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To address gaps in organizational competency, health systems can establish a chain of command and split up responsibilities more efficiently.
Before its leaders began putting resources toward revamping its quality program, Alameda Health System was in a tough spot. In 2020, the San Francisco Bay Area public health system received low hospital safety grades from the Leapfrog Group and five condition-level findings from the Joint Commission accrediting body, leading to a preliminary denial of accreditation and palpable tensions among staff.
Nearly 3,500 employees went on strike in October of that year, citing underfunding, unsafe conditions and worker shortages. In turn, Alameda County supervisors called on the health system’s board of trustees to resign, with five members departing; the system’s former CEO submitted his resignation toward the end of 2020.
“These were many of the elements that led me to consider an exit myself, wondering whether this was the right place for me,” said Dr. Taft Bhuket, chief of gastroenterology and hepatology, who was serving on the board of trustees at the time. Now board president, Bhuket said, “It was the darkest moment I’ve ever felt in any single healthcare organization.”
Bhuket—and Alameda Health System—found relief when new leadership came in at the beginning of 2021. In addition to rebuilding trust and increasing employee engagement, the executives made it a goal to construct a quality division that combined central governance with greater support for front-line quality workers.
The system established a core quality team, along with committees in various departments that help manage quality concerns and communicate them to the board of trustees, Bhuket said.
“We’ve been very thoughtful about building a quality division, putting the right people in the right seats on the right bus,” he said. “We’ve tried to provide the tools to the quality team with which they can measure things and create an infrastructure for them to do their job.”
A particularly useful tool for Bhuket is the Midas Quality Management Monitor. Produced by Houston-based Symplr, the software platform uses reports from clinicians to provide data on areas for intervention, analyze treatment outcomes and identify opportunities for improvement. Distributing responsibilities to caregivers and automating data production through Midas has streamlined work for the quality team and reduced much of their burden, Bhuket said.
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