I think of November as a month focused on gratitude, given the Thanksgiving season. It has me reflecting on all that has been accomplished as this year comes to an end and thinking about the work that needs to continue in the year ahead. What is the impact we are making in quality and safety in our organizations, and where do we go from here?

One of those goals for this year has been to create deeper and more visible links between quality/safety and the cost of care. To make those issues more consistently visible requires information and education, as well as new members of quality teams and work.

The work on key quality issues, such as infections, falls, medication errors, and beyond is increasingly being reported in many settings reflecting cost projections, such as resulting increased length of stay, readmissions, needs for additional treatment and dissatisfaction. Historically, the issue of cost or the economics of care were rarely included in reporting about quality and safety, and that is changing. This increased visibility in reports of added cost, or at times cost avoidance, is a powerful message to any reader. Poor quality, or gaps in safety, result in patient harm and also in additional and avoidable costs.

Many clinicians working in quality and safety may have little insight or awareness of the costs of care. This informational opportunity of discussing costs also provides a key learning for clinicians. It also provides a key learning about care delivery for those working in operations and finance within a healthcare setting. How is care delivered and how much does it actually cost? This education may bring together experts from different functions within a healthcare setting to share their knowledge and expertise. It is powerful for clinicians to work with those from operations and finance to share insights about how care is delivered, and what it costs. This knowledge can change practice for both and build new collaboration within an organization.

In what ways can that help? We all recognize that the high cost of healthcare is unsustainable. Efforts to reduce costs while improving quality and safety are needed across virtually all healthcare settings. Finding new ways to make this impact will not happen by doing what we have always done or working in silos. New collaboration around enhancing quality of care and reducing costs is a significant opportunity for us all. It will be a part of all of our goals for the future.

The opportunities for new collaborations and new insights are something for which I am grateful!

I wish you all a Happy Thanksgiving! May the gratitude of the season inspire you all.

Nidia Williams, PhD, MBB, CPHQ, FNAHQ
NAHQ President

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