Quality & Patient Safety

Quality & Patient Safety / en Fri, 25 Apr 2025 11:13:19 -0500 Mon, 21 Apr 25 08:18:45 -0500 Quality 101: How University of Utah Health Strengthens Board Culture for Better Patient Outcomes /advancing-health-podcast/2025-04-21-quality-101-how-university-utah-health-strengthens-board-culture-better-patient-outcomes Developing a strong board culture of quality and safety is a heavy but necessary lift for any health system. In this conversation, University of Utah Health's Kencee Graves, M.D., hospitalist and palliative medicine physician, and David Colling, vice chair, Community Board of Directors, discuss how a “Quality 101” approach helped bridge knowledge gaps between clinicians and board members, and why making this transformation interactive leads to stronger strategic alignment and better patient outcomes.<hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:01 - 00:00:30:06 Tom Haederle Welcome to Advancing Health. Quality and patient safety are the twin engines driving the mission of every hospital and health system, and both clinicians and board members have an important role to play in achieving these goals. Coming up in today's podcast, we hear from two experts from University of Utah Health about some of the best ways to help board members understand the critical role they play in making sure that quality and safety are always foremost in the patient experience. 00:00:30:09 - 00:00:53:15 Nikhil Baviskar Hi, I'm Nikhil Baviskar program manager, trustee services here at the �� Association. Today I'll be discussing the critical role the board plays in quality and safety. With me are Dr. Kencee Graves, who is the interim chief medical quality officer at University of Utah Health and is an associate professor of internal medicine, where she practices as a hospitalist and palliative medicine physician. 00:00:53:18 - 00:01:16:24 Nikhil Baviskar Also with us today is David Calling, who has served on the University of Utah Hospitals and Clinics Board since 2016 and is currently vice chair and co-chair of the board Quality and Safety Committee. Dr. Graves, I'd like to start with you. You recently presented to the board at University of Utah Health on quality and patient safety, an extremely important topic now and always for board members. 00:01:16:29 - 00:01:19:18 Nikhil Baviskar Can you give us an outline of that presentation? 00:01:19:20 - 00:01:51:22 Kencee K. Graves, M.D. Thanks for having us. And I think this is a really important topic. So when I gave this presentation to our board, I was new in this role. And what I learned was people around me, our board, our staff, people did not really understand the nuts and bolts of quality and the details. And so one of the things I offered to do was a quality 101 session. And my intent in doing that was to make sure that the group I would be working with and I were starting on the same page, so we both knew kind of what was going on in the landscape of quality. 00:01:51:25 - 00:02:10:18 Kencee K. Graves, M.D. So the content of my presentation really came from the questions I was being asked in my first few months in this role. And that is, what is quality? What is safety? How they are different. So what sets those apart? What are these ranking systems all about? Why do we do that? What are accreditation bodies, why do we do that? 00:02:10:20 - 00:02:22:05 Kencee K. Graves, M.D. And then, what is a quality structure? So what are you responsible [for]? Who works for you, that kind of stuff. And so really that's what my outline was, was just the basics, what I consider the basics in quality. 00:02:22:07 - 00:02:38:29 Nikhil Baviskar I think it's great that you, you did something where everyone starts at a level playing field. That sounds like a really wonderful way. I know that not everyone has the opportunity to do so, but definitely a good way to get everyone on the same page. Can you give us the response that you received from the board members to that presentation? 00:02:39:01 - 00:02:57:20 Kencee K. Graves, M.D. Yeah, I do want to call out - when I started, I actually had really good support from our board members. And they told me that this is something that they wanted. And so I felt like I had an open invitation because Dave and our CEO said, hey, we really think people could use something like this. Would you be open for it? 00:02:57:20 - 00:03:15:20 Kencee K. Graves, M.D. So they gave me the time. Many of them had been to the AHA and we used an AHA podcast by Jamie Orlikoff to kind of set the tone for that session. And so people went in with a really curious mindset. I actually did a Google survey after I gave the talk to make sure people learned and felt like it was valuable. 00:03:15:22 - 00:03:35:21 Kencee K. Graves, M.D. The feedback I got were that people felt like they knew more about quality after this session than they did before. They loved hearing about what we did at the U. They really felt strongly about supporting quality and supporting our leadership and driving toward high quality care, and they wanted to know how they could be more involved. 00:03:35:23 - 00:03:44:27 Nikhil Baviskar So, David, question for you as one of the University of Utah Health board members, what was your reaction to this presentation? 00:03:45:00 - 00:04:03:12 David Colling Yeah, Nikhil, what I would say is a couple of things, a few things that Kencee mentioned. But also remember, community board members typically are not clinicians, they're not health care employees, so this is a bit of a foreign environment for them. And that's part of the point, right. To have community board members get, you know, to offer a different perspective. 00:04:03:14 - 00:04:22:09 David Colling But what can happen is, as a board member, you can get pretty overwhelmed pretty quickly with whether it's the acronyms, the accreditation, you know, all the different things Kencee trained on can be pretty overwhelming for community board members. So, I thought it was excellent. And once again, I want to reiterate, it was really a 101. Kencee 00:04:22:09 - 00:04:40:02 David Colling didn't take any for granted, whether it was an acronym or a word, something need to be defined. It was really quite effective in the way that she approached it. You know, the other thing I think is it helped us continue to elevate quality and safety, you know, as a really important topic for the board. Right? So this is not a sideline. 00:04:40:09 - 00:04:55:17 David Colling This is a really, really important really the driving force behind the board. You know, maybe besides finance and some other things, you know, a really important piece of piece of the work that we do. So I think there's a couple of things, that I reacted to. And frankly, I've been a board member for, as you mentioned, almost ten years. 00:04:55:19 - 00:05:03:13 David Colling And I learned a lot. So what does that tell you? Right. So I think it's good for existing board members and new board members. 00:05:03:16 - 00:05:14:01 Kencee K. Graves, M.D. I think it was a really important launching point for the CMS structural measure that requires patient safety to be part of board meetings. That would have been difficult if we had not done already the Quality 101 session. 