Tags: coordinated care , uniform high quality , redesigning care

By Thomas Sequist, M.D., M.P.H., and Sadiqa Mahmood, B.D.S., M.P.H.

Today, Partners HealthCare is comprised of 11 hospitals and more than 6,000 physicians. By working together, our network of medical experts has created a whole that is much greater than the sum of its parts when it comes to patient care.

One particular program that enables us achieve this goal is the clinical collaboration program. This program brings together more than 30 leadership committees, which are comprised of physicians, nurses, and pharmacists from across Partners. Committee members share best practices, promote system-wide innovation in patient quality and safety, advance the measurement of important indicators of high quality care, and pursue transparency of data sharing.

More specifically, the clinical collaboration committees work on three types of projects: 

  • Design clinical pathways to transform clinical care:  We focus on making system-level changes that improve clinical workflow and practice. For example, our clinical leaders in colorectal surgery have agreed on a standard set of practices designed to enhance patient recovery after major abdominal surgery, reduce hospital length of stay and prevent surgical site infections. Clinical leaders participating in this collaborative are now focused on adoption of the standard practices via front-line staff engagement, optimizing communication among care team members, and creating patient-education materials that inform patients and their families about our new practices.
  • Use of measurement and analytics to support patient care: Measurement is an essential component of these collaboration committees. Measurement helps us monitor our performance and find opportunities for clinical improvement and research. While Partners has a rich source of data from our system-wide electronic health record – we rely on the clinical expertise of these committees to define high quality care in their specialty areas and to develop the precise methodology required to produce metrics that will drive improvement in health care.
  • Use of technology to improve patient care: The clinical collaboration committees have also helped tailor our fully integrated electronic health record to the Partners HealthCare environment. They have helped solve practical challenges and developed innovative approaches to using the electronic records. For example, a multidisciplinary group of critical care and infection disease specialists designed the Partners HealthCare Sepsis Pathway with the goal of early detection and management of infections known as Sepsis (bacteria infecting the blood stream and internal organs). As part of this effort, the workgroup developed electronic documents, reminders, structured physician ordering and documentation templates, and other tools in the electronic health record system to ensure high quality and safe guideline concordant care. These tools have allowed us to be ahead of the curve in national efforts to reduce the incidence and complications that result from Sepsis. 

This work is time-consuming and painstaking but well worth it in the end if safer, higher quality care is the result. Watch for in-depth reports on this clinical collaboration effort in future posts. 

Dr. Sadiqa Mahmood is the Program Director for the Clinical Collaboration Program at the Partners HealthCare System. Partners is an integrated health care delivery system in Boston, Massachusetts, that includes two large academic medical centers—Massachusetts General Hospital and Brigham and Women’s Hospital— with more than 6000 physicians. Dr. Mahmood works with the clinical leadership of Partners hospitals and institutions to improve quality of care by sharing best practices and measurement. 

Prior to joining Partners, she served in clinical operations and quality improvement roles at leading Boston hospitals including Boston Medical Center, Dana-Farber Cancer Institute and Children’s Hospital Boston. Simultaneously, at Northeast Business Group on Health, she worked with health systems and commercial health plans in the New York State to design a business model that presents a framework for designing improved operational processes and achieving reduction in preventable hospital readmission rates. At Harvard Law School’s Center for Health Law and Policy Innovation she worked with the Executive Office of Health and Human Services Massachusetts (EOHHS) and health systems across Massachusetts to design policies for sharing protected health information on Health Information Exchange (MassHIway).

Dr. Mahmood received her dental surgery training in Pakistan and completed her M.P.H. degree at the Harvard T.H. Chan School of Public Health.

Thomas Sequist, MD, MPH, is the chief quality and safety officer at Partners HealthCare, where he works with the leadership of multiple hospitals and institutions to measure and improve the delivery of health care across the care continuum. He is an associate professor of medicine and health care policy at Harvard Medical School, with joint appointments in the Division of General Medicine at Brigham and Women’s Hospital and the Department of Health Care Policy at Harvard Medical School. Previous to his current role, Dr. Sequist served as a general internist and director of research and clinical program evaluation at Harvard Vanguard Medical Associates and Atrius Health. Dr. Sequist’s research interests include ambulatory quality measurement and improvement, with a focus on patient and provider education, and the innovative use of health information technology. Dr. Sequist is particularly interested in health policy issues affecting care for Native Americans, and has worked collaboratively with the Indian Health Service to evaluate the provision of care for this population.  

Dr. Sequist is a member of the Taos Pueblo tribe in New Mexico and is committed to improving Native American health care, serving as the director of the Four Directions Summer Research Program at Harvard Medical School and the medical director of the Brigham and Women’s Hospital Physician Outreach Program with the Indian Health Service. He graduated from Cornell University with a BS in chemical engineering. He received his MD from Harvard Medical School, and his MPH from the Harvard School of Public Health.