Impacting patient safety indicators
Kelly R. Gray-Eurom, M.D., M.M.M., FACEP
Kelly Gray-Eurom, MD, credits commitment and teamwork for the turnaround in quality and patient safety.
Kelly Gray-Eurom, MD, realizes nothing in health care happens alone, it involves a multidisciplinary effort to ensure every UF Health patient receives exceptional care that leads to an optimal outcome. It’s a lesson she first learned 26 years ago as a third-year resident at the University of Florida College of Medicine – Jacksonville.
“After doing several rotations here, I knew right away that this is where I wanted to be,” she said.
Since then, Gray-Eurom has served in several roles, such as emergency medicine physician, director of business operations, and medical director and vice chair of emergency medicine. In late 2014, she became the chief quality officer at UF Health Jacksonville, where she relies heavily on teamwork to make patient safety the top priority.
“We knew there was a tremendous amount of really good work going on, but we did not have clear organizational priorities,” she said. “At the time, not only were our unfocused projects diluting our quality resources, but they were also diluting what our staff could do.”
Gray-Eurom and leaders in the Quality and Performance Improvement division immediately identified mortality and hospital-acquired infections as the first targets for change. They worked with department leaders to vet projects to prevent overlap and tested quality improvement methods using five steps:
1. Identifying specific areas to tackle;
2. Determining what processes can be changed to enhance outcomes;
3. Developing and executing effective strategies;
4. Tracking performance and results; and
5. Disseminating those results to drive hospitalwide progress in quality.
“We were always conscious that if we were going to ask someone to do something differently or require them to do more, there had to be something in it for them,” Gray-Eurom said. “So when we change a flow or order set, alter a process in Epic or roll out a new protocol, we not only consider how it is going to impact our patients, but also our bedside staff who are the ones carrying out these projects.”
Vizient, formerly the University Health Consortium, began its Patient Safety and Accountability study in 2014. UF Health Jacksonville was ranked 92nd out of more than 100 academic health centers and given a 1-star rating in the study. This year, the hospital is ranked 44th, an increase of 33 spots since last year, and has a 3-star rating.
“The whole organization has truly made a commitment to improving quality, and it started with Russ Armistead, our CEO, and Dr. David Vukich, our chief medical officer,” Gray-Eurom said. “Our organizational structure is extremely successful because quality, risk, infection prevention and accreditation are all part of the Quality and Performance Improvement division. Most hospitals don’t have that type of coordinated team approach to quality.”
Quality and Performance Improvement provides the data and structure the organization needs to make progress, but Gray-Eurom credits a lot of the change to the frontline staff who carries out the work.
“It also involves our Finance, Purchasing and Health Information Management departments,” she said. “If they were not willing to partner with us, none of this would happen.”
Gray-Eurom and various quality committees now have their sights set on reducing readmissions and the number of excess days patients spend in the hospital. In addition, collaboration continues on improving patient perception, which will lead to higher Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, scores.
“Quality is not a sprint. Quality is absolutely a marathon,” Gray-Eurom said. “I am not sure if it ever has an end, but the men and women who provide care at this organization really are passionate about what they do. They regularly go above and beyond to improve how we serve our patients.”
Kelly R. Gray-Eurom, M.D., M.M.M., FACEP