00:05:14:03 - 00:05:35:29 Nikhil Baviskar Thank you for mentioning that. What you're referring to as quapi, we're seeing a lot of folks, other boards that are realizing this is something that has to be integral to the planning process and the strategic planning process. David, I wanted to ask you, a follow up on that. So as the co-chair of the Board Quality and Safety Committee, you said you learned a lot. 00:05:36:01 - 00:05:46:01 Nikhil Baviskar Do you do you feel like Kencee's presentation sort of set maybe an agenda or help you and your other co-chair plan going forward? 00:05:46:04 - 00:06:02:13 David Colling Yeah. I mean, again, it gave such a good foundation, and I liked what Kencee said about us all being on the same page. So I do, I think it's set an excellent foundation for the committee moving forward. Got us all kind of in the same spot, whether you'd been there for ten years like myself or whether you're a brand new community board member. 00:06:02:15 - 00:06:19:22 David Colling You know, the other thing I thought it was nice to, you know, we had it wasn't just board members. It was the clinical and health care staff there as well. I think it's important for them to listen to the dialog, understand that should help them understand kind of that knowledge gap, whether it's quality and safety or whether it's other, you know, board activities. 00:06:19:22 - 00:06:32:15 David Colling You know, the community board members do need to be constantly reminded of definitions and things that come naturally to clinicians and health care workers, that that we need to continue to, to bridge that knowledge gap. So, yeah, absolutely. 00:06:32:17 - 00:06:43:01 Nikhil Baviskar So as you know, this podcast will be listened to, by other board members. David, can you give some nuggets of wisdom or some advice to other board members that may be listening? 00:06:43:04 - 00:07:04:06 David Colling Yeah for sure. So again, going to reiterate 101 basics. You know, don't take anything for granted. Don't make any assumptions. Assume that you're starting with everyone that knows very little about, you know, not necessary quality and safety, but certainly quality and safety in the context of the health care environment. I'd highly recommend making it interactive, almost a Q&amp;A ongoing, right? 00:07:04:06 - 00:07:23:12 David Colling So in other words, and I think we did that, you know, we never have enough time in our board activities. We probably could even have allotted more time. But as opposed to a report out on a presentation with Q&amp;A at the end, and we did some of this, I would argue we could have even done more with this kind of back and forth discussion with the community board members asking further questions. 00:07:23:16 - 00:07:41:15 David Colling Kencee being able to elaborate a little bit more, potentially even the health care folks and clinicians in the room adding a little bit of color. And we did some of that but I would encourage that. And once again, I would make sure that you include all certainly all community board members, regardless of tenure. You know, there might be the occasional one that feels like they know it. 00:07:41:15 - 00:08:01:11 David Colling I'd be amazed if, if a community board member, no matter how long you've been serving didn't learn something from the presentation. And once again, I would say the entire board should be included, that dialog is healthy and I think creates good understanding amongst all parties. And you know, Kencee, you mentioned the podcast that that we kind of did a pre-work. 00:08:01:12 - 00:08:20:28 David Colling You know, we asked everybody to listen to Jamie's podcast, and I want to say that was about a 30 minute give or take podcast, excellent foundation to reinforce the importance of quality and safety, right? So before we go into the 101 and the teaching piece, get everybody on the same page of the importance of it and the role it plays with the board. 00:08:20:28 - 00:08:29:10 David Colling So I thought that was excellent. You know, I'll call it pre-work and everyone should kind of be required to listen to that I think prior to the actual presentation itself. 00:08:29:12 - 00:08:46:16 Kencee K. Graves, M.D. I'm really glad you called out some of the interactive stuff and the keep it fun. I don't know if there's any chief quality officers listening, I do think that's an important piece. And so a couple things that I did that I thought worked really, really well. Survey questions after sections of my presentation. So I would talk about patient safety. 00:08:46:16 - 00:09:04:11 Kencee K. Graves, M.D. And then I would ask people what it is. And then I would give them four multiple choice questions. Put one in there that was funny. And that kind of thing kept people really engaged. I also put together a laminated front-and-back about what ranking system that we use at the University of Utah, and explained every section of that. 00:09:04:14 - 00:09:23:11 Kencee K. Graves, M.D. I went through my office and introduced people and talk about what they did, and that's the kind of stuff that people loved. They loved getting to know who their leaders are, and they really liked the human part. And I think that's critical because we're here for humans, right? Like quality care is for humans. And so that was kind of my undertone. 00:09:23:11 - 00:09:24:29 Kencee K. Graves, M.D. I'm glad David picked up on it. 00:09:25:01 - 00:09:42:16 David Colling And Nikhil, I'll just add one more comment to that. Yeah, the structure within the organization where quality and safety fits, the different roles. Again, something I kind of knew but didn't know in that level of detail. There's quite a bit more to the quality and safety than many would imagine. So I thought that was know really well done. 00:09:42:16 - 00:09:58:17 David Colling You know, Kencee, I don't know if I've mentioned it to you, but I think that presentation it's interesting is I went back and reviewed it. That almost needs to be kind of a continuous piece of reference material. I almost feel like I want to make it a little less of a PowerPoint and more of a reference piece. So there's an assignment for you. 00:09:58:17 - 00:10:16:07 David Colling But, you know, because it is so well done. It should be a continuous reference, you know, that's almost in your little in your toolbox as a community board member, because this is how busy we as committee board members are. You know, we've got our day jobs and we get so focused. So that presentation, which was extremely effective was only a few months ago. 00:10:16:09 - 00:10:30:20 David Colling But when I reviewed it, you know, even prior to this, discussion, I was like, oh yeah, I need to, you know, keep remembering this kind of thing. So I'm going to be referring back to that pretty regularly. So that might be another piece of advice, you know, use it as an ongoing resource for the for the board. 