Quality is a verb

“Excellence every time” was the rallying phrase of a new employee training that many of you may recall. Although those sessions have since been discontinued, the idea at the heart of them is one we can all agree has value. Because what else is excellence but quality? And how else do we achieve excellence every time except by building systems that minimize risk or improving on existing ones? This sort of work is often referred to as quality improvement, and although it is often paired closely with patient safety, that is not always the sole goal of a QI project. The search for efficiency or cost-savings are also worthy supplemental goals; freed-up time and resources can be used in all sorts of ways, on research or with trainees, or even on self-care, catching your breath or connecting with colleagues. Whatever the goal, a focus on quality is ingrained in every aspect of our missions here.

Our department is filled with leaders in quality at University of Iowa Health Care. Since May, we have been fortunate to have Dr. James Murphy as our Chief Quality Officer. Dr. Murphy’s appointment is within the Division of Pulmonary, Critical Care, and Occupational Medicine, but those of you who have gotten to meet him know that his interests are as diverse as the road that has led him to Iowa. (At that last link, you can read about his undergraduate majors and where he was when he decided to pursue medicine.) Systems are only as robust as the people who operate them and Dr. Murphy’s curiosity about people should help him be successful in identifying how to improve our processes. One of his new initiatives that is already getting off the ground is the Quality Leadership Academy, which should prove to be successful at broadening the culture of quality here. A recent addition to Dr. Murphy’s Quality team is Dr. Ethan Kuperman, named Associate Quality Officer for Adult Inpatient Services. Dr. Kuperman’s been a trailblazer for quality in the department and in UI Health Care, especially working with the residents on their QI projects and in leading their Morbidity, Mortality, and Improvement conferences for some time. Under Dr. Kuperman’s leadership, in fact, that third word was added to the conference’s title and focus.

Our residents learn how important quality is to this department even before their first “official” day as interns. Program Director Dr. Manish Suneja and Jane Rowat, our Education Development Director, have refined the “Objective Structured Clinical Examination” (OSCE), a clinical skills evaluation, over the years into a well-oiled machine. The program presents each intern with a series of stations where they perform tasks they have been trained in, like obtaining informed consent or taking an overnight nurse call. But because they have been trained by a variety of different medical schools, certain aspects of these tasks may have been stressed over others. This is what makes the OSCE a critical part of our quality assurance. Flush with data on each intern, as I said earlier this month, the residency program can tailor its training to individual needs. And, of course, each year our residents learn that quality matters as they get to know our Chief Resident for Quality and Safety. This year, they will all work with Dr. Sam Zetumer, who follows in a strong tradition first set here by Dr. Alexis Wickersham, each of them guided over the years, first by Dr. Krista Johnson and now by Dr. Carly Kuehn, herself a former CRQS. It is interesting to see what each of these former Chiefs have gone on to do, most of them staying in some form of education role with a focus on quality.

Finally, we see a similar attention to quality in the training we offer not only our own first-year critical care fellows, but seven dozen of them from across the country. The Midwest Fellows Critical Care Ultrasound Symposium has always been a bit of a misnomer with fellows and faculty from programs in New Mexico, Colorado, and Kentucky, but our reputation for results stretches beyond the region. A big congratulations to symposium director Dr. Greg Schmidt and the rest of our Pulmonary Division on another successful showcase of Iowa’s talent, organizational acumen, and our beautiful landscape.

About Isabella Grumbach, MD, PhD

Isabella Grumbach, MD, PhD; Interim Chair and DEO, Department of Internal Medicine; Kate Daum Endowed Professor; Professor of Medicine – Cardiovascular Medicine; Professor of Radiation Oncology

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