What keeps IU Health's VP of quality, safety and performance improvement up at night — and makes her get out of bed in the AM

Michele Saysana, MD, has served as vice president of quality, safety and performance improvement at Indianapolis-based Indiana University Health since 2017.

Her biggest takeaway on quality improvement and safety efforts? It's a marathon, not a sprint.

"You have to be in it for the long haul." she said. "You need to keep practicing and training."

Here, Dr. Saysana reflects on some of her key accomplishments and challenges in her first two years in the role, and shares advice for other safety and quality leaders.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What safety or quality initiative are you most excited about right now?

Dr. Michele Saysana: We recently implemented a new quality initiative focused on how to better understand care goals and preferences for patients at the end of life. We've realized we need to have these types of conversations with patients before they come to the hospital for end-of-life care. These discussions should be happening when patients are visiting their primary care physician or specialist. We're really excited about moving this initiative beyond the walls of our hospital. We're thinking about how to involve not just physicians, but also our nurses, chaplains, social workers, etc. 

Q: What is the No. 1 challenge you are facing in your role and how are you tackling it?

MS: Quality and safety tend to be at the intersection of many different healthcare priorities, such as payment reform, patient experience or interoperability. The No. 1 challenge is how to connect the dots between all of those different things and help leaders understand that it's not 95 different priorities they have to juggle. It's about making sense of our work in a way that helps all of these things.

Every other month, our CMOs, chief nursing officers, patient experience design leaders, and quality and safety leaders formally meet to talk about the work they're doing. It's really an effort to help everyone see that their work is all connected. After these meetings, leaders then bring this message and information back to other team members at their respective regions.  

Q: I know you became IU Health's vice president of quality, safety and performance improvement in 2017. What advice would you give to a leader who's stepping into a similar role for the first time?

MS: I have a couple of friends who are also pediatricians, and we all ended up in similar quality and safety roles within about six months of each other. It was great because we were able to network with each other, and we still talk on a regular basis. My advice would be to find people that do quality and safety work in other places and ask them what they've been doing. 

I also think it's important for quality and safety leaders to understand the current state of their own organization and where people are at before they start launching into their own ideas or solutions. Sometimes, the employees you talk to may have way better ideas than you originally had. Understanding what people are already doing and how you can build on that is really key. 

Q: What has been your proudest moment as IU Health's vice president of quality and safety?

MS: This year, it's been really exciting to see all our regions perform very well in terms of decreasing harm in our hospitals. We focused on reducing healthcare-associated infections for the past two years and have seen our teams come together and do great work to achieve fairly aggressive targets. My responsibility was to build on a foundation that was already there. They took it and ran with it and have done amazing work. We're seeing great results, which gives us the opportunity to focus on other areas like mortality and patient experience.

If you could fix one patient safety issue overnight, what would it be? 

MS: What keeps me up at night and gets me out of bed in the morning is the goal of better understanding quality and safety opportunities across the care continuum. If I could fix one thing, it would be to know exactly what's going on in all of our outpatient sites and how we could better help and support those teams. That's really where our patients get the majority of their care — in our primary care offices, emergency departments, infusion centers, etc. We have to get better about focusing on the true continuum of care, rather than just what's going on in our hospitals.

More articles on clinical leadership & infection control:
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5 ways to improve pediatric care for immigrant children

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