Quality and Safety
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What Does Quality & Safety Mean for Your Child?
When you get “outstanding quality” health care, it means your care is based on evidence, family –centered and provided by skilled and knowledgeable professionals who communicate and coordinate the care in a timely way.
You and your child should feel safe at MGfC, and of the best ways to improve patient safety is to constantly monitor performance and family experiences to set up systems to provide the best care for your child. The MGfC Quality and Safety is committed to this work every day.
High Quality & Safe Care at MGfC Is:
- Evidence-based
- Family-centered
- Provided by skilled professionals
- Rooted in a culture of open communication and continuous improvement
- Driven by feedback from our families
About Us
Our Vision for MGfC Quality and Safety
MGfC, as a national leader in Quality and Safety, is distinguished by a culture that partners with patients and families to assure that care is safe, high quality, equitable, and efficient.
This culture is characterized by:
- Teamwork
- Transparency
- Continuous learning and improvement
- Communication
- Innovation
MGfC Quality and Safety Core Team
Brian Cummings, MD, Vice Chair, Medical Director, MGfC
Sandra Dodge McGee, MHA, Executive Director, MGfC and Mass General Brigham Pediatrics
Esther Israel, MD, Quality Chair, Pediatrics
Cassandra Kelleher, MD, Quality Chair, Pediatric Surgery
Lindsay Carter, MD, Director, Inpatient Quality and Safety
John Co, MD, MPH, Director, Outpatient Quality and Safety
Kristen Solemina, MPH, Quality and Safety Manager
Caren Harris, RN, MSN, Quality Nurse Coordinator
Jessica Mascola, MS, Quality and Safety Program Coordinator
Cathleen Glynn, RN, MSN, Quality and Safety Data Analyst
Our History
The MGfC Quality and Safety Team work with leadership and staff to provide the highest quality, safest and patient-centered care to our families. We strive to create a culture of continuous improvement through communication, education, information dissemination and data-driven improvement.
Since 2009, our team has implemented safety initiatives and evidence-based care models across all care delivery areas at MGfC.
MGfC Quality and Safety Structure
Our structure begins with unit-based triads (physician, nurse and administrator), that report into our ambulatory and inpatient quality and safety team to foster shared learning, teamwork and communication. Our work is driven by priorities set by MGfC leadership, and MGH leadership including Patient Care Services, Practice Improvement and the MGH Center for Quality and Safety.
Strategic Plan (5-Year Plan, 2017) – Our Key Areas of Focus
- Reinforce the culture of continuous improvement
- Improve safety culture
- Improve patient safety, especially in high risk areas
- Optimize the patient experience
- Advance provider skills in safety science and quality improvement
- Establish a national presence through scholarly activity
A Culture of Continuous Improvement
Strategic Plan, Goal #1. Reinforce the culture of continuous improvement
Quality and Safety Initiatives
Mass General for Children (MGfC) is engaged in a variety of local and national quality improvement (QI) initiatives, impacting children's health care locally and nationally.
- Every primary care practice, subspecialty division, and inpatient unit is engaged in quality improvement initiatives that they have identified as most meaningful to their patients and themselves. Projects focus on improving different dimensions of care delivery, including patient safety, care effectiveness, patient experience and value.
- To help encourage and support improvement work, MGfC has developed a Quality and Safety Mini-Grant Program to provide resources and recognition for work initiated by front line care providers. Projects and initiatives are highlighted on the Department’s Quality Dashboard, with practices encouraged to present their practice specific data and metrics at division level meetings.
- MGfC assesses several key quality metrics according to patient/family demographics in an effort to identify and reduce health care disparities.
- At MGfC, several practices/care units are engaged in quality improvement efforts through national collaboratives, including:
- Every primary care practice, subspecialty division, and inpatient unit is engaged in that they have identified as most meaningful to their patients and themselves. Projects focus on improving different dimensions of care delivery, including patient safety, care effectiveness, patient experience and value.
- To help encourage and support improvement work, MGfC has developed a Quality and Safety Mini-Grant Program to provide resources and recognition for work initiated by front line care providers. Projects and initiatives are highlighted on the Department’s Quality Dashboard, with practices encouraged to present their practice specific data and metrics at division level meetings.
- MGfC assesses several key quality metrics according to patient/family demographics in an effort to identify and reduce health care disparities.
- At MGfC, several practices/care units are engaged in quality improvement efforts through national collaboratives, including:
- Pediatric Gastroenterology – Improve Care Now
- Neonatal Intensive Care Unit – Vermont Oxford Network
- Pediatric Intensive Care Unit – Pediatric Intensive Care Unit
- Pediatric Hospitalists Unit – AAP Value in Inpatient Pediatrics Network Projects
- Pediatric Surgery – American College of Surgeons National Surgical Quality Improvement Program
Safety Culture/Patient Safety
Strategic Plan, Goal #2. Improve safety culture
Strategic Plan, Goal #3. Improve patient safety, especially in high risk areas
It can be difficult for infants and children to communicate their concerns or changes in symptoms. MGfC offers our patients, families and staff a robust patient safety program which focuses on family participation in care, mitigation of safety risks, teamwork and rapid response to emergencies. We are committed to being a high reliability organization where our systems support patient safety and allow our patients, families and staff to feel free to speak up about patient safety concerns.
