Stan, Clarence, Barry, and the Health Chatter team chat with Dr. Jennifer Lundblad, President and CEO of Stratis Health, about quality assurance and quality improvement in healthcare.Dr. Lundblad leads Stratis Health, an independent non-profit based in Bloomington, Minnesota, focused on collaboration and innovation in health care improvement. With a strong foundation in leadership, organizational development, and program management, she brings deep experience from both the nonprofit and healthcare sectors.Listen along as Dr. Lundblad shares how quality assurance and improvement are critical to improve health outcomes.Join the conversation at healthchatterpodcast.comBrought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.More about their work can be found at https://www.huemanpartnershipalliance.org/
Chapter 1: What is the main focus of quality assurance and improvement in healthcare?
Hello, everybody. Welcome to Health Chatter on this bright sunny day in Minneapolis, Minnesota. Thanks for being with us. We've got a great show today on quality improvement and quality assurance with a dear colleague that I go back quite a ways with. So stay tuned. I'll introduce her in just a second.
We have a great background research team that does wonderful, that provides us, Clarence and I and Barry, with wonderful information and that guides us in our discussions. Maddie Levine-Wolf, Aaron Collins, Deandra Howard, Matthew Campbell, Sheridan Nygaard, our second to none. Sheridan also does our marketing and Matthew does our production to get the shows out to all of you in good, good form.
Clarence Jones is my partner in this since day one. Thank you, Clarence, for being with us. Barry Baines, is our medical advisor and provides some medical insights into this show as well. Thank you to everybody.
Chapter 2: How do quality assurance and quality improvement differ in practice?
You're all special people. Human Partnership is our sponsor for these wonderful podcasts. You can check them out at humanpartnership.org, great community health organization. I recommend that you check them out. Also, you can check us out, healthchatterpodcast.com, where all the research is on there.
And there's also, you can obviously listen to the podcast, but also if you'd like to, you can also read the transcript of it as well. So thank you to everybody and let's get the show going. Today we have a wonderful guest with us. I don't know how long I've known you, Jennifer, but it's been a while. And it's been very, very special. We know how to connect with one another for sure.
But then when we decided to do a show on this, you were the natural person to connect with. So thanks for being with us. Dr. Lundblad leads Stratus Health, an independent nonprofit quality improvement organization based in Bloomington,
Chapter 3: What role does data play in healthcare quality improvement?
Minnesota that leads collaboration and innovation in healthcare quality and patient safety. She has extensive background in leadership, organizational development, program management in both the nonprofit and education settings. You've been at Stratus Health for how long now, Jennifer? It's been a while.
More than 25 years. Wow. I found my professional home and I love it.
Wow, wow, wow, wow. Well, there's a long history of Stratus Health that really started out as what was once called the peer review organization around the country. We were the one in the state of Minnesota back then it was called the Foundation for Healthcare Evaluation. Then it morphed into Stratus Health and a variety of different things that you're involved with today. So thank you.
Thank you so much for being with us today. You're a special guest for sure.
Chapter 4: How can healthcare organizations effectively use community input?
So let me start this out and then you guys can chime in on this. It's like for those of us who have been involved in health, there's always this umbrella, I guess you might want to say that's over our heads, that we're always looking at quality improvement and quality assurance.
And it's almost, whether it be at a community level, whether it be internally within hospitals and hospital systems, delivery of care, et cetera. So there's always that, how is it that we improve and how is it that we assure that that we're going in the right direction. So let's start out with that first of all. Comment on that a little bit, Jennifer, from your experience.
Yeah, the headline when you think about quality is that quality assurance is getting it right and quality improvement is doing it better. They are two sides of a really important coin. And whenever you have a recurring process, a recurring activity, you need both of those, right?
You want to be sure that whatever standard that you've set, whatever way you've determined that you want things to go, whatever your goals are, you want to be sure you can do that each and every time, quality assurance, right? And we're all in the business of improving, making things better. In health care, that's essential to what we do, right?
New research comes out, new evidence, new studies, new approaches.
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Chapter 5: What are some examples of quality assurance in healthcare settings?
