For those of you who may not be familiar with Curb Your Enthusiasm, there was an episode at the beginning of the 2020 season that discusses when exactly it’s too late to say “happy new year”. According to Larry David, it’s only 3 days, so I am well overdue in sending out my happy new year wishes and sentiments. Admittedly, wishing a happy new year at the beginning of 2022 felt a bit enthusiastic with omicron weighing heavily like a thundercloud getting ready to drop torrents of rain. About three weeks later, there does seem to be a glimmer of sunlight on the horizon with predictions that omicron will peak in the next month or so.
Despite the uncertainty surrounding the start of this year, one thing is for certain as I reflect on 2021: it brought shining examples of collaboration and innovation in healthcare. HCIF started the year planning for the 15th anniversary of the Partnership for Patient Care program. This program has offered leadership and guidance for the region in quality and patient safety since its inception. Throughout the past year, programming often reflected the needs of our partners, including discussions and resources related to COVID-19. We celebrated our milestone anniversary during the year by highlighting partners through our social media and communications channels and developing new materials, including our 15th anniversary video. The year culminated in our Annual Leadership Summit in November, which while unable to be held in person, was nonetheless compelling and educational. The theme of the summit was health equity and featured healthcare leaders discussing their equity journeys and the links to quality and patient safety.
2021 also saw the launch of our newest program – the Health Equity Data Strategy (HEDS) initiative. This program aims to reduce healthcare disparities by supporting and educating health systems in the collection and utilization of racial, ethnicity, and language (REaL) data. A comprehensive assessment was administered to eight regional health systems in September 2021 to establish a baseline for improvement efforts. This program will continue in 2022 with development of best practice recommendations, sharing of resources, and education from expert leaders.
Cities Changing Diabetes continued to change the landscape of diabetes prevention and management in Philadelphia through targeted community interventions. These include an initiative to train youth champions to support policies that prevent diabetes and obesity; a program that provides resources for individuals with disabilities and diabetes to practice healthy lifestyles; a nutrition and education program to help address obesity, diabetes and chronic conditions in a recently incarcerated population; and a program to engage youth leaders and community health workers to provide health education to a targeted community. Expansion of these initiatives, as well as additional programming through faith-based institutions, is anticipated for 2022.
Work began in earnest in 2021 for the next round of the Southeastern Pennsylvania regional Community Health Needs Assessment (rCHNA). The highly-anticipated report will be released in June 2022 and features a number of expanded areas in this new iteration, updated from 2019. In addition to quantitative data analysis, the report will highlight qualitative data collected from over 40 community discussions, and thoughtfully captures the voice of the youth and other specialized groups.
Our health literacy work continued in 2021 with the delivery of trainings to various groups and a recognition of the linkages between health equity and health literacy. With an opportunity to renew our program in 2021, HCIF engaged a health equity consultant to further pursue these linkages. The consultant will work with HCIF to develop a vision for our health equity work, help us in integrating equity principles into our health literacy materials and programming, and support the development of a health literacy leadership committee.
In April 2021, we launched a comprehensive strategic planning effort which concluded in December. The culmination of this initiative is a strategic roadmap which, rather than providing a step-by-step plan, offers HCIF more flexibility in implementing three new strategic priorities. These are: 1.) develop a strategic approach to advance health equity and positive health outcomes for all, 2.) catalyze efforts to engage patient and community voices more fully, and 3.) integrate clinical improvement and population health frameworks in future programs. The strategic planning imitative also allowed us to revisit our vision and mission statements and we are excited to be guided by these in the future:
Healthier communities through equitable, accessible, and quality health care.
Driving superior health care through collaboration and shared learning.
So despite some of the uncertainty facing us again in 2022, there is so much promise of good things to come. In fact, in the immortal words of Larry David, 2022 looks pretty pretty pretty good.
HCIF: A Study of a Highly Effective Board of Directors
December 20, 2021
In 2019, attorney Thomas Hyatt authored a blogpost on the traits of high-performing boards. The traits include: full board involvement and a sense of engagement and participation; a respect for processes that further the organization’s mission; willingness to try new directions; strategic vs. operational focus; and an effective partnership with staff leadership. If I were to choose the characteristics that best describe HCIF’s Board of Directors, Hyatt seemed to read my mind a year before I even joined the organization. As a staff leader, I won the Board lottery!
