In this week’s episode, host Dr. Mark Hoffman discusses quality and safety in OBGYN and medicine as a whole with Dr. Komal Bajaj, a professor of OBGYN at Albert Einstein College of Medicine, reproductive geneticist and Chief Quality Officer at NYC Health and Hospitals/Jacobi in North Central Bronx. In addition, Dr. Bajaj is the clinical director of the NYC Health Simulation Center.

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SHOW NOTES

The episode begins by discussing the core principles of a Chief Quality Officer and how a typical week demonstrates those values. Dr. Bajaj emphasizes the importance of measurement as a key tool for quality and safety assessment. Information is helpful, however data literacy and transparency is also important to help the healthcare community to better understand a set of data. A significant challenge in ensuring quality and safety is identifying a precise dataset and developing an effective measurement methodology, which may be costly and labor intensive.

Dr. Bajaj discusses how a culture of safety adopted by the entire healthcare team protects the patient and adds to the quality of care. An additional key principle is learning from events through risk management; each event should be thoroughly discussed as an opportunity for future changes.

According to Dr. Bajaj, a crucial aspect of her role as the quality and safety officer is to take into account regulatory and accreditation standards. These guidelines aid healthcare systems in identifying areas of care that require improvement. Dr. Bajaj often looks at her hospital as a functioning ecosystem, with multiple interplaying parts, each which interact with one another to help make patient care of the best quality. She stresses the importance of physicians as leaders understanding the interlinking between the different parts of the system to improve patient safety and outcomes.

Dr. Hoffman and Dr. Bajaj engage in a discussion about the prevalent issue of resistance when it comes to finding solutions for enhancing quality and safety. They strongly advocate for empowering providers to take initiative in identifying problems within their institutions and seeking necessary changes. The two doctors believe that unanimity is not always essential to make a positive impact on quality and safety. Rather, they acknowledge that some providers may require more time to embrace change in their routines.

Dr. Hoffman and Dr. Bajaj then delve into the relationship between quality, safety, and the financial aspects of healthcare. They reach a conclusion that emphasizes how quality and safety initiatives in a healthcare system provide financial incentives for all stakeholders, including staff, patients, and the entire ecosystem. The level of care patients receive directly influences crucial factors such as hospital funding, ratings, and assessments by national organizations.

The future of quality and safety in OBGYN is explored last. Dr. Bajaj introduced the idea of a person-centeredness approach to quality and safety that incorporates staff and patients' voices into initiatives. Then she shared how an emphasis on the basics, safety, an empowering culture, and strong leadership are being re-examined as key goals for the future. Lastly, she touched on sustainability as an emerging area for improvement in healthcare delivery.

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RESOURCES

Accreditation Standards:

https://www.accme.org/accreditation-rules/standards-for-integrity-independence-accredited-ce