00:10:30:22 - 00:10:48:28 Kencee K. Graves, M.D. That's really good advice. And I want to go back to a point you made earlier where our accreditation partner is, that Det Norske Veritas or DNV. They were on site at the end of January. And so I reported that out to the board in February, and I included what DNV stands for and what it means and what they gave us citations on. 00:10:48:28 - 00:11:07:27 Kencee K. Graves, M.D. And I used graphics to demonstrate kind of each bucket. And I did have people that have worked at the University of Utah in leadership for more than a decade come up and tell me, thank you for doing that, because I think quality is such an alphabet soup that for those of us who work in it, it's easy to forget that it doesn't mean a lot to anybody else. 00:11:07:27 - 00:11:16:23 Kencee K. Graves, M.D. And so I would just say, I think it's really, really important to continue to revisit those abbreviations that may not land well without an introduction. 00:11:16:25 - 00:11:35:05 David Colling And Kencee, I would say that the entire clinical or healthcare environment, health care environment is a big alphabet soup. If I had one advice for, you know, the clinical and health care staff, beyond quality and safety, there are acronyms and short you know, wordings used for things that just don't come natural to community board members. 00:11:35:05 - 00:11:38:06 David Colling So I think that's a good reminder beyond quality and safety as well. 00:11:38:08 - 00:11:59:03 Kencee K. Graves, M.D. Yeah, I've spent a lot of time talking about what I think chief quality officers should do. But I'll tell you what I think has been valuable to me as interim chief quality officer with a board. The board members ask really good questions. And for me, that is my check on. Am I explaining something well? What does an average patient hear and think and see? 00:11:59:03 - 00:12:17:24 Kencee K. Graves, M.D. And how do they perceive us through the media? And what does the community say? And that is incredibly valuable because there are not a lot of spaces in my life where I hear that because I work in health care, I work around other doctors and nurses and the community board is my window to what the rest of the world sees when they see our health system. 00:12:17:27 - 00:12:37:28 Nikhil Baviskar That's very helpful. As you said, the board should reflect the community and that's really important. You know, Kencee or Doctor Graves, I'll ask you just one more thing. For the board members listening, I already asked this to David, but what do you think that the board member should take away when it comes to, you know, working on quality, understanding it and learning about it? 00:12:38:01 - 00:13:01:02 Kencee K. Graves, M.D. Part of that is, is what I said in that ask questions, stay engaged. And so if you see something or hear something that doesn't make sense, ask about it. The other thing that our board has asked me to do, which I found very, very helpful, is if I bring them a problem they've also asked me to report on who is responsible for it, what is the fix and when do I report back? 00:13:01:05 - 00:13:23:29 Kencee K. Graves, M.D. And that cadence has kept me giving them information that is meaningful. And then also they've learned to trust the information I bring them. It keeps me honest and keeps a closed loop communication. So I think that's been really good. I do think it's possible to skim over things, and I would just say, I think board members can and should ask really really good questions. 00:13:24:01 - 00:13:35:08 Nikhil Baviskar Well, thank you both so much for your time. This has been an awesome discussion and we really do hope that you know, your quality journey just continues getting better from here on out. So thank you again. 00:13:35:11 - 00:13:36:04 David Colling Thank you. 00:13:36:07 - 00:13:38:16 Kencee K. Graves, M.D. Thank you for having us. 00:13:38:19 - 00:13:47:00 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </details></div> Mon, 21 Apr 2025 08:18:45 -0500 Quality & Patient Safety AHA launches online collaborative focused on quality improvement /news/headline/2025-04-08-aha-launches-online-collaborative-focused-quality-improvement The AHA Living Learning Network is launching the Quality Exchange, a virtual collaborative for health care quality and patient safety professionals at hospitals and health systems. Participants will convene online monthly to explore and share strategies, resources, solutions and metrics for sustaining quality improvement in patient care and organizational performance. The deadline to <a href="https://forms.office.com/pages/responsepage.aspx?id=QJMRube-Xk6EsjzBj3s2pml74gh-eaFHrnQINP8bdpxUODlRWEE1NFo3Q0FaT1dJQ083WjFIRjdSMy4u&amp;route=shorturl" target="_blank">sign up</a> is April 22 and enrollment is limited.&nbsp;<a href="/center/living-learning-network/ahas-quality-exchange?utm_source=newsletter&amp;utm_medium=email&amp;utm_campaign=aha-today" target="_blank">LEARN MORE</a>&nbsp; Tue, 08 Apr 2025 15:45:06 -0500 Quality & Patient Safety AHA’s Quality Exchange: Collaborate to Drive Excellence in Quality Improvement | Center /center/living-learning-network/ahas-quality-exchange Fri, 04 Apr 2025 15:30:00 -0500 Quality & Patient Safety AHA webpage highlights how hospitals and health systems integrate patient safety /news/headline/2025-04-01-aha-webpage-highlights-how-hospitals-and-health-systems-integrate-patient-safety As part of the AHA's <a href="/aha-patient-safety-initiative" target="_blank">Patient Safety Initiative</a>, a dedicated webpage features case studies showing how hospitals and health systems across the nation are implementing effective and innovative programs to create a culture of safety, improve staff well-being and connect with their communities. <a href="/aha-patient-safety-initiative/us-hospitals-and-health-systems-enhance-patient-safety" target="_blank">READ NOW</a> Tue, 01 Apr 2025 15:38:04 -0500 Quality & Patient Safety Leadership Dialogue /leadership-dialogue <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/leadership-dialogue-freese-decker-wightman-900x400.jpg" data-entity-uuid="050ab622-3282-4178-a8e8-8b9dfdc90207" data-entity-type="file" alt="Tina Freese Decker headshot. Leadership Dialogue. A conversation with AHA Chair Tina Freese Decker and Lori Wightman, R.N., CEO of Bothwell Regional Health Center." width="900" height="400">In this episode, Tina Freese Decker, 2025 chair of the AHA Board of Trustees, talks with Lori Wightman, R.N., CEO of Bothwell Regional Health Center, in Sedalia, Mo., about the challenges that rural hospitals and health systems face.Freese Decker and Wightman discuss working in a “family atmosphere” unique to a rural hospital and navigating the same pressures that face urban hospitals, including workforce shortages and the high costs of labor, supplies and drugs. Rural hospitals also experience severe underpayments by Medicare and Medicaid, and most have “razor-thin” operating margins.Wightman describes leading annual advocacy days — where Bothwell board members meet with state legislators (and candidates in election years) — and emphasizes the importance of all team members telling the hospital story.<hr><hr><div></div>&nbsp;<div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> View Transcript </h2> </summary> 00:00:01:05 - 00:00:23:09 Tom Haederle Welcome to Advancing Health. In the face of today's multiple challenges, every hospital needs support and buy in for its mission of great care. Storytelling - sharing the right kinds of stories with the right audience at the right time - is a great way to build and maintain that support. This is particularly important for rural hospitals and health systems, most of which have razor-thin operating margins. 