• Justin Spencer Returns to Suffolk as Featured Speaker


High-Stakes Responsibilities at Dana-Farber for Suffolk Alumnus

Justin Spencer, a 2007 graduate of Suffolk’s MPA/Health program, returned to Suffolk as the featured speaker at the April 1, 2009, meeting of the Institute for Healthcare Improvement (IHI) Suffolk Chapter.

Professor Lauren Williams and Justin Spencer
at the April 1 event

The IHI works to improve healthcare across many fronts, including patient safety and quality of care. As Clinical Research Coordinator for the Center for Patient Safety at the Dana-Farber Cancer Institute and an active member of Suffolk’s healthcare community, Spencer was an ideal speaker for the chapter: he works on patient safety research studies and implementation of quality-improvement initiatives.

His lively talk, accompanied by a comprehensive slideshow, examined the multidimensional approach that Dana-Farber is taking to promote safety and quality care. Data he cited drove home how high the stakes are: it’s estimated that annually in the United States medication errors cause more than 1.5 million preventable injuries, and more than 7,000 deaths.

A pivotal event

In the past, Spencer reflected, efforts to address safety and quality issues tended to be regarded as “nice” to do in a healthcare culture that did not promote open discussion of safety issues or seek to identify systemic problems. A pivotal event was the 1994 death of Betsy Lehman. A 39-year-old health reporter for the Boston Globe and mother of two, she was undergoing chemotherapy at Dana-Farber when a medication error that quadrupled a chemotherapy dosage level ended her life.

Dana-Farber had already been addressing quality and safety issues, Spencer explained, but Lehman’s death illuminated systemic problems and prompted far more aggressive efforts. Now, Dana-Farber has embedded safety and quality into its core values and, as its web site puts it, “is committed to creating a culture of safety that permeates the entire organization.” (Indeed, a 2007 National Academies of Sciences publication, Preventing Medication Errors, states, in discussing the Lehman case, “Today, the hospital has a strong culture of safety.”)

The multidimensional approach

Dana-Farber achieves – and, crucially, maintains – success by pursuing safety and quality relentlessly and comprehensively. Continuous risk assessment, monitoring, and feedback are among many practices it employs. Inclusiveness is key: many parties are actively engaged – not least, patients and their families. Patient-centered care, programs that empower patients to play an active role on their healthcare team, and initiatives to improve communication across the Institute are promoted. (On the subject of communication, don’t miss the 40-second YouTube video cited in Spencer’s slideshow.)

Another priority is transparency in decision making, as well as in data handling: like a growing number of healthcare organizations, the Institute reports its safety and quality data publicly – a dramatic index of progress.

Justin Spencer
Suffolk MPA/Health 2007

Also crucial is a workplace culture that is “fair and just.” “It is inevitable,” Spencer stressed, “that people will make mistakes.” The institute “is committed to learning from mistakes rather than blaming staff for them.” This empowers staff and creates an environment of awareness that allows for continuous learning and improvement. Indeed, the Institute views itself as a laboratory for innovation.

This is an exhilarating vision! Students and faculty surely carried home from Spencer’s talk a heightened sense of the urgency of safety and quality goals and deeper insight into the opportunities for achieving and maintaining gains. Our Suffolk healthcare community will continue to follow, and learn from, the vital work that he and his colleagues at Dana-Farber are advancing.

For more information

In addition to Spencer’s valuable slides, Dana-Farber’s web site offers extensive and instructive information on safety and quality. It’s well worth exploring.

An article Spencer coauthored, "The You CAN Campaign: Teamwork Training for Patients and Families in Ambulatory Oncology," was published in the February 2009 Joint Commission Journal on Quality and Patient Safety.)

IHI’s brochure, “Closing the Quality Gap,” describes “an ever-evolving learning system” in which “all teach; all learn.”

Suffolk MHA student Jaclene Coit contributed to this story.

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