC Safe
Table program, you have also participated in numerous other PPC programs over
the years. What do you think makes HCIF unique and what have you found most
valuable about working with HCIF?
is one of the only organizations to provide a venue for regional healthcare
organizations to gather and collaborate on improvement activities.
of the things I value most about my work with HCIF is the mutual commitment to
healthcare improvement, and HCIF’s ability to convene various stakeholders to
What is a quote that inspires you in your
Einstein is credited with this quote: “The definition
of insanity is doing the same
thing over and over again, but expecting different results.” It reminds me that good
quality work is the opposite of that; you are forced to rapidly make
adjustments to improve care.
If you are
interested in connecting with Barbara on LinkedIn, you can find her at: https://www.linkedin.com/in/barbaragrebold/. Something that you may not know about Ms.
Rebold is that her husband and children as well as herself enjoy renovating
classic cars and drag racing cares. They have almost 10 cars and she has
actually been a drag race driver on several occasions! In addition to her love
of cars and once travel opens up again, she would like to return to one of her
favorite places to visit, Hawaii!
Care Improvement Foundation’s (HCIF) Partner Profiles highlight the efforts of
valued and innovative health leaders. Our partners’ work supports HCIF’s vision
for a responsive, coordinated health care community that fulfills the needs of
patients and consumers to achieve better health.
In recognition of Men’s Health Month, we celebrate the work of Dr. Adam Reese, Chief of Urologic Oncology at Temple University Lewis Katz School of Medicine. Dr. Reese actively engages with PURC as the physician champion for Temple University and as the chair of the PURC Active Surveillance working group. His active involvement in pioneering PURC initiatives such as the development of the PURCASE tool that standardizes active surveillance initiation across practices and providers has greatly contributed to PURC’s successes.
What led you to urology?
What interests you most about urology?
school, I had the opportunity to work with several urologists who had a
significant impact on my career decision.
They seemed to truly enjoy their work, much more so than many physicians
in other fields did. The more time I spent with them, the more I realized urology
was the right field for me.
focus in urology is caring for patients with urologic malignancies. We are learning that many malignancies can be
managed in a conservative fashion with surveillance, allowing patients to avoid
the potential morbidities caused by surgery and other aggressive treatment
approaches. I am very interested in risk
stratification of urologic malignancies, which helps us to differentiate low
risk patients who can be managed with surveillance from higher risk patients in
whom more aggressive treatments are necessary.
What is one thing you
think people should know about providing prostate cancer care?
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. For this reason, it is critical for the
doctor to work in conjunction with the patient to select the best available
treatment for reach individual patients.
What are your greatest
accomplishments within your field so far?
I am most proud
of being named the program director for our Urology Department at the Temple
University Lewis Katz School of Medicine.
The education of future urologists is one of the most important
responsibilities of an academic medical center, and I am proud to have been
entrusted with this responsibility at Temple.
If you could motivate
people in your field to tackle one issue or address one challenge, what would
encourage people to avoid the overtreatment of clinically indolent, low risk
prostate cancer. Active surveillance is
an excellent management strategy for these patients, but it is still
under-utilized in my opinion.
What have you found most
valuable about working with HCIF? What is something you’ve learned from our
I have found
the ability to collaborate with my colleagues across the region as the most
valuable aspect of working with PURC.
Without organizations such as PURC, it is easy to become isolated at
your own institution. Collaborative such
as PURC open our eyes to different ideas and opinions from physicians at other
centers that I would not have otherwise encountered.
Dr. Reese is a firm believer that a physician should treat their patients as they would like to be treated. Beyond hospital walls, he is an avid watcher of professional sports, specifically the English Premier soccer league and NFL. He also enjoys spending time with his kids, and hopes to travel with them to Australia someday.
Incorporating the patient voice into our work has been an explicit goal for HCIF, and the Pennsylvania Opioid Surgical Stewardship Enterprise (POSSE) is an example of a program that has greatly benefitted from the patient perspective. This month’s Partner Profile highlights one of POSSE’s Patient Advisors, Paula Boffa-Taylor, who has provided invaluable feedback that informed the development of patient education materials on post-surgical pain control and opioid use. We connected with Paula through Temple University Health System, which has one of the most robust Patient and Family Advisory Councils (PFAC) in the region. Paula recently rotated off of Temple’s PFAC, but will continue to serve in a Patient Advisor role for POSSE.
How did you become a patient advisor? What motivated
you to serve as an advisor?
About 3 years ago,
a dear family friend approached my husband to say that Temple Heart and
Vascular Institute was starting a PFAC and asked if he would like to become a
patient advisor. Ron had quintuple bypass at Temple Hospital 17 years ago and
has received all his care there over the years, making him a great candidate.
When I heard what the PFAC would be doing, I “nominated” myself! I think my
statement was, “I want in!”
What did you find most enjoyable about
participating in a Patient and Family Advisory Council?
Although I’ve had
many jobs over the year, I consider myself a teacher at heart, and someone for
who clear communication is a passion. Being able to help bring a patient or
family member point of view to the table has been greatly rewarding.
If you could motivate health care providers
to tackle one issue or address one challenge, what would it be?
During my years as
a PFAC member, I had the opportunity to work on a variety of committees at
Temple Hospital. Based on my experiences, I would urge providers to continue to
include “outside” voices to ensure that the incredible work they are doing can
be best accessed by patients and their families. One of my favorite volunteer
positions was as a member of the Performance Improvement/Patient Safety
Committee. There I got to see and learn firsthand the amazing work being done,
problems being tackled AND offer ways to make it more accessible and/or
For example, I had
the opportunity to serve on a national panel of PFAC members to discuss what
health care institutions needed to consider as they welcomed people back after
quarantine. I believe it was helpful for institutions to hear that while their
focus was on “the now,” they really needed to speak to what had transpired if
they wanted to get patients to trust and listen to why/how it was once again
safe. I spent many years in business as a Client Relationship Manager. I
learned early on that if you wanted to get back on track with constituents and
customers, you need to resist the urge to just dive back in. Addressing what
came before, what was learned, how it would be different are all important
components of helping people move forward and being open to your message.
People can’t hear you if you act like nothing happened, no matter if it was as
a result of someone’s fault or a national pandemic.
What’s something you’ve learned from
bringing your perspective to POSSE and the work in opioid surgical stewardship?
I learned that I
was by no means alone. I was especially pleased to meet the many “kindred
spirits” who are working to improve health care by including the patient and
family member perspective.
* * *
As is evident from
her profile, Paula loves to problem solve and understand. She is always looking
for ways to do things better and to learn something new. Something she does
unconsciously while reading or listening is try to figure out what’s behind the
speaker’s point of view. Paula holds a Master’s degree in Music from The
University of Michigan. While she did not continue as a musician, the rigorous
training she received there has kept her in good stead her entire life.
information about POSSE’s patient-centered domain or how HCIF is incorporating
the patient voice into their programs, contact Director of Health Literacy,
Susan Cosgrove, firstname.lastname@example.org.