00:00:23:12 - 00:00:40:10 Tom Haederle In this month's Leadership Dialogue, hosted by the �� Association's 2025 Board Chair Tina Freese Decker, we hear more about the importance of advocacy and of all team members participating in telling the hospital story. 00:00:40:13 - 00:01:07:25 Tina Freese Decker Thank you so much for joining us today. I'm Tina Freese Decker, president CEO for Corewell Health, and I'm also the board chair for the �� Association. Last month we talked about trust and how our hospitals and our health systems can strengthen that trust with our communities and the people that we serve. Our rural hospitals are uniquely positioned to do this, as they are often the largest employers in their towns and communities, and frequently the only local source of care. 00:01:07:27 - 00:01:28:07 Tina Freese Decker Rural health care is about being a family. We take care of each other in our communities as best as possible, and we're here to provide that care close to home, no matter what headwinds that we all face. I recently had the opportunity to attend the �� Association's Rural Conference and you could really feel that sense of family and community in the room. 00:01:28:09 - 00:01:59:15 Tina Freese Decker We work in hospitals in red states and blue states all across the country, but we are all focused on the same thing: helping our neighbors in our communities to be healthier. There are some big challenges that are facing real health care, but together with a unified voice, we can get what we need. As I have traveled around our country meeting with the �� Association's regional policy boards and visiting the rural hospitals and my health system and others, the number one concern that I have heard from our hospitals, our communities, is access. 00:01:59:18 - 00:02:22:28 Tina Freese Decker And that is why it is so integral to the �� Association strategy and it is why it is so important that we come together as a field and that we're united as a field, because these challenges that we are facing are real. So today, I am pleased to have a distinguished leader in rural health care with us to talk about how we can all work together to advocate for the needs of our hospitals. 00:02:23:01 - 00:02:45:09 Tina Freese Decker I'd like to welcome Lori Wightman. She is the CEO of Bothwell Regional Health Center, a 108 bed acute care hospital in Sedalia, Missouri. Laura has served in this role since 2019, but even prior to Bothwell, she worked in real health care as the president of Mercy Hospital Ada in Ada, Oklahoma. So, Lori, welcome. Glad you were able to join us today. 00:02:45:15 - 00:02:46:17 Lori Wightman, R.N. Thank you, Tina. 00:02:46:19 - 00:03:03:20 Tina Freese Decker And I wanted to start out with just telling us a little bit about yourself. I know you started your health care career as a nurse and then you made the shift to administration. Can you tell us about yourself and how you see that family aspect in the hospital and the community in our rural areas? 00:03:03:22 - 00:03:30:01 Lori Wightman, R.N. Sure. Well, my father was a hospital administrator and my mother was a nurse, so I did both. And so it was a natural progression. And I think the foundation that nursing lays gives you all kinds of transferable skills that have been very helpful as I went into hospital administration. My career and dating advice has always been, you can't go wrong with a nurse. 00:03:30:03 - 00:03:57:14 Lori Wightman, R.N. And there's certainly served me well. And you talk about that family atmosphere. That is why I continue to choose rural health care. I've done the CEO position in a suburban hospital, and I sat at our senior leadership team meeting and thinking I was the only one on our senior leadership team that even lived in the area that we served. 00:03:57:17 - 00:04:23:24 Lori Wightman, R.N. Everyone else lived in a different suburb, and I just thought that was strange and disconnected. And, so I returned again then to rural health care because it is like a family. And it's ironic because we just finished revisiting our mission, vision and values. And our new mission statement talks about together we work to provide compassionate and safe care to family, friends, and neighbors. 00:04:23:27 - 00:04:37:07 Lori Wightman, R.N. Invariably, when I met new employee orientation, a significant number of people were born at the hospital. That's why I love rural. It's like that "Cheers" phenomenon where everyone knows your name. 00:04:37:09 - 00:05:01:02 Tina Freese Decker Very true. I used to lead a couple of rural hospitals as well. And like you said, even just walking into a rural hospital it feels like family where everyone there knows your name and of course, protect things from a confidentiality and a privacy perspective, but that feeling that we're all in this together. So I love that your mission statement is about together, that you can make an impact on people's health. 00:05:01:05 - 00:05:13:28 Tina Freese Decker I described a little bit about what it's like to walk into a rural hospital. Can you share a little bit about what is like to be a rural hospital, what it means in today's environment and why it's such a great place to work? 00:05:14:01 - 00:05:47:06 Lori Wightman, R.N. Well, in many ways, rural hospitals are uniquely the same as our suburban or urban counterparts. Forty six million people depend on a rural hospital for their care. So we struggle with the same labor shortages, the cost of labor supplies and drugs is rising faster than our reimbursement. We have all of those same struggles. Unique is that family atmosphere, I think. 00:05:47:06 - 00:06:13:26 Lori Wightman, R.N. And we have multiple generations working at the hospital. Now, you can't say anything bad about anyone because invariably they're somehow related. Or they were best friends in high school, or they used to be married to each other. So I mean, it's unique in that way. We have the same types of struggles that &nbsp;our counterparts do. 00:06:13:28 - 00:06:18:03 Tina Freese Decker What pressures are you feeling the most acutely right now? 00:06:18:06 - 00:06:47:09 Lori Wightman, R.N. Well, you take all of those common challenges that I talked about, and you turn up the volume a little bit. Because for us, 78% of our patients and our volume is governmental payers, so 78% of our business, we're getting reimbursed below cost. You can't make that up in volume. So we rely on all of the governmental programs, you know, disproportionate share all of those things. 00:06:47:09 - 00:06:54:22 Lori Wightman, R.N. And, 340B is doing exactly for us what it was designed to do, save rural hospitals. 00:06:54:25 - 00:07:11:22 Tina Freese Decker Those areas are critical that they remain. And so that we can continue to provide that sustainable, high quality care in our communities and all of our communities. 78% being governmental. It's a huge portion of what we do and what we rely on for access and caring for people. 