Harvey V. Fineberg, a nationally recognized leader and authority on issues in public health and former president of the Institute of Medicine, discussed the role of nursing in safety and quality of health care at the annual dean’s lecture series at the Betty Irene