During its 15 years of training New York-area clinicians, United Hospital Fund and Greater New York Hospital Association’s Clinical Quality Fellowship Program has produced hundreds of quality improvement initiatives tackling pressing challenges across the health care system. But its impact extends even further than each class's 15-month experience.
With more than 300 physicians, nurses, and physician’s assistants trained thus far, the program has also built an influential—and growing—network of dedicated changemakers throughout the region. On November 6, the power of this network was particularly evident as alumni, faculty, mentors, and UHF and GNYHA staff gathered for the first-ever CQFP alumni reception.
“The future of this fellowship is really a shared endeavor that each of you can have a role in helping us to shape,” said Erin DuPree, MD, GNYHA’s senior vice President and physician executive, quality and clinical initiatives. “Together we can create an environment that empowers every fellow to maximize their potential to lead not only with compassion, but also courage, and to drive change that resonates far beyond the program."
The alumni reception, held at The Harvard Club of New York, comes as CQFP celebrates its 15th year training fellows to become quality improvement and patient safety leaders in their organizations.
Since its start in 2009, the program has evolved to address new and persisting challenges in health care quality. Joan Guzik, director of quality and efficiency at UHF’s Quality Institute, noted specifically a recent focus on health equity and public health priorities in CQFP’s curriculum and capstone project selection process.
“UHF, Greater NY, and our faculty are continually working to improve this program,” Ms. Guzik said at the reception. “This program really aligns with United Hospital Fund’s mission to build a more effective and equitable health care system for all New Yorkers.”
The keynote speaker at the alumni reception, Ronald Wyatt, MD, also focused on health equity’s role in quality improvement. Dr. Wyatt—the founder and president of Achieving Healthcare Equity, LLC, and a senior fellow at the Institute for Healthcare Improvement—provided attendees with a comprehensive overview of health inequity as a critical issue in patient safety, quality, and risk management, offering practical ways alumni can execute and sustain health equity initiatives.
“[Quality and equity] are inextricably linked,” Dr. Wyatt told attendees. “There is one core value to quality and safety, and that is equity. They cannot be siloed from each other.”
In addition to providing a thorough history of health inequity, and his own experiences as a clinician, Dr. Wyatt offered tools to address these challenges. Among them were methods to rebuild trust between patients and providers, a growing adoption of “structural competency” training for clinicians, and creating cultures of equity by diversifying the health workforce. At the root of each of these tools, Dr. Wyatt emphasized the necessity of clinicians to see themselves as public servants to their patient populations and the community.
“Equity starts when you know and understand who you serve,” Dr. Wyatt said.
In honor of this 15th anniversary celebration, UHF is reflecting on recent fellow capstone projects that have driven significant change across the New York region.
Each of the highlights below emphasizes both the real results spearheaded by the fellowship project and the personal impact of the program on fellows’ long-term careers and capacity for quality improvement within their institutions. More than 70 percent of CQFP alumni said they received a promotion or took on a leadership role within one to three years of completing the CQFP, according to a recent survey conducted by GNYHA. Plus, nearly all alumni surveyed—95 percent—said they encouraged others to pursue a career in quality improvement after completing the program.
Here are some highlights of their work:
One doctor tripled the rate of potentially lifesaving follow-up calls to patients visiting the emergency room for substance use and doubled the follow-up rate to those visiting for mental health reasons across 11 facilities.
One doctor tripled the percentage of patients with lung disease who took a “cough questionnaire” during each visit, helping providers track their progress or the need for new treatment options.
An OB/GYN equipped her women’s health center with telehealth capabilities, shaving 40 minutes off the average appointment time for patients’ first pregnancy evaluation.
One physician developed a tool now used by six hospitals that helps ensure patients with serious illness can access palliative care.
A nurse manager ensured all heart attack patients received an EKG within the recommended 10 minutes of arrival to the emergency room, allowing quicker diagnosis and treatment.
One physician assistant’s new protocol in the emergency room doubled the rate of stroke patients who were treated within a critical 40-minute window of arrival.
The Clinical Quality Fellowship Program is one of several ways UHF works to advance the quality and efficiency of health care in New York. Despite recent progress and investment, health care quality, safety, and outcomes remain far too variable, underscoring the importance of training leaders to tackle these critical issues both at a system level and in their day-to-day work.