Joint Commission's Wyatt says collaboration is the key
Hospitals facing "perfect storm" of issues, he says
Ronald Wyatt, MD, MHA, has spent 20 years working in just about every kind of healthcare setting imaginable — primary care, emergency medicine in a VA hospital, nursing homes, as a sole practitioner and in a multispecialty setting. He's been a hospitalist, worked in a rehabilitation facility, in a community health clinic, and in medical education. It is this breadth of experience that is part of what made him a contender for his latest role, medical director for the division of healthcare improvement at The Joint Commission. And being familiar with all those healthcare settings and roles is something Wyatt thinks will give him an entrée into the organizations that seek JC accreditation and help in achieving and exceeding the standards that bring it.
"The real-world experience I have had speaks with authority about patient safety and quality," he says. "I have seen the challenges first hand, I have witnessed — and made — mistakes. I have also instructed patient safety managers in my role at the Department of Defense, and heard from them directly about the challenges they experience from process and policy perspectives. I have talked with them about how to engage patients and their families, and others in the healthcare community in the urgent need to improve quality and safety."
He calls the situation hospitals find themselves in right now a "perfect storm" of issues. "Hospitals have to lower cost, they have to show value, they have to maintain volume, and they have to respond to all of the regulatory requirements. And they have to do this while improving quality."
He mentions the recent report from the Institute of Medicine on providing the best care at the lowest cost (http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx). It talks about reducing readmissions, reducing mortality, reducing injury and the costs associated with not addressing those concerns — thousands of lives lost, millions of dollars misspent. Finding one area to focus on, even just during his first month or two, is impossible. "I think the most important thing I can do now is to help organizations focus on the areas that are the highest priorities for them."
Hospitals need to figure out how to use their resources more efficiently, and Wyatt says part of that is re-examining the purpose behind every single project you take on. They should all relate directly to improving patient safety and quality and maximizing efficiency. No one of those things should negatively impact another. He wants organizations to look at what patients and their families are telling you about the care they get, as well as what data show. Address the things that pop up because patients have access to more data than ever about your facility and your competitors.
Wyatt describes a role for himself that seems kind of like a director. Bring out the best performance through coaching, pointing organizations to information, tools, and strategies that can help them improve, and advising them where they might want to look first. Or next. "I think we can work in a collaborative way to make healthcare safer and disseminate the information organizations have accumulated on what works."
With all the various requirements for reporting and improvement, isn't there a danger that a ball is dropped or that something gets forgotten in the shuffle? Sure, he says. Certainly what the people in their ivory towers tell you is a problem in the nation might be very different from what you experience as a problem in your hospital. That is where keeping an eye on your own data becomes vital. "There are major initiatives around certain conditions, and it may be there is a different priority on the front line than what others see. Some hospital-acquired conditions are the subject of a lot of focus, but there are others behind those. I think what will be exciting for me is to help make sure that something doesn't just fall off the radar." If you use your data correctly, you can see any emerging issues before they are problems and track things that might become vulnerabilities in the future.
Wyatt sounds fired up when he talks about these issues. His speed of speech increases and you can sense him gesticulating. "This isn't a philosophical thing for me," he says. "I think that the work we do can really change the world, and I want to contribute to that transformation in a positive way. I want to help design the pieces that are needed. I want to know that what I do every day helps make a patient's stay in the hospital safer."
He thinks everyone in healthcare should be working to answer this question: How do you figure out a way to decrease cost and increase quality and engage patients? "This requires innovative thinking and reinventing what we do." The last part — the engagement of patients — is something Wyatt sees as imperative in the process.
It used to be that The Joint Commission wasn't seen as a collaborative organization, one that was dedicated to helping hospitals and other healthcare organizations become better providers to their patients. The old JC isn't an organization that Wyatt would have fit in so comfortably, either. Before agreeing to take the job, he talked to some of his mentors about what they thought of TJC. "They see it as having a different approach now that The Joint Commission recognizes that accreditation is crucial, but so is helping organizations improve for the sake of patients and families. I don't think you can do that without being a collaborative and learning organization."
So his door is open. "If you have questions or concerns, come to us. We can assist. And maybe at the same time, we can learn from what your problems or issues are. We have to listen to the voice of our customer, just like you have to listen to yours."
He suggests that everyone take a minute to re-evaluate the purpose of what you do, prioritize your work, and focus on where you can do the most good. "You can't solve every problem every day, but you can make a difference. And share what you learn. Share it internally, and externally."
For more information on this topic, contact Ronald M. Wyatt, MD, MHA, Medical Director, Division of Healthcare Improvement, Joint Commission, Oakbrook Terrace, IL. Telephone: (630) 792-5800.
Ronald Wyatt, MD, MHA, has spent 20 years working in just about every kind of healthcare setting imaginable primary care, emergency medicine in a VA hospital, nursing homes, as a sole practitioner and in a multispecialty setting.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content