uncertainty 1 01
improvement
The Hard Work of Health Care Certainty
University of Utah Health’s success is driven by teams doing the right work for our patients — and sharing that work across the system. Chief Medical Quality Officer Bob Pendleton reflects on the universal importance of continuous improvement while looking at health care through the eyes of a patient.
E

very day at University of Utah Health, I see work being done by dedicated teams committed to making our organization better for patients. Reflecting on that work gives me vital context to the national discourse on changes in health care delivery.

"Seeing our health system through different eyes—as a family member and caregiver—has been a grounding experience."

When we watch TV or read the news, we hear so much about the disruptive changes in the health care industry. Amazon is partnering up with Berkshire Hathaway and JP Morgan Chase. CVS is merging with Aetna. I don’t know about you, but all of this leaves me feeling anxious about the uncertainty and looming disruptions.

Yet, when I see the world of health care delivery through our patients’ eyes, it puts that uncertainty and disruption into context. Recently, my wife has navigated a journey through the University of Utah Health system, culminating recently in a surgery and a couple nights spent in our hospital. She’s at home now, and her recovery has been outstanding.

Seeing our health system through different eyes—as a family member and caregiver—has been a grounding experience. I’ve taken off my tie and badge and put on my jeans and T-shirt to just be by my wife’s side. In doing so, I’ve realized that for patients, there are more certainties than uncertainties with health care. Our nurses, doctors, and support staff are truly caring people who are all in the business of continuing to figure out how to do better by patients.

"We are all in the business of continuing to figure out how to do better by patients."

That is our core here at University of Utah Health — and that core is not going away. We are doing the right work. At my wife’s bedside, I saw the fruits of that labor. I saw pilots of innovation from three, four, and five years ago translated consistently into patient care in clinics and at the bedside.

These included seamless coordination of a care team, the collection of patient outcome data at check-in, bedside nursing shift reports, bar-code medication administration, pharmacy and respiratory-driven protocols, patient-centered nutrition services, and much more.

Our success is not super complicated, either.

Utah's success relies on four pretty simple tenets:

1. Clarity of purpose 

This is crystal clear — we are here for our patients. That is our true north.

2. Respect

This applies both to how we respect our patients and family members as well as how we respect each other. How do we treat each other at work? Are we really caring for each other and caring for our patients in an authentic way?

3. Continuous improvement

This is universally important: how do we identify a problem and then start chipping away to make things better by tackling that problem? We don’t just implement a solution and then forget about it. We go through two, three, four, even five rounds of improvement—and then we share it with other people across the system. That’s what continuous improvement is.

4. An effective team

We talk a lot about how well we work as a team, but we live in a complicated environment where the makeup of that team needs to be dynamic. Sometimes we need to work with someone who’s not part of our traditional team. We might need help from someone on the Epic team, the value engineering team, or the environmental services team. The ability to take a problem and then formulate the right team to tackle it is something that I refer to as “the team of teams.” It’s not just about an isolated group of people working together. It’s how teams work together across the organization.

I saw these four tenets of success translated at my wife’s bedside in such a powerful way. Seeing the great care that she received, I could not have been prouder of our organization for providing our patients with this kind of certainty in an otherwise uncertain world.

That’s why we rank top 10 in the nation for quality. That’s what makes our system-wide patient experience scores the highest they’ve ever been. That’s how we become more efficient in trying to curb overall health care spending. That system-level success is driven by teams doing the right work—and sharing that work to lead continuous improvement.

This article was adapted from Dr. Pendleton's opening presentation at the April 25, 2018, Evidence Based Poster Fair "Best of the Posters" session at University of Utah Health, Salt Lake City, UT.

Contributor

Bob Pendleton

Founder and Chief Sponsor, Accelerate

Subscribe to our newsletter

Receive the latest insights in health care equity, improvement, leadership, resilience, and more.