Boards typically work behind the scenes in terms of driving strategic direction and organizational performance, and they don’t always get the credit they deserve. Although I have only been with HCIF for about 18 months, I am certain that HCIF has weathered the storms of the past 2 years because of the strength, commitment, and leadership of our Board members. Not only did our Board lead the organization through a search and leadership transition, they did this during the time of COVID – quite a challenging time to recruit and onboard a new leader. They proactively identified solutions and mitigation strategies to counter the financial ups and downs associated with the virus. They also reacted swiftly to the social justice issues of the summer of 2020 and made a powerful and committed statement about our organizational stance on racism. Finally, they have been active participants in an 8-month long strategic planning process to identify organizational priorities, including health equity, community engagement, and bridging population health and clinical care.
The Board has been capably and adeptly led by former Board chair, Steve Wray since 2017. Steve has been a true partner in every sense of the word since I joined HCIF. I recall my first Board meeting – 2 days after starting with the organization. I was nervous and (virtually) meeting some members for the first time. I worried that I didn’t know Robert’s Rules very well, or that my technology wouldn’t work, or that one of my kids would interrupt the meeting. But Steve set the tone for the meeting, provided a little levity, and made me feel comfortable – as did all of our other Board members.
Mike Casey, our former vice-chair, was one of the first Board members I met during the interview process. With terrific business acumen, Mike has provided great strategic insights and recommendations during my tenure with the organization. I will always be grateful for his warm reception and gift of time during my first few months at HCIF. He has also been one of our go-to Board members to interview and recruit new members.
Joe Tate joined the Board as a consumer representative in 2016 and has provided great counsel on his experiences as a patient. Joe offered his legal expertise and guidance as we amended our bylaws in 2020 and has always contributed to our many strategic discussions. Betty Craig also joined the Board in 2016 and brought her insights to our work from her role as a Chief Nursing Officer. Her contributions in providing firsthand accounts of clinician and patient experience has been essential to our work, especially during COVID.
Unfortunately, Steve, Mike, Joe, and Betty all had terms that expired at the end of 2021. I am so appreciative of their commitment and contributions to HCIF and greatly value all that they have offered. Now it’s time to welcome a new slate of leaders to the Board as we implement our new strategic roadmap. I am pleased to share that Patricia Sullivan, PhD, RN, Chief Quality Officer of the University of Pennsylvania Health System, will serve as our new Board Chair and Natalie Levkovich, Executive Director of the Health Federation of Philadelphia, will serve as our Vice-Chair. I am looking forward to partnering with them on the next chapter of HCIF’s story. I am also excited to welcome Norm Weinstein to the Board for 2022. With our new leadership at the helm, I trust that we will continue to have a highly-effective and functioning Board that will continue to guide us as we encounter new triumphs and challenges.
November marks National Diabetes Month. For most of my career, the better part of 25 years or so, I have worked in programs focused on diabetes prevention and management. This disease is infuriating and no matter how many resources we seem to throw at it, it continues to rage on in our communities. What is most heartbreaking and frustrating about diabetes is how it ravages communities of color. African Americans are 60% more likely to be diagnosed with diabetes and are twice as likely to die from it. In Philadelphia, 17% of adults with diabetes are African American, while overall prevalence is 12% (Health of the City 2020, Department of Public Health, City of Philadelphia). Poor social conditions caused by systemic racism, such as poverty, lack of access to healthy food, and unsafe housing contribute to poorer outcomes.
While many of the programs I have been involved in throughout my career were noble in their efforts to improve prevention and management, they didn’t strike at some of the systemic issues that plague communities and cause diabetes in the first place. For the first time, however, I feel hope that there is a way to combat diabetes. With an “it takes a village approach,” HCIF’s Cities Changing Diabetes – Philadelphia program engages multiple stakeholders in addressing diabetes in innovative ways. What feels palpably different about this program is that it embraces the most vulnerable of communities, including recently incarcerated citizens, individuals living with disabilities, and other overlooked or underserved populations. The authentic engagement of these communities is how we embody our values and commitment to equity. Additionally, the program helps to integrate fundamental social determinants of health issues into diabetes prevention and management.
I have thought a lot about diabetes and equity recently. When you read about healthcare disparities in journal articles, it doesn’t quite hit home until you realize that people who you know are impacted by diabetes due to longstanding inequities. In trying to learn more about diabetes and disparities, I stumbled across the American Diabetes Association website and learned that they recently developed a Health Equity Bill of Rights: https://www.diabetes.org/healthequitynow
One of the rights impacted me the most:
#8: The right to a built environment that does not put you at greater risk for getting diabetes.
