The Exec: Cultural Transformation Key Element of Improving CMS Stars Ranking

HL: You have helped grow healthcare service lines at NewYork-Presbyterian Queens. What are the keys to success in managing service lines?

Jaffer: I have been fortunate in my time at NewYork-Presbyterian Queens to work very closely with our operational leaders to strategically grow our service lines including orthopedics, cardiovascular, neurosciences, pediatrics, women, cancer, digestive diseases, and primary care. I attribute our success to working collaboratively with our medical group to recruit world-class physicians and build clinical programs with amazing outcomes. In many cases, these programs require multiple disciplines to collaborate, along with equipment and technology that require capital investments. Each year, we build strategic plans with tactical and actionable interventions that have allowed increased market share in a very competitive landscape.

HL: You helped lead the transformation of NewYork-Presbyterian Queens from a 1-star Centers for Medicare & Medicaid Services (CMS) rank to 5 stars. What were the main elements of this transformation?

I am proud to be working with our president, Jaclyn Mucaria, on a team that supported the transformation of NewYork-Presbyterian Queens to become a CMS 5-star ranked hospital. This happened in part due to a cultural transformation where we set a clear vision and the goal of wanting to be a regional center of excellence and to be the first choice for patients, employees, and physicians.

As part of this work, we committed to putting patients first and outlining our values (respect, empathy, teamwork, innovation, and responsibility) that helped lay a strong foundation for our high reliability framework of tiered huddles and helped create a safety culture, which created psychological safety and the ability for people to speak up with leaders. Working in tandem with our care team and leadership team, we created transparency through scorecards and dashboards, and we held our leaders accountable across the board, which helped increase our scores over five years.

HL: What are the keys to success in care coordination?

Jaffer: In my experience, the key to success in care coordination is a 360-degree approach where we are constantly evaluating every individual at every portion of their wellness journey. If it has been determined that an individual’s health is declining in the outpatient setting, we should work with them and ensure we can have the best possible team managing their care. Similarly in the inpatient setting, I believe we should be working with the full care team to develop a plan to bring patients back to their baseline health status—putting the patient’s safety and ultimate transition back to a pre-illness state or improved as the end goal.

Good communication is paramount, including our doctors, nurses, case management, social workers, navigators, and care coordinators.

We are proud of our robust care coordination services that allow us to be successful and have low readmission rates, along with our navigator program that aids patients in being guided to additional services post-hospital stay.

HL: Your hospital serves a diverse patient population. What is the hospital doing to promote health equity?

Jaffer: NewYork-Presbyterian Queens is proud of the diverse patient population we serve. NYP launched the Dalio Center for Health Justice in 2020 with the aim of understanding and addressing the root causes of health inequities, and with the goal of setting a new standard of health for the communities we serve.

HL: You have a clinical background in internal medicine. How has this clinical background helped prepare you to serve in administrative roles such as CMO?

Jaffer: When I started my career, I thought I would eventually want to be a gastroenterologist but found that as a generalist, I had more opportunities to teach students and residents, which was my passion early in my career. I began taking on more responsibility in building innovative programming, and my generalist background allowed me to have a 360-degree view in working with different types of patients such as surgical, medical, inpatient, and outpatient. As an expert in hospital and perioperative medicine, I had the opportunity to work collaboratively with different specialties that allowed me to see the large spectrum of diseases.

Through my career and as a CMO working with every specialty and a variety of physicians across different specialties, I have gained a deeper understanding of the various disciplines. I am never shy to ask whether I can come and observe and round in their area. As a leader, this understanding helps me to address challenges they are experiencing and better understand how to help physicians and solve problems.