00:07:11:29 - 00:07:23:15 Lori Wightman, R.N. Right. We are the typical rural hospital. We have razor-thin margins and aging plant of 18 years. 00:07:23:18 - 00:07:31:10 Tina Freese Decker So those are challenges that you're trying to navigate right now with all of the other things that happen. And how is your staffing levels going? Are those going okay? 00:07:31:13 - 00:07:55:12 Lori Wightman, R.N. Have the same labor shortage issues. We still have 22 traveling nurses here, but we have started being very aggressive in a grow your own program. And so as soon as the next month we're going to cut that number in half and then, within six months, we're hoping to have all of contract staff out. 00:07:55:15 - 00:08:02:04 Tina Freese Decker Is that something that you're most proud of, or is there something else that you want to share that you're most proud of from a rural hospital perspective? 00:08:02:06 - 00:08:29:24 Lori Wightman, R.N. I think what I'm most proud of is you get to personally view the impact of your decisions on people. I'm very proud of our all the talented people that we have here, from clinicians to community health workers. All of our physicians get to use all of the things they learned in medical school and residency, because there isn't a lot of subspecialists, so they are working at the top of their license. 00:08:29:26 - 00:08:50:21 Lori Wightman, R.N. Just several months ago, one of our critical care physicians diagnosed a case of botulism. Now as an old infection control nurse I get very excited about that because I never thought in my career I would see botulism. But it was diagnosed and treated here and the person's doing well. 00:08:50:23 - 00:09:25:27 Tina Freese Decker Oh, that's wonderful to hear. When you talk about all the different people that are part of health care in rural settings, or also another settings, it's quite amazing to see how many different areas we need to come together to take care of our community. When you think about an even larger scale, from rural hospitals to urban and teaching hospitals and others, how do you think about the whole ecosystem of our field and how we, you know, do we need all of us or and is there a way to form that greater fabric and social connection, or is there something else that we should be doing? 00:09:25:29 - 00:09:50:21 Lori Wightman, R.N. We are all very interconnected and I believe we are all needed. And I especially feel that as an independent hospital, not part of a health system, this is my first independent hospital. I rely on my hospital association more than I ever did when I was working for a health system, because it all comes down to relationships. 00:09:50:21 - 00:10:18:13 Lori Wightman, R.N. And so how do you develop, how do you get yourself in situations where you are meeting and now working with your partners around the state or the region? Because it comes down to relationships, you really need to know who your neighbors are in terms of other hospitals, who you're referring your patients to and develop that working relationship because it is all interconnected. 00:10:18:13 - 00:10:25:06 Lori Wightman, R.N. And we rely on our partners that we refer to, and they rely on us, too. 00:10:25:08 - 00:10:43:23 Tina Freese Decker One of the things I heard you say about the Rural Health Conference that the �� Association just put on, and the value of the �� Association is that we're not alone. And those values of relationships are really critical. So I appreciate that. The �� Association also talks a lot about how do we tell the hospital story. 00:10:43:25 - 00:10:55:15 Tina Freese Decker So how do you engage in advocacy to make sure we're telling that hospital story so that our legislative leaders and others know the value that we're bringing to the community? 00:10:55:17 - 00:11:22:11 Lori Wightman, R.N. Well, we are surrounded by stories. And so the first thing is to always be picking up on what is the story that is surrounding us, and how can we capture that? Because the most effective way is to bring that patient or nurse or physician to the legislator to testify, because they are the most effective way of communicating a message. 00:11:22:18 - 00:11:49:07 Lori Wightman, R.N. You know, the suits can go and talk about data, but nothing is more effective than what I call a real person telling their story and how a decision or a potential decision is going to impact them and how it feels. The other thing we do is every October, it's become tradition. We have Advocacy Day with our board, at our board meeting. 00:11:49:09 - 00:12:21:12 Lori Wightman, R.N. We invite our state elected officials &nbsp;- so people representing us at the state capitol - to come to our board meetings. On election years their challengers also come and I invite the hospital association and they all answer two questions: What do you hope to accomplish in the next legislative session, and what do you think might get in the way? That sets the scene for my board to understand that part of their role in governance is advocacy. 00:12:21:14 - 00:12:29:19 Lori Wightman, R.N. And so I've had two of my board members...almost every legislative session I go and testify on on some bill. 00:12:29:21 - 00:12:50:01 Tina Freese Decker That is really a good idea. Thank you so much for sharing that. Do you have any other final suggestions for us as AHA members, as other hospitals, whether it's rural or urban, that we should think about or do as we think about advocacy and access or also field unity? 00:12:50:03 - 00:13:22:11 Lori Wightman, R.N. You know, having been on the board of two different state hospital associations, I get it. You know, sometimes members can be at odds with each other on a given issue. And my advice to AHA would be to play the role of convener, facilitating conversations between members to better understand each other's position. And if a middle ground can't be reached, then that might be an issue that AHA remains neutral on. 00:13:22:14 - 00:13:34:07 Lori Wightman, R.N. But there are so many issues where we can agree on and that is very much the role and what all of us depend on AHA to play in advocating. 00:13:34:09 - 00:14:02:15 Tina Freese Decker There's a lot that binds us together. Like you said, we're all caring for our neighbors and our communities, and that's the most critical piece of it. And we have to keep that front and center with every decision that we make and every action that we do. Well, Lori, thank you so much for being with us today on this AHA podcast, for sharing your expertise in rural health care and for talking about some new ideas that all of us can take forward to ensure that we're telling the hospital story in the best way possible. 00:14:02:18 - 00:14:21:09 Tina Freese Decker So while I know that we have our work ahead of us, I know that I continue to be energized every time I speak with committed and passionate hospital leaders like Lori. Again, appreciate your work that you do every single day for the neighbors and for the people in your community that you serve. We'll be back next month for another Leadership Dialogue conversation. 