This is something that many of us take for granted – access to clean air, clean water, safe places to exercise and play, and access to healthy food. To address these issues, it will take a village to create innovative solutions and a community-based approach. I am comforted that a program like Cities Changing Diabetes exists and am hopeful that in another 25 years when I look back, it will serve as a model for how we can improve outcomes and decrease disparities in chronic conditions in cities across the country.
Only two weeks until our Partnership for Patient Care 2021 Leadership Summit! As with most events during the past 18 months or so, the Summit has taken on a bit of a different direction this year. During the late spring and summer of 2021, we were deep in the throes of hopeful menu planning for our first in-person event in over a year. Deciding whether to serve wasabi tuna sliders or bruschetta on focaccia felt very important at the time. However, as COVID-19’s Delta variant began to surge in the mid to late summer, it became clear that we had a responsibility to our partners and health care stakeholders to move to a virtual event.
Although mainstays like the Delaware Valley Patient Safety and Quality Awards will continue to be a part of the program, the virtual platform has given us an opportunity to try new ways of delivering important content. We are thrilled to welcome Dr. Tejal Gandhi, Press Ganey’s Chief Transformation Officer, as our keynote speaker this year. Focusing on our theme of health equity, Dr. Gandhi will be providing critical insights about the connections between patient safety and equity. We will also have the opportunity to hear from leaders throughout the region about their health-systems’ health equity journeys. This virtual panel discussion will be moderated by Sara Lomax-Reese, CEO of WURD Radio.
While we had hoped to toast in person, we will have a virtual celebration of the 15th anniversary of our Partnership for Patient Care (PPC) program. We will be featuring virtual memories from the past 15 years of excellence in quality and safety from the program creators, participants, and HCIF staff. As we have recounted its history in planning for the Annual Summit, PPC has truly been a remarkable achievement. PPC’s original mission was to support the region in providing the highest quality and safest care in the country. Through the hard work and dedication of over 2,000 participants over the years, we are proud to say that PPC has contributed to reductions in hospital acquired infections, wrong site surgeries, and readmissions. It has also led to more transparent discussions about patient safety, and has allowed health-systems to share best practices without fear of retribution.
Today, PPC is recalibrating its focus on equity through a recently-launched program related to the collection of race, ethnicity and language data (REaL). The Health Equity Data Strategy (HEDS) program will provide organizations with the opportunity to evaluate their REaL data collection and utilization practices and learn about strategies to improve healthcare disparities. PPC’s evolution from safety to now include equity has been part of a natural progression in response to the needs of our region. I am so very proud of this program, the HCIF staff who lead it (Pam, Liz, Kaynaat, and Cassidy) and those who have been involved over the years. I am eager to see where we will end up 15 years from now.
Although we will have to forgo pigs in a blanket and hummus and carrots this year, the Annual Summit promises to deliver critical perspectives on health equity and serve as a celebration of PPC’s achievements over the past 15 years. We hope you’ll join us as we honor the past and look forward to the future.
What Do Patient Safety and Gratitude Have in Common?
September 28, 2021
My house is very busy right now. With two kids in high school and one in middle school, the house is abuzz with activity by 6:30 a.m. Packing lunches, arguing about who gets to shower first and shotgun, and putting books in backpacks, it is a familiar and welcome clamor. My children are going to school after a year and a half of being home. An unnatural interruption, a pause in life, a time lapse that I can only pray will not have long-term consequences on their development. They are going to school and I am grateful.
I am sincerely grateful to the clinicians who persevered against great odds to selflessly take care of COVID patients. Without appropriate personal protective equipment or enough knowledge for how to protect themselves or their patients, they used patient safety best practices and principles to fight against COVID. I am grateful to the frontline leaders and teams who analyzed and evaluated events related to COVID to ensure that future patients would be protected and harm would be minimized. I am grateful to the scientists who created a vaccine that is safe and effective. I am grateful to the first willing recipients of the COVID vaccines.
World Patient Safety Day, observed every year on September 17th, was established only two short years ago in 2019 by the World Health Organization. This past year and a half has been a constant reminder to clinicians, quality and safety leaders, administrators, and other healthcare stakeholders that patient safety must be a foremost priority when fighting a formidable enemy such as COVID. I propose that in observance of World Patient Safety Day (even though you may not be reading this column until after the day), we honor all of those who have sacrificed to protect our patients, keep them safe, and help us return to some sense of normalcy. If you are a healthcare worker who has been practicing in the throes of COVID, thank you.
As the alarm clock buzzes before dawn, the house slowly comes alive, and sounds of school buses rumble down the block, I am grateful.