Quality and Patient Safety
The Importance of Quality and Patient Safety
2024 COG Chair Vincent Williams shares specific ways for trustees to focus on quality
By Sue Ellen Wagner
Interview
As we begin a new year, Sue Ellen Wagner, vice president, trustee engagement and strategy at the AHA, looks at what lies ahead for boards with Vincent Williams, board chair, Sinai Health System, Chicago, and 2024 Committee on Governance (COG) Chair.
Sue Ellen Wagner: Can you tell us a little about yourself and your role as board chair at Sinai Health System in Chicago?
Vincent Williams: I usually answer that question starting with my professional bona fides, but I think what makes me who I am in the governance space is I’m the youngest of seven children raised on the West side of Chicago. After law school, I started to get involved with a community hospital, Loretto Hospital, and I participated on committees, eventually becoming vice-chairman of the board. Most recently, I have served as the chairman of the board at Mount Sinai.
I have learned so much about health care and how it is a vital part of who we are as a community and what we mean to our citizens.
Wagner:The AHA 2022 National Health Care Governance Survey Report highlights several trends in governance. Can you highlight three top governance issues that boards will likely face in 2024?
Williams: One issue that is liked by management and confuses most folks in the governance space is the desire for a distinct separation between the management and governance of an institution.
Placing a priority on issues regarding the roles of board members and reminding them of their fiduciary, financial and other responsibilities needs to be something that is top of mind in order to make these institutions work.
The second issue that is just as important is giving emphasis and priority to quality and safety. This is something that we as board members must become very clear about. Not that it outstrips the issues regarding finance and facility, but I think our core business is providing quality health care to our patients. Focusing on quality and safety will be and has been one of the issues that boards have had to wrestle with, so setting up committees that are functional and maintaining strong relationships with providers and administrators is crucial to understanding the challenges. We aren’t just looking at statistics and graphs — our board members have to truly understand the impact of quality and safety in our hospitals and health systems.
Thirdly, keeping an eye on the patient should be our number one priority. Hospitals struggle to provide quality health care, and sometimes we get so lost in the technical and administrative aspects of satisfying the people who are requiring us to be certified, or the policies that we have to follow to keep everyone safe. Unfortunately, sometimes the patient gets lost. Patients may receive unexpected bills, or they may not be in a relationship with the provider that can access the best the institutions have to offer. I think that connection with patients is probably the issue that will guide how we move forward in this next iteration of health care.
Wagner: Quality and patient safety should be a board imperative. In early 2023, CMS issued the quality assessment performance improvement (QAPI) guidelines for boards. You already spoke about why boards should make quality and patient safety a priority, so can you elaborate and highlight some of your board’s focus in this area?
Williams: At the Sinai Health System board, one of the things that we’ve done that has changed the most since I first joined the board is moving away from the perfunctory conversations about major health care issues. This practice involved covering a specific topic and somebody from staff providing data on the issue. The report was approved, added to our minutes and we moved on to the next issue.
We moved away from that practice. We are now very engaged in understanding the nuances of sentinel events. What happens in a hospital on a daily basis? What is rounding about? Having ownership of issues when they come to bear is what being in a relationship with the regulators means and why it’s so important that we continue to do that. Being survey-ready and constantly reinforcing the notion of quality are things that we did and we have captured all of that on new dashboards. We used to get so many reports that I used to call it “show and tell.” Many people’s eyes would glaze over and they didn’t really understand what they were hearing. But we never really got to the meat of the matter. When we developed our dashboards, they were focused on how we are actually delivering care and whether or not patients are satisfied with the services that we provide. Patient satisfaction is so important, again, as a prime mover, because it motivates everything else we do from a quality and safety perspective. So we looked at slips and falls, bed sores and other key events -- any of those issues that were creating concerns about our ability to provide the very best health care.
Our board has done a lot over the last several years, but the biggest thing I think we’ve done to help ourselves is biting the bullet and upgrading our technology. We have brought in the EPIC electronic health records system that allows us to have much better data recovery and much better access to information. It gives our board a level of confidence that the data that we’re receiving is accurate and reflects what we actually do.
Wagner: Can you tell our readers what you most look forward to about chairing the AHA COG in 2024?
Williams: I believe that the American Hospital Association provides wonderful exposure for trustees to learn about and understand what it takes to run hospitals. Being able to work with my peers and to lead them during this time is an honor that I can only wish my parents were here to see.
I think it’s important that our association has representatives from every type of hospital, from all states across the country, and we listen to each other. We also develop a sense of what it really means to be a leader. I’m just glad to be given this honor and opportunity to keep the tradition going of making trustees aware of issues happening in our field and changes going on in the legislatures, particularly in Congress and in the Administration. Our job is to make sure that we take this information back to our colleague and hospitals and make them better in 2024 than they were in 2023. I look forward to playing a small role in making that happen.
Wagner: On behalf of the AHA, we look forward to working with you on the COG and thank you for your leadership.
Sue Ellen Wagner (swagner@aha.org) is vice president, trustee engagement and strategy, at the American Hospital Association.
Please note that the views of interviewees do not always reflect the views of the AHA.