00:14:21:13 - 00:14:23:01 Tina Freese Decker Have a great day. 00:14:23:03 - 00:14:31:13 Tom Haederle Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </details> </div></div><div class="col-md-4"><div class="views-element-container"> <section class="top-level-view js-view-dom-id-fef6bad5fee266fcc91b90c97a77293b6f7ccba1912e28db35c2fff339741984 resource-block"> <h2>Previous Leadership Dialogues and Rounds</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/chairpersons-file/2025-02-24-chair-file-leadership-dialogue-advancing-health-and-building-trust-lynn-hanessian-and-robert" hreflang="en">Chair File: Leadership Dialogue — Advancing Health and Building Trust with Lynn Hanessian and Robert Trestman, M.D.</a> </div><div class="views-field views-field-created"> <time datetime="2025-02-24T08:21:34-06:00">Feb 24, 2025</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/chairpersons-file/2025-01-27-chair-file-leadership-dialogue-tackling-todays-health-care-challenges-aha-leaders-stacey" hreflang="en">Chair File: Leadership Dialogue — Tackling Today’s Health Care Challenges with AHA Leaders Stacey Hughes and Ashley Thompson</a> </div><div class="views-field views-field-created"> <time datetime="2025-01-27T09:40:27-06:00">Jan 27, 2025</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/chairpersons-file/2024-12-16-leadership-dialogue-assessing-health-care-challenges-and-successes-tina-freese-decker" hreflang="en">Leadership Dialogue — Assessing Health Care Challenges and Successes With Tina Freese Decker, President and CEO of Corewell Health</a> </div><div class="views-field views-field-created"> <time datetime="2024-12-16T08:16:44-06:00">Dec 16, 2024</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/chairpersons-file/2024-11-18-leadership-dialogue-advancing-health-care-innovation-amy-perry-president-and-ceo-banner" hreflang="en">Leadership Dialogue — Advancing Health Care Innovation with Amy Perry, President and CEO of Banner Health</a> </div><div class="views-field views-field-created"> <time datetime="2024-11-18T10:04:06-06:00">Nov 18, 2024</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/chairpersons-file/2024-10-28-leadership-dialogue-value-health-systems-tom-priselac-president-and-ceo-emeritus-cedars-sinai" hreflang="en">Leadership Dialogue — The Value of Health Systems with Tom Priselac, President and CEO Emeritus of Cedars-Sinai </a> </div><div class="views-field views-field-created"> <time datetime="2024-10-28T10:22:11-05:00">Oct 28, 2024</time> </div></div> </div> </div> <div class="more-link"><a href="/topics/leadership-dialogue">Watch More Leadership Dialogues and Rounds Videos</a></div> </section> </div> </div></div></div> Mon, 31 Mar 2025 10:30:00 -0500 Quality & Patient Safety Can Collaborative Efforts to Improve Device Design Improve Safety? /news/blog/2025-03-28-can-collaborative-efforts-improve-device-design-improve-safety During World War II, the U.S. Army Air Corps depended on its B-17 bombers to inflict incredible damage against the Axis powers in Europe. These “Flying Fortresses” were deemed essential to winning the war in the European theater, but they had one big problem. Despite the plane’s technically advanced design and the provision of effective training for the young pilots responsible for steering them through war zones, too many crashed on landing, destroying the machines and often killing the pilots and crew.Initial investigations into B-17 crashes concluded that the accidents resulted from pilot error, and the Army invested in training and retraining pilots. Yet, the crashes continued. Then Alphonse Chapanis, a young psychologist who joined the Army Air Corps’ aeromedical lab in 1942, noticed that the switches for the plane’s flaps and the landing gear were adjacent on the dash and identical in appearance — but radically different in function.It was far too easy for pilots — stressed and weary after hours of combat flying — to flip the wrong switch when trying to land the B-17. The plane’s design had failed to account for the likelihood of normal human error. Chapanis suggested changing the knobs so that one was triangular and the other was spherical, making it easy for pilots to differentiate. This small change in design led to an immediate and substantial decrease in the number of B-17 crashes. (<a href="https://uxmag.com/articles/pilot-error-chapanis-and-the-shape-of-things-to-come" target="_blank">Read more about Chapanis</a> and his influence on device design).While most health care isn’t delivered in war zones, health care and device company leaders recognize that care is often delivered in high-stress, high-risk situations. Despite elegant efforts to design for safe use, rigorous standards and regulatory requirements from the Food and Drug Administration and standards bodies, and lots of training of health care professionals, many acknowledge that there is still room to ensure clinicians are “flipping the right switch” when using medical devices.<h2>AHA and AAMI Meeting</h2>Earlier this year, the �� Association (AHA) and the Association for Advancement of Medical Instrumentation (AAMI) brought together a small group composed of hospital and health system leaders, device manufacturers and policy leaders to explore how to make devices safer by design. Their energy and commitment were palpable. Participants were invigorated and challenged by the shared goal of creating devices that could be used more easily, effectively and safely.The meeting began with table-setting presentations to make sure all attendees understood each other’s perspectives. Clinical leaders described the stresses and distractions of the busy hospital environment that make it difficult for staff to use devices as the designers had envisioned, including their personal experiences of devices being implicated in near misses or safety events. Manufacturers discussed their rigorous processes for designing, testing and providing instructions to ensure safe use. An AAMI leader described the role of standards in promoting safety, and a former FDA official spoke about the role of regulation, oversight and post-market surveillance in promoting safety. The group then broke into multidisciplinary groups with direction to identify practical, actionable pathways that augment or replace current activities and lead to better safety by design.<h2>3 Key Takeaways from the Conversations</h2><ul><li>Users and manufacturers need better information. Engineers and users need to be able to exchange the right information to make design improvements that address usability issues. Right now, they are not connecting well. Health care providers often discover a design challenge with a piece of equipment when conducting a root cause analysis and then report that information to their patient safety organization, but that information is not readily available to manufacturers. Manufacturers get information from FDA databases, but these may not have sufficient information to understand exactly how the device design may have contributed to the occurrence of patient harm or inform design alterations that could prevent it in the future. Finally, post market surveillance reporting is often slow to reach the manufacturer, limiting their ability to alter design in a timely fashion.