The Exec: How to Promote Innovation in the Hospital Setting
By Christopher Cheney
The new CMO of Boca Raton Regional Hospital has extensive experience in promoting innovation in the hospital setting.
William Holubek, MD, was announced in November as CMO of Boca Raton Regional Hospital, which is part of Baptist Health South Florida. Prior to taking on his new role, he was CMO of University Hospital in Newark, New Jersey, a 519-bed academic medical center serving as the principal teaching hospital of Rutgers New Jersey Medical School.
Innovation in healthcare goes beyond adoption of new technology, according to Holubek.
“Innovation is truly doing something in a new way, and that new way does not have to be complicated,” Holubek says. “An innovative way of doing something in healthcare in my view is to make things as simple and efficient as possible. We should also get rid of waste because waste makes things complex and less efficient.”
Promoting innovation in the hospital setting involves developing standard work and a vision, Holubek explains.
“We map out in detail what we are doing right now in order to get to the new vision,” Holubek says. “We identify the pain points, the obstacles, and the sources of waste. The people who can identify waste are the frontline workers.”
Innovation involves identifying top opportunities for improvement, then creating action plans to try new things, according to Holubek.
“This is where the scientific method comes into the equation,” Holubek says. “You try a new approach, then determine whether the new approach works.”
A primary element of a good action plan includes setting a period of time for attaining a result, Holubek explains.
“You want to see whether what you are doing is having the desired effect,” Holubek says.
Another essential element of an effective action plan is assigning someone to manage the effort, according to Holubek.
“Typically, someone needs to own an action plan,” Holubek says. “If there are any questions, you can be consistent when someone owns an action plan. That person should have a timeframe and metrics to follow. They should be simple metrics that people can understand.”
How a CMO can boost patient safety
A critical element of safety in a high-risk environment like a hospital is psychological safety, Holubek explains.
“It doesn’t matter whether it is staff, patients, or families,” Holubek says. “If they see something that is not right or potentially unsafe, they should have the sense of psychological safety to speak up.”
A hospital CMO must foster psychological safety by supporting individuals who raise safety or quality concerns, according to Holubek.
“For example, anyone in an operating room can stop the line if there is a concern about a procedure or anything else in the operating room,” Holubek says. “My job as CMO is to support that process and to support the people who speak up for safety.”
“Somebody who raises a concern about safety may be right or they may be wrong. If they are wrong, it is OK,” Holubek says. “If you see a safety concern, you have to speak up. My job is to make sure that people feel safe to speak up for patient safety.”
A hospital CMO needs to embrace the reporting process for patient safety incidents. According to Holubek, Boca Raton Regional Hospital has an incident reporting system, which is managed on a daily basis.
“Staff can report incidents anonymously if they want to,” Holubek says. “We track all safety incidents, and we encourage people to report incidents at the hospital.”
How to promote patient-centered care in the hospital setting
To achieve patient-centered care in the hospital setting, staff must involve patients and family members in medical decision-making at every step of care, Holubek explains, adding the most extreme example is end-of-life care.
“We need to ask patients what they want done in situations where the heart stops,” Holubek says. “Do you want us to resuscitate you? Do you want to be put on a breathing machine? These types of expectations are patient centered.”
“We want patients to feel as though we are listening to them,” Holubek says. “We want them to feel as though we are treating them with courtesy and respect. We want them to understand their health issues and what they can do to help themselves to become healthier.”
Addressing social determinants of health (SDOH) is another aspect of providing patient-centered care in the hospital setting, Holubek explains. For example, SDOH can impact a patient’s ability to adhere to medication regimens after discharge from the hospital.
“We need to understand what is preventing a patient from taking their medications,” Holubek says. “Do they have financial issues? Do they have insurance coverage issues? Do they have lack of access to a pharmacy? Do they have lack of transportation to get their medication prescriptions filled?”
Patient-centered care in the hospital setting also involves tailoring a treatment plan to a patient’s desires and expected outcomes, according to Holubek.
Prepared to play the hospital CMO role
Working as an emergency medicine physician is excellent preparation to serve in the hospital CMO role, Holubek explains.
“Emergency medicine has prepared me very well to be a CMO, because I have developed skills sets to connect with clinicians in different specialties,” Holubek says. “I can build trust quickly whether it is a pediatrician or a neurosurgeon.”
Functioning effectively in an emergency department provides a solid foundation for CMO skills, according to Holubek.
“In the emergency room, it is a high-risk area, and you develop skills to communicate effectively and quickly,” Holubek says. “You learn how to hone down to root problems.”
Emergency medicine physicians also learn how to work effectively as members of teams, Holubek explains.
“I have worked in a dyad relationship with the nurse leader in the ER,” Holubek says. “I have worked with many nurses. I have worked with advanced practice providers such as physician assistants and nurse practitioners. I have worked with medical students and residents. I have worked with housekeeping and environmental services. So, I can function well as a member of a team.”
Christopher Cheney is the CMO editor at HealthLeaders.