Adverse drug reactions (ADRs) can occur even when medications are prescribed and administered correctly, yet reporting has historically varied across Mayo Clinic campuses, limiting opportunities to identify enterprise-wide trends and improve patient safety. In this episode of Key in to Quality, a multidisciplinary team representing pharmacy, nursing, patient safety, quality, analytics and regional stakeholders shares how they developed a standardized, enterprise-wide approach to ADR reporting and evaluation.

After reviewing existing safety processes, FDA MedWatch standards and frontline feedback, the team created a five-level ADR severity scale focused on patient outcomes rather than medication errors. The scale was integrated into Mayo Clinic's electronic patient safety reporting system and paired with enterprise dashboards that enable standardized reporting, trend analysis and organizational learning.

Since implementation, the framework has improved reporting consistency, strengthened FDA reporting and enhanced the ability to identify system-level safety opportunities. Validation showed users applied the scale with more than 85% agreement compared with expert review, demonstrating how standardized reporting, multidisciplinary collaboration and enterprise data can transform individual adverse drug reactions into actionable insights that improve medication safety across the organization. 

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode of Key in to Quality explores how a multidisciplinary team at Mayo Clinic Arizona reduced catheter-associated urinary tract infections (CAUTI) by approximately 50% during the COVID-19 pandemic. Despite increased patient acuity, greater catheter use, and the operational challenges of the pandemic, the team achieved lasting improvements through collaboration, frontline engagement, and continuous learning.

Rather than relying on a single intervention, the team brought together infection prevention, nursing, quality, leadership, and performance improvement experts to identify contributing factors, test solutions, and use data to guide decisions. A culture of psychological safety and a no-blame approach encouraged open communication and problem-solving, while unit-based CAUTI champions helped drive local improvements and share successful practices.

The effort not only reduced infection rates beyond external benchmarks but also strengthened teamwork, increased frontline engagement, and created sustainable infrastructure for ongoing improvement. The team's experience reinforces that successful quality improvement depends on both technical methods and human factors, with trust, adaptability, and collaboration serving as the foundation for lasting change.

Gina Hull, M.S.N., R.N., CIC, LinkedIn

Eric Siebeneck, M.S., LinkedIn

Christine “Chris” Aliory

Brigid Kiley, M.S., R.N., C.C.R.N., S.P.E.C.

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode of Key in to Quality highlights how a Mayo Clinic inpatient care team transformed its approach to workplace violence and behavioral safety through a structured, multidisciplinary response model. As verbal threats, physical aggression and behavioral escalations increased — particularly following the COVID-19 pandemic — the team recognized that the challenge was not a lack of compassion, but a lack of visibility, coordination and consistency in responding to risk.

To address these concerns, the team implemented twice-weekly multidisciplinary safety huddles, daily shift discussions focused on behavioral risk, behavior safety plans, visual communication tools and expanded use of Behavioral Emergency Response Teams (BERT). By bringing together nursing, security, leadership, behavioral health, human resources and legal partners, they created a shared framework for early identification, proactive planning and coordinated intervention.

The initiative drove a significant cultural shift, empowering staff to move beyond the belief that unsafe behavior was simply “part of the job.” Results included a 64% increase in documented behavior safety plans, a 32% increase in reporting to security and an 80% reduction in employee injury reports related to aggression. The episode demonstrates how routine communication, shared accountability and psychological safety can create safer environments for both staff and patients.

Hosted by Dr. Timothy Morgenthaler and Sheri Nemec.

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

Guest Social Links/Handles (LinkedIn): www.linkedin.com/in/allyse-hutchinson

#patientsafety #keyintoquality #qualityimprovement #safetyculture #patientexperience

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

In this episode of Key in to Quality, the team explores how hyperbaric oxygen therapy (HBOT) delivers care in a highly specialized environment where oxygen is the treatment, and how safety is highlighted in this environment. Because HBOT combines elevated oxygen levels and pressure, risks such as fire hazards and equipment failures require rigorous safety systems, disciplined processes and constant vigilance.

The discussion highlights how safety extends beyond policies and compliance. Daily huddles, pretreatment safety timeouts, ongoing training and clear team communication help create consistency and situational awareness. The episode also examines the concept of “drift” — the gradual departure from standard practices that can occur over time, even among experienced teams — and the importance of accreditation, leadership oversight and learning from near misses to prevent it.

A central theme is psychological safety. Team members must feel empowered to speak up, ask questions and identify risks without fear of blame. Through real-world examples and practical insights, the episode demonstrates that safe care is built through people, processes and culture working together every day. The lessons from hyperbaric medicine offer valuable guidance for improving quality and patient safety across healthcare.

Guest Name(s): Andrew Melnyczenko,  Director of Hyperbaric Tech and Safety, Mayo Clinic, LinkedIn

Hosted by Timothy Morgenthaler, M.D., and Sheri Nemec. 

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

In this episode of Key in to Quality, Dr. Andrew Bowman, Dr. Nelly Tan, Jacob Varner, and Dyan DeYoung discuss how a multidisciplinary Radiology Patient Experience team across Mayo Clinic sites created a scalable approach to listening to patients and improving care. Recognizing that radiology lacked a consistent way to measure patient experience, the team launched a simple post-visit feedback system that began in MRI and expanded across modalities.

The guests describe how reviewing feedback, responding quickly to concerns, and sharing positive comments with frontline staff strengthened morale, improved workflows and reinforced a culture of ownership around patient experience. They also explore how collaboration among clinical, operational, analytics and experience teams — and the use of automation and AI tools — helped the program grow sustainably without adding unnecessary burden.