</li><li>Work as imagined differs from work as done. In designing each particular product, engineers imagine the clinical environment in which it will be placed, plan for a rigorous training of the health care professionals who will be operating it and create comprehensive instruction manuals. Health care professionals use an expanding and rotating panoply of devices every day, and their ability to be trained on each and every one of those, remember that training and use it in a moment of emergent patient need is radically different from what the designer imagined. Better communication between users and designers is the only way to help designers anticipate how their devices will actually be used.</li><li>There is a natural tension between innovation and the experience that promotes safe use of a device. In a busy clinical environment, it is challenging for clinicians to keep up with all they must learn, but device makers may want to make routine improvements to the software or user interface of their devices to refresh perceptions of the device. Honest discussions about the kind of innovation device manufacturers intend and how the alteration will work in a busy clinical environment are needed to ensure innovation better contributes to safety and ideally decreases the draw on clinicians’ already-stretched mental capacity. Further, the regulatory framework needs to support this balance between innovation and safety by recognizing and creating safe tables and sandboxes within which to drive progress.</li></ul>One actionable item that drew keen interest was creating an opportunity for the manufacturers’ engineers to participate in a hospital’s response to a patient safety event. Stakeholders across the spectrum agreed that open sharing of how design may have contributed to an event is vital to generating changes needed to promote safer use and reduce patient harm. AHA and AAMI are committed to working to make these conversations a reality as part of our ongoing efforts to make care safer.Nancy Foster is the AHA’s vice president of quality and safety policy. Fri, 28 Mar 2025 11:56:05 -0500 Quality & Patient Safety AHA podcast: A Great Catch — Strategies for Building a Culture of Safety Reporting /news/headline/2025-03-26-aha-podcast-great-catch-strategies-building-culture-safety-reporting Mindy Estes, M.D., former CEO of Saint Luke’s Health System and former AHA board chair, and Nancy Howell Agee, CEO emeritus of Carilion Clinic and former AHA board chair, discuss the importance of bringing a culture of safety reporting to an organization and how technology cannot replace the human factor in a successful patient safety strategy.&nbsp;<a href="/advancing-health-podcast/2025-03-26-great-catch-strategies-building-culture-safety-reporting" title="March leadership dialogue">LISTEN NOW</a>&nbsp;&nbsp;<div></div> Wed, 26 Mar 2025 15:28:00 -0500 Quality & Patient Safety Member Advisory for Hospital and Health System Leaders <div class="container"><div class="row"><div class="col-md-8">Hearst Newspapers contacted AHA seeking comment for a national project spearheaded by a group of regional Hearst reporters that focuses on incidences of retained surgical items (RSI).The reporters say their research using data from state health departments and the Centers for Medicare &amp; Medicaid Services show that there are hundreds of RSI cases reported annually, among the tens of millions of annual surgeries across the country. The reporters pointed out that their data show cases are relatively rare but can result in additional surgery or other complications.We are aware that some of the journalists working on this project write stories for the Houston Chronicle, San Antonio News Express, San Francisco Chronicle, Albany Times Union of New York, Connecticut Post and New Haven Register. However, Hearst owns 26 dailies and 52 weeklies so the story could appear more widely. The regional reporters likely will seek to localize the story for their respective communities and have been reaching out to hospitals and health systems around the country to ask what policies they use to prevent instances of retained surgical items.<h2>AHA RESPONSE AND RESOURCES</h2>The AHA shared the following statement with Hearst Newspapers from AHA Chief Physician Executive Chris DeRienzo, M.D. “Hospitals and health systems have ramped up their efforts to enhance patient safety and will continue implementing effective, evidence-based approaches toward the goal of eliminating unplanned retention of surgical items (RSI). With more than <a href="/infographics/2024-06-13-hospitals-are-cornerstones-their-communities-infographic" target="_blank" title="Hospitals Are Cornerstones of Their Communities Infographic">28 million surgeries</a> performed at community hospitals in 2023, the data show that the likelihood of patients experiencing this kind of event is extremely rare. But there is more work to do. To that end, hospitals and health systems are embracing new strategies to improve the safety of surgical care, sharing best practices with each other, upgrading equipment and employing new technologies that enhance patient outcomes in their commitment to delivering top-tier patient care around-the-clock, 365 days a year.”Hospitals and health systems across America and their dedicated care teams strive to deliver safe, high-quality care to every patient, continually identifying what drives better outcomes and then implementing changes to improve patient care. As you know, the AHA launched its <a href="/aha-patient-safety-initiative" target="_blank" title="Patient Safety Initiative Website">Patient Safety Initiative</a> in 2023 to reaffirm hospital and health system leadership and commitment to patient safety. Please visit the Patient Safety Initiative <a href="/aha-patient-safety-initiative" target="_blank" title="Patient safety webpage">webpage</a>, which includes reports, member stories and data-driven analyses highlighting the excellent work and improvements that hospitals and health systems are leading to create a culture of safety for patients and staff.<h2>WHAT YOU CAN DO</h2><ul><li>Please share this Advisory with your quality, patient safety and communications teams, government relations leaders and other key executives.</li><li>Prepare to share how your hospital works 24/7 to provide safe, high-quality care.</li></ul><h2>FURTHER QUESTIONS&nbsp;</h2>If you have further questions, please contact Sharon Cohen, AHA senior associate director of media relations, at <a href="mailto:scohen@aha.org" target="_blank" title="Sharon Cohen email ">scohen@aha.org</a>.