Some examples of our Patient Safety initiatives include:
Safety Culture – MGfC is committed to a strong safety culture in which families and staff feel free to raise patient safety concerns and those voiced concerns result in patient safety improvements. We are proud that we have outperformed our peers on the AHRQ (Agency for Healthcare Research and Quality) Safety Culture Survey.
Near Miss Safety Reporting – Staff are encouraged to report near misses which represent opportunities to improve patient safety. Over 1200 reports are filed across pediatrics every year.
Medication Safety – An interdisciplinary medication safety committee, Preventing Pediatric Medication Errors (PPME) Committee, consisting of physicians, nurses, pediatric pharmacists, information systems experts and quality specialists who oversee pediatric medication safety projects.
Rapid Response – MGfC Neonatal and Pediatric Rapid Response Teams can be activated for any acute or unexpected clinical concerns. The Rapid Response Team comes to the patient location to assist patients and care teams with their urgent concerns.
Good Catch Program – MGfC recognizes staff who speak up and prevent an error which could have reached a patient.
Integrated Electronic Medical Record – Single electronic medical record across all practices enables all providers to review notes from other provides, test results and medication lists. The patient portal (My Chart) provides patient access to parts o their medical record as well as a secure portal for communicating with their providers.
Family-Centered Rounds – Families are encouraged to participate as team members during morning rounds. This enables parents to actively participate in their child’s care planning and provides a time for raising questions or concerns.
The Patient Experience
Patients and families may receive a phone call or mail survey following their hospitalization or ambulatory visit asking about their experience and anything that we can do better for the family in the future. At MGfC, we utilize our patient experience survey scores and responses to continually assess the quality of care we provide to our patients and families. Suggestions that families make or improvement opportunities identified allow us to constantly hold ourselves to the highest standards of care for our patients and families.
The MGfC Quality and Safety team partners with parent volunteers to hosts staff training sessions. These sessions focus on understanding and optimizing the family experience at MGfC. Staff gain perspective from the parents as well as strategizing improvement opportunities by directly collaborating with families.
Patient Experience Survey Comments
“The staff were amazing. The receptionist is amazing. The nurses are brilliant. My kid just loves it there. Anytime he goes there he feels comfortable, and the staff are unbelievable.”
“They delighted me because they are kind of like an extended family to us. They always treat us with respect. They are always just very courteous. It's just a great experience in stressful times, especially.”
“They were very respectful. They kept us informed on the time of wait. They gave us very good information about the procedure, as well as having very good bedside manner.”
“His ability to sit and talk to a child, engage a child, explain what he was doing, and what was happening. He's a wonderful doctor.”
“[The doctor] is a phenomenal medical doctor, surgeon, and caretaker. He had a kind and wonderful bedside manner with my 11-year-old son. He explained the surgery, was reassuring, and confident. [The doctor] was kind to my son. He patiently listened to questions I had and answered each question. He is the best pediatric surgeon in the world.”
“[The doctor] is the best pediatrician I have ever encountered. She is nice, courteous, great with kids, and has excellent medical knowledge. I have the greatest possible confidence in her abilities to care for our children and have recommended her to numerous friends.”
Quality & Safety Education
Strategic Plan, Goal #5. Advance provider skills in safety science and quality improvement
Resident Program – The MGH Pediatric Residency program is committed to educating its trainees in the principles of patient safety and quality improvement, as well as meaningfully engaging residents in improvement initiatives for providing experiential learning opportunities as well as ensuring its initiatives are informed by residents.
- During the first year of the residency program, residents are taught the fundamentals of patient safety and quality improvement by faculty from MGfC/MGH Quality and Safety leadership.
- By the end of the second year of training, residents are expected to have become a member of and meaningfully participated in a quality improvement initiative at MGfC.
- The MGfC Quality and Safety team has implemented “Resident Quality and Safety Rounds,” which is a forum for communication between residents and MGfC Quality and Safety leadership regarding residents’ quality and safety concerns.
Psychological Safety Leadership Programs – A four-session psychological safety leadership series focused on communication techniques and teamwork.
Mass General Brigham's Clinical Process Improvement Leadership Program (CPIP) is an intensive 6–8 session program with the purpose of engaging clinical teams in the use of process improvement tools to reduce variation in care and improve outcomes for patients.
Team STEPPS – An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.
Patient Safety Awareness Week – MGfC celebrates patient safety accomplishments and educates patients, providers and staff on patient safety. Every year the hospital recognizes a select group of Patient Safety Stars, nominated by their peers, for their commitment to patient safety within the hospital.
Interdisciplinary Tracer Program – A team consisting of nurses, doctors, physician assistants, registered pharmacists and quality and safety specialists visit each unit to evaluate hospital and patient care operations.