When a physician sees a quality initiative as an administrative burden rather than improved patient care, LeWanza Harris, MD, chief quality officer at Atlanta-based Emory Healthcare, sometimes agrees with them.
“First, I tell them they are sometimes right,” Dr. Harris said on the “Becker’s Healthcare Podcast.” “Some measures reward documentation more than care, and pretending otherwise ends the conversation. Acknowledging that opening is what earns the right to talk about the rest.”
That candor runs through how Dr. Harris, who marked two years in the role Sept. 30, thinks about physician engagement — which she is careful to separate from compliance.
“Compliance asks, ‘Did you do the right thing?’ Engagement asks, ‘Is this the right thing for my patient, and how do we make it easier to do it every single time?'” Dr. Harris said.
A compliant physician completes CMS’ sepsis bundle, known as SEP-1, bundle because the order set demands it, she said. An engaged physician asks why the system’s sepsis mortality looks the way it does, questions the data and helps redesign the workflow.
“Compliance gets you to the floor of the measure,” she said. “Engagement is how you get past it.”
With that approach, the 11-hospital system has nearly doubled compliance with the SEP-1 bundle from 32% in March 2025 to 60% in summer 2026.
Dr. Harris looks for three signals: physicians helping choose what gets measured, challenging the data before accepting it, and bringing problems to leaders before leaders bring problems to them.
“When all three are present, we are no longer managing compliance,” she said. “We are building a shared practice of care.”
Trust starts with the chart, not the rate
None of that works without trust in the data, and Dr. Harris said trust comes from transparency — i.e., numbers physicians can take apart. They will ask about definitions, exclusions, risk adjustment and the patient-level cases behind a figure.
“What truly earns trust is showing the case, not just the rate,” she said. “A mortality index means little until someone reviews the actual patients together.”
When a physician can pull up the chart behind a patient safety indicator or a sepsis event and agree or disagree with it, she said, the conversation changes.
It also helps to admit a measure’s limits, keep definitions consistent from a single source of truth, and let clinicians validate attribution and documentation before a dashboard goes public or lands in a leadership meeting.
The fastest way to lose that trust, she said, is faulty attribution.
“If I had a dollar every time attribution came up, I would be a very wealthy woman,” Dr. Harris said.
Assigning an outcome to the discharging physician when the harm happened three handoffs earlier does not build credibility, she said — and neither does surprise data, such as blinded rankings shown in a large meeting before physicians have seen them. That produces defensiveness rather than improvement.
She is equally wary of metrics that move because coding changed rather than because care did.
“When a metric improves because coding changed, physicians notice,” she said. “It tells them the work is about the score, and it costs us credibility for the next initiative.”
Earning the ask
When physicians push back on a quality initiative as one more task, Dr. Harris said she brings it back to the patient.
“Behind every sepsis bundle is a family waiting to hear whether their mother will come home,” she said. “Behind every CLABSI (central line-associated bloodstream infection) is a patient who came in for one problem and left with another.”
Her side of the bargain is to “earn the ask”: retire a requirement whenever a new one is introduced, build the right action into the workflow so it is the easiest click in the EHR, share outcomes back with the teams doing the work, and separate what exists because a payer requires it from what exists because it changes outcomes.
“If an initiative cannot explain how it helps a patient, it should not survive our review,” Dr. Harris said.
Much of the friction between the C-suite and the front line, she added, comes from each side underestimating how much the other cares about patients. Executives can treat physician time as unlimited and read skepticism as obstruction; physicians can assume every decision is about money and opt out of governance roles where decisions get made with or without them.
“My role as a physician in the C-suite is to translate in both directions,” she said. “The goal is a shared language built around the patient, where leaders understand the realities of practice and physicians understand the realities of running a health system.”
Resistance as information
Asked how to handle physician resistance to a rollout, Dr. Harris said she listens first — on the unit. She rounds, sits in on team meetings and asks what gets in the way of the care clinicians want to give.
“Resistance is usually information,” she said. “It may mean the data is wrong, the attribution is unfair, the workflow is broken or a past initiative burned [people] out… I would rather learn that in a conversation than in a stalled project.”
Leadership rounding, she said, has taught her one thing above all: “People tell you exactly what is wrong when they believe that you came to actually hear it.”
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