</div><div class="col-md-4"><a href="/system/files/media/file/2025/03/member-advisory-for-hospital-and-health-system-leaders-3-26-2025.pdf"><img src="/sites/default/files/2025-03/cover-member-advisory-for-hospital-and-health-system-leaders-3-26-2025.png" data-entity-uuid data-entity-type="file" alt="Member Advisory: Member Advisory for Hospital and Health System Leaders PDF" width="NaN" height="NaN"></a></div></div></div> Wed, 26 Mar 2025 13:48:17 -0500 Quality & Patient Safety Top 4 Takeaways from New AHA Safety Insights Report /aha-center-health-innovation-market-scan/2025-03-25-top-4-takeaways-new-aha-safety-insights-report <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/Top-4-Takeaways-from-New-AHA-Safety-Insights-Report.png" data-entity-uuid="0033e72b-2c55-4754-ac0a-facda1a20ca4" data-entity-type="file" alt="Top 4 Takeaways from New AHA Safety Insights Report. The cover of the AHA &quot;Insights Report: Improvement in the Safety Culture Linked to Better Patient and Staff Outcomes&quot; overlayed on an image of a surgery being performed by four clinicians." width="1200" height="677">Over the past six months, the AHA and its data partners have produced two comprehensive reports that document the progress hospitals and health systems continue to make on key patient safety measures.In September 2024, the AHA partnered with Vizient on a <a href="/guidesreports/2024-09-12-new-analysis-shows-hospitals-performance-key-patient-safety-measures-surpassing-pre-pandemic-levels">report</a> showing that numerous outcome measures of health care quality and patient safety — including decreasing risk of mortality and lower levels of health care-associated infections — are improving while hospitals care for more patients with significant health needs.Meanwhile, the newly released Insights Report, <a href="/guidesreports/2025-03-11-improvement-safety-culture-linked-better-patient-and-staff-outcomes">“Improvement in Safety Culture Linked to Better Patient and Staff Outcomes,”</a> highlights progress on additional outcome measures of patient safety including some that reflect the ongoing work led by nurses to protect patients.The latest report, created in collaboration between the AHA and Press Ganey, shows clear improvement on the experience of both patients and the health care workforce. It also shows improvements in safety culture, a leading indicator of better safety outcomes and better experiences for patients and staff.<h2>4 Takeaways from the New Data</h2><h3>1 | 4 key quality and safety areas are improving.</h3>Hospitals are performing at or better than prepandemic levels on multiple quality and safety measures, according to the March report. The findings are based on the Press Ganey National Database Quality Indicators reflecting quality measures reported by more than 25,000 units across 2,430 acute care inpatient hospitals. The data show improvements from their mid-pandemic levels in four key measurement areas:<ul><li>Catheter-associated urinary tract infections</li><li>Central line-associated bloodstream infections.</li><li>Patient falls that result in harm.</li><li>The number of patients who develop hospital-acquired pressure injuries such as bedsores.</li></ul><h3>2 | Patient experience and safety improvements are being noticed.</h3>The report’s data, based on responses from 13 million patients, show steady gains in their experience of care and their perceived safety of care after a drop during the COVID-19 pandemic. Drivers of these improvements include patient perception of good teamwork among staff, attention and responsiveness to patient needs and communication among patients and clinical care team members.<h3>3 | Patients are attuned to team dynamics and interpersonal competencies.</h3>One key factor driving improvements in patients’ perceptions of care is the teamwork of their caregivers. Across clinical areas — inpatient and outpatient, surgical and medical, emergency and scheduled — the single largest driver of a patient’s likelihood to recommend a hospital, facility or provider is the perception of how well their care team members work together, the report notes. Better teamwork has long been shown to drive better outcomes.Similarly, patients who perceive that their care was safe are 2.5 to 3 times more likely to recommend their hospital to others. Their perceptions of safety are based on their own interactions with hospital team members, their observations regarding practices such as handwashing and cleanliness, and how they see team members interacting with one another to deliver care.<h3>4 | Workforce experience and well-being are improving.</h3>As the enormous strain of the COVID-19 pandemic recedes, the health care workforce is beginning to rebound as well. Press Ganey data from 1.7 million health care workforce members show a rise in their resiliency and perceived work experiences. A resilient workforce is essential in health care, given the complex and high stakes nature of the work.Hospitals that score higher on team member engagement surveys also see higher patient experience scores reported from patients. This correlation is becoming more pronounced every year, with the top-performing quartile of hospitals on staff engagement in 2023 scoring in the 80th percentile on patients’ likelihood to recommend.<hr><h2>Learn More</h2>A key goal of the <a href="/aha-patient-safety-initiative">AHA’s Patient Safety Initiative</a> is to help hospitals and health systems improve their safety culture. Launched in 2023, the initiative catalyzes hospitals’ and health systems’ collective expertise and momentum for improvement and focuses on (1) safety culture, (2) identifying and addressing disparities in health care outcomes and (3) the workforce’s well-being.</div><div class="col-md-4"><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } Tue, 25 Mar 2025 06:15:00 -0500 Quality & Patient Safety Advancing Patient Safety: Integrated Nursing Practice, Professional Development and Patient Education  /education-events/advancing-patient-safety-integrated-nursing-practice-professional-development-and-patient-education Advancing Patient Safety: Integrated Nursing Practice, Professional Development and Patient Education &nbsp; &nbsp; Practical approaches to elevate care quality and outcomes &nbsp;Thursday, May 8, 2025&nbsp; 1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. PacificIt is critical to implement strategies in both nursing development and patient education to enhance patient safety in today’s health care landscape. This webinar will showcase how leading hospitals do just that through innovative approaches. &nbsp; &nbsp;During this roundtable conversation, leaders from the AHA and Elsevier will share success stories and approaches that have transformed health care organizations. The discussion will illustrate how these approaches create exceptional care delivery and optimal patient outcomes. &nbsp;Hospital leaders and nursing professionals attending this session will gain valuable insights into enhancing nurse readiness and development, implementing supportive systems that empower nurses at every career stage, and adopting forward-thinking patient education approaches to advance both safety and satisfaction. &nbsp;Attendees Will Learn:<ul><li>Discover evidence-based strategies to bridge the readiness gap for novice nurses and accelerate their clinical and professional development. &nbsp;&nbsp;</li><li>Explore comprehensive support systems that empower nurses at all experience levels to progress and deliver safer patient care.</li><li>Examine innovative frameworks for patient education that enhance safety outcomes and create sustainable improvements. &nbsp;</li></ul>Speakers:Tiffany McCauley, MSN, RN&nbsp; Clinical Nurse Executive&nbsp; ElsevierTammy Purcell, MSN, RNC-OB&nbsp; Clinical Nurse Executive&nbsp; ElsevierClaire M. Zangerle, DNP, MBA, RN, NEA-BC, FAONL, FAAN&nbsp; Chief Executive Officer, American Organization for Nursing Leadership;&nbsp; Chief Nurse Executive, �� Association&nbsp; Tue, 18 Mar 2025 09:13:26 -0500 Quality & Patient Safety