What Northwell's new chief quality officer refuses to look away from

Peter Silver, MD, hasn't allowed the demands of the COVID-19 pandemic distract him from the goal that has defined his career: providing his patients with the highest quality of care possible. 

Dr. Silver has spent 35 years at New Hyde Park, N.Y.-based Northwell Health's department of pediatrics, most recently as medical director of Cohen Children's Medical Center. 

Throughout his tenure, he has led multiple initiatives with the Children's Hospital Association focused on sepsis and central line-associated bloodstream infections. He was also awarded the excellence in healthcare award for quality improvement by the United Hospital Fund in 2019.

After decades of service, Northwell appointed Dr. Silver senior vice president and chief quality officer on Jan. 10. 

Dr. Silver spoke with Becker's to outline his goals, discuss strategies from pediatric care that can be applied to adult care and offer some advice to other quality leaders to enhance care during the pandemic and beyond.

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

Question: What are some of your biggest goals over the next year as Northwell's chief quality officer?

Dr. Silver: My first goal as chief quality officer of Northwell is to make sure in the short term, that not only are we providing the best healthcare possible during the pandemic, or specific to the pandemic, in terms of providing care to our hospitalized patients, our communities, etc., in terms of COVID, but also to remember that all other aspects of healthcare still continue.  So, we still need to maintain the highest quality of care for all other aspects of healthcare, whether it's cancer or cardiac care or obstetrics or newborn pediatric care. And that's a challenge, not only to get us through the pandemic, but to continue the trajectory of quality improvement that we've seen across healthcare, particularly at Northwell. As devastating as the pandemic is, we can't be distracted into thinking that's all we have to worry about. 

My second is to define what our targets are. Very often, we think of targets as inpatients. The metrics often center around events in hospitals, whether it's infections or other conditions that patients acquire when they're in the hospitals. The challenge is to extend that, and to think about how the patients really do. Not only the avoidance of those negative events, but also how they do following whatever it is they were hospitalized for. I'm thrilled to know that CMS is starting to look at those patient-related outcomes for hospital metrics. That's what's exciting to me. That's what healthcare is all about.

But even more than that, the challenge is in our communities too. It's not just our hospitals, we here at Northwell are responsible. We're a leading provider of healthcare in New York, so we feel responsible for the healthcare in our communities as well. It's not just the inpatients, but it's the communities.

How do we measure that quality of healthcare that we're delivering to our communities? And with a focus in communities where there may be some inequities in healthcare, whether it's on the basis of economic insecurity, food insecurity, housing insecurity, health literacy, language barriers, etc. How are we doing with our delivery of healthcare in those areas? How do we measure it, and how do we improve on it? Those are my goals and challenges for the next year or two. 

Q: What’s one piece of leadership advice that's stuck with you throughout your career?

PS: It's all in the details, and in healthcare the details are people. It's a unique industry, whether those people are your patients or they're your team members. With patients or families or team members every detail in healthcare is a person. It's such a common phrase, but in healthcare it's pretty unique because every detail is a life.

Q: Children's hospitals have long included patients and families in strategic decision-making. When it comes to achieving safe, patient-centered care, what strategies could adult acute care hospitals borrow from children's hospitals?

PS: We've been advocates for family-centered care for years. Obviously with children it makes sense, but I'm not sure that it's any different for adult patients. I think the thing to remember is that adult patients typically are part of family structures that are vital in the ongoing care of that patient. And it would be truly a disadvantage to the patient to ignore that. That goes from many things, in terms of best decision-making, optimize discharge planning, and ongoing care once discharged. The family typically plays a key role in those vital steps. The way to optimize each of those steps is to have the families involved to the highest degree possible throughout the patient's care. 

It's a bit of a challenge at times when hospitals have visitation limitations, like many are going through now because of COVID. But there are ways to work around that from video visits, etc. That shouldn't be a game stopper.

Q: What advice do you have for healthcare leaders looking to reinvigorate quality improvement efforts amid the pandemic? 

PS: As significant as the pandemic has been throughout our society, our patients still rely on us to provide the best care possible, whether we're talking about inpatients or ambulatory. It's our obligation not to get distracted by the pandemic as easy as that might be. And to really continue to focus on the quality of care that we give. Focus, focus. We can't take our eyes off the road. It's so easy to get distracted with COVID. It's had such an impact on our communities and on our teams. We have to continue to focus on quality. Our patients demand it, and it's their right.


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