The episode highlights a central lesson for healthcare teams everywhere: patient experience is shaped by many small touchpoints, and meaningful improvement happens when teams learn from feedback together.

Hosted by Timothy Morgenthaler, M.D., and Sheri Nemec.  

Guest Social Links/Handles (LinkedIn):  Dr Tan  Nelly Tan | LinkedIn & Dyan  Dyan DeYoung | LinkedIn

#keyintoquality #qualityimprovement #patientexperience

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

In this episode of Key In to Quality, Jodi Miller discusses Mayo Clinic’s Concierge Financial Navigation program. Designed to support people receiving complex, high-cost care, the program connects patients with trusted financial advocates who explain insurance coverage, resolve billing issues, address denials, and secure copay, grant, and premium assistance.

What began as a pilot for hematology and oncology patients has grown into a multidisciplinary program supporting thousands of patients across specialties, including transplant, gastroenterology, rheumatology, and dermatology. The program partners closely with providers, nurses, social work, and patient account services to identify patients at risk and intervene proactively.

Learn how to addressing financial concerns is an essential part of patient-centered care—and how helping patients navigate the cost of care can improve experience, trust, and healing.

Guest: Jodi Miller, Mayo Clinic Jodi Miller, M.H.A | LinkedIn

Here are some helpful financial support resources that physicians and care teams can share directly with patients:

Fundfinder.org   Fund Finder | PAN Foundation

RXAssist.org  RxAssist - Patient Assistance Programs

Mayoclinic.org (tile-grant programs) Copay and Grant Assistance Program - Mayo Clinic

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode of Key in to Quality explores Mayo Clinic’s Hospital at Home program, an innovative model delivering 24/7 acute-level care in patients’ homes. Wendelyn Bosch, M.D., and Laila Hakam, M.D., discuss how digital tools, remote monitoring, and coordinated multidisciplinary teams make this possible at scale.

Originally developed to address hospital capacity challenges, the program expanded rapidly during COVID-19 with support from a CMS waiver. Today, it demonstrates strong safety outcomes and patient experience scores that exceed traditional hospital settings.

The model relies on a complex network of virtual care teams, paramedics, pharmacy, diagnostics, and logistics to ensure seamless, high-quality care. Clinicians also gain valuable insights by treating patients in their home environments, improving understanding of social and behavioral factors.

Hosted by Timothy Morgenthaler, M.D., and Sheri Nemec. 

Guests: Wendelyn Bosch, MD and Laila Hakam, MD

Laila Hakam | LinkedIn

#mayoclinic #mayokeyintoquality #patient safety #healthcare

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode of Key in to Quality explores psychological safety in residency training, and why it’s foundational to patient safety, team performance, and joy at work. Experts from Mayo Clinic Arizona describe how Culture of Safety Survey results and root cause analyses surfaced a recurring risk: residents hesitated to ask questions or escalate concerns in real time, often due to hierarchy and fear of judgment.

The team partnered with the Resident Leadership Academy to deliver focused education to physician leaders. The sessions emphasized practical, real-world behaviors, being present, inviting questions, and designing spaces that make speaking up easier. These tools deliver a clear message for any organization: psychological safety is a cornerstone of high-reliability care.

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

Mayo Clinic Guests:

Dr. Shari Ochoa  Shari Ochoa | LinkedIn, Daniel Cotto  Daniel Cotto | LinkedIn, Johanna Heredia  Johanna Heredia | LinkedIn

#patientsafety #keyintoquality #qualityimprovement #safetyculture #mayoclinic

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode of Mayo Clinic Key in to Quality focuses on a core insight from patient experience research. Patients judge care through two lenses: warmth and competence. Host Tim Morgenthaler and cohost Sheri Nemec speak with Chris Malone, author and founder of Fidelum Health, and Mayo Clinic’s Laurie Wilshusen about how trust forms and why small, human cues can create outsized impact.

The discussion shares concrete examples of clues patients notice: respectful use of time, eye contact, tone of voice, clear explanations, reliable follow-up. The episode even tackles how to avoid “performative” warmth and instead remove barriers that prevent clinicians’ genuine care from showing. Finally, they explore how AI and digital tools should enhance, not replace, authentic connection.

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Co-Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

Guests: Chris Malone (32) Chris Malone | LinkedIn    Laurie Wilshusen  (32) Laurie Wilshusen | LinkedIn\

#MayoClinic #Mayokeyintoquality #patientexperience #qualityimprovement 

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality

This episode examines a hospital-wide hypoglycemia management protocol at Mayo Clinic. Recognizing the serious impact of inpatient hypoglycemia, a multidisciplinary team launched a prevention-focused protocol inspired by 2020 ADA guidelines. 

Their initial strategy was to intervene at glucose levels below 90 mg/dL to prevent low blood sugar before it occurred. However, real-world data revealed unintended consequences. Many patients between 70–90 mg/dL were not at true risk for hypoglycemia, resulting in overtreatment, unnecessary IV dextrose and glucagon use, increased costs, and strain during a national dextrose shortage. 

Hear how the team navigated these challenges, highlighting key quality improvement lessons.

Hosts: Timothy Morgenthaler, MD and Sheri Nemec, MS, CPXP

Guests: 

Sneha Mohan MD, Associate Consultant, Endocrinology, Diabetes and Metabolism

Marny Carlson, M.S., R.N., NPD-BC, Nursing Education Specialist

#patientsafety #keyintoquality #qualityimprovement #safetyculture #mayoclinic

Host: Timothy Morgenthaler, M.D. | https://www.linkedin.com/in/timorgenthaler/

Host: Sheri Nemec| https://www.linkedin.com/in/sheryl-sheri-nemec-a627982a/

#mayokeyintoquality