We want to continue to improve so that we're delivering and getting the best possible care for the patients that we are supporting and serving. So, again, I think this is a great way to start a conversation about quality is thinking quality assurance and quality improvement. They are different, distinct, related, and one is about getting it right and one is about doing it better.
Yeah, you know, for all the years that I've been involved in health, it always seemed to me that, and correct me if I'm wrong, that it seems to me that one of them, quality improvement, really is a measurement or an assessment of some type based on something that you're seeing or dealing with. And then assurance is, again, correct me if I'm wrong, is going forward.
How is it that, okay, now that we know, how do we assure that these types of quality aspects are maintained? Does that seem... reasonable yet today with all the things that we're dealing with?
Yes. Yes. And it's more than that. Okay. I'll give you a couple of examples.
Chapter 6: How do technological advances impact quality improvement efforts?
So, um, One is a non-clinical or non-healthcare example. So our Stratus Health Board meets four times a year. So that's a recurring activity. There are a whole bunch of things we need to do behind the scenes in order to make sure that that meeting goes smoothly, that we're able to get that full engagement, that everything lines up for all the details and logistics that needs to happen. So
We've created a checklist. It details who's responsible for what and at what time and how much in advance of or in follow-up to the meeting. And that checklist is quality assurance for us. That's helping us get it right so that we can take best advantage of the wonderful people who are the contributors on our board. So that's a simple example of quality assurance.
Anytime we have something recurring... We have tools that we can use to help us get it right. And we measure that. So there's measurement that's part of both.
Chapter 7: What challenges do healthcare organizations face in implementing quality initiatives?
And then I'll give you a clinical example or a kind of healthcare example. We know that there are certain things that when someone is having a heart attack or a stroke that are time sensitive when they reach the emergency department. So we need to get those right because those are actually life and death situations.
That timing of certain things in an emergency room is something we want to have protocols. We want to train people and we want to get it right every single time. We want to assure that we are meeting those time sensitive requirements. medical care needs. That's quality assurance. We measure that. We track that. We assure that we're doing that for the patients in the emergency department.
But in the emergency department, maybe we've noted that it's tough times in emergency departments right now. There's a lot of boarding. There's a lot of people that stay in emergency departments too long.
Chapter 8: How does Stratis Health collaborate with other organizations for quality improvement?
So maybe as a hospital, we're committed to saying, we want to improve, we want to move people through the emergency department better. So we look at our data and we see that the average time that someone spends from the moment they walk in the door till either they're discharged or admitted is four hours or 10 hours or whatever it might be.
We set some goals, we measure, we do some small tests of change, we try to understand what are the barriers that to doing better and we look at that emergency department throughput and that's maybe an improvement project that we have. So again, we use data in a lot of ways in all parts of quality and that can inform and guide our work and help in our decision making.
Yes, yes, Jennifer, thank you. So I'm going to ask some real basic questions. I think you probably have answered these already, but for me, to enter the conversation, I want to ask a couple of questions. One is, who are your clients? And then the second thing is, what is the process for evaluating your clients?
Great question. So in Stratis Health's work as a nonprofit organization that essentially serves as an external change agent. Right. So we're providing training and technical assistance and coaching and support for those that we're working with. we'll receive funding from perhaps a federal agency or a state agency or a foundation.
And that funding will allow us to design and implement improvement initiatives. So in those initiatives, Clarence, our clients are sometimes a group of hospitals or a group of clinics or a group of nursing homes. So it might be setting specific work in healthcare. It might be a geographic area so that we're working with a community or a region or a state.
Or it could be a community defined by not just geography, but maybe race or ethnicity or religion. So we've done work with the Jewish community in the Twin Cities. We've done work with the African-American communities in Frogtown and St. Paul. So it depends on...
What the initiative is, our client is a health care organization, a community or a group that has come together because they have a shared goal or interest in improving health or care for their members.
we've really shifted over that time span that you've known Stratus Health from a primary focus on healthcare organizations as individual entities to really thinking about community as our unit of action. And that has also changed how we think about quality and quality improvement. So that long answer, Clarence, we have a wide range of
who our clients are from healthcare organizations to communities to state agencies and others.
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