College launches new tool to improve patient quality and safety
The Management, Discussion & Analysis tool will enhance accountability, peer learning and communication
Sept. 21, 2023 — A new tool launched by the University of Florida College of Medicine is advancing accountability and standardization in the way quality and patient safety efforts are identified, prioritized, implemented and communicated.
The Management, Discussion and Analysis, or MD&A, tool has proved effective in fostering continuous learning and improvement in patient safety and internal risk, improving patient outcomes and patient experience and enhancing value.
Originally created for financial reporting, the MD&A tool was adapted to the medical field and first introduced in a paper published by John Hopkins University in 2016. This system creates a common framework for institutions to focus on patient quality and safety initiatives and builds a shared language and understanding to cultivate peer-learning, teamwork and interdisciplinary efforts. This introduces opportunities for improvement, with teams better able to prioritize needs, allocate resources, review and reflect on progress, identify obstacles and celebrate successes. The framework also enhances knowledge-sharing, reporting and communication with leadership.
Example of an MD&A Dashboard
As part of the value pillar of the UF College of Medicine’s strategic plan, and a project now housed under the new state-funded Quality and Patient Safety initiative, the MD&A tool will help faculty focused on patient quality and safety better reach desired outcomes. To pilot this project, Colleen Koch, M.D., M.S., M.B.A., dean of the UF College of Medicine, and department chairs invited faculty members to serve as departmental MD&A leads, with the initial cohort including representatives from the departments of neurology, medicine and pathology, immunology and laboratory medicine, as well as UF Health Physicians.
Participants in the first cohort began by using the MD&A framework to select projects they believed would have the greatest impact on patient quality and safety. Then, by using the MD&A template and a safety matrix to document and report on these priority projects, they had a standardized format from which to present at an annual meeting with leadership.
Maria Kelly, M.D., FAAP
“The goal of this process is for this tool to become the common framework for our institution to discuss quality and safety,” said Maria Kelly, M.D., FAAP, assistant dean and chief medical officer for UF Health Physicians. “As CMO, my biggest responsibility is to ensure a patient-centric clinical environment with the highest-quality medical care and patient safety for all UF Health Physician practices. The MD&A tool really aligns with that.”
Kelly joined the pilot program with four projects, including one focused on improving the co-prescription of naloxone with opioid prescriptions in UF Health outpatient clinics to prevent overdoses.
Amita Singh, M.D., M.S., an assistant professor of neurology at the College of Medicine, also participated in the pilot, using the MD&A tool.
“The management, discussion and analysis tool has provided the department of neurology with a robust framework to allow us to identify impactful quality initiatives to focus our efforts on,” Singh said. “We worked with IT to create neurology-specific dashboards to evaluate areas of improvement with the ultimate goal of improving the quality of care we provide along with the patient experience.”
Kelly and Singh were the first from the initial pilot program to present their focus areas using the MD&A tool to the dean’s senior leadership committee.
“The institutional support from the dean’s office was a big part of the success of these projects,” said Kelly, noting that the office worked closely with faculty in the pilot cohort to lay the foundation and support each project.
Jeremy Schmidt, a senior project manager for the dean’s office, collaborated with Kelly and Singh to push these projects forward.
“It was a great opportunity to work with Dr. Kelly and Dr. Singh to help deliver the highest-quality care,” Schmidt said. “Through these projects, the college will advance in the way it conceptualizes and pursues patient safety.”
Now located within the Quality and Patient Safety initiative, the MD&A initiative is expanding to additional departments at the college with cohort 2, including the departments of emergency medicine, anesthesiology, ophthalmology, radiation oncology, and physical medicine and rehabilitation.
“The MD&A tool, when done as intended, allows for vertical and horizontal alignment within the institution,” Kelly said. “This tool allows for peer learning, collaborative environments and a shared approach to reaching outcomes, all while facilitating standardized and regular communication with leadership to ultimately propel projects forward. Moving forward, I think a consistent process to approach quality and safety, on an institutional level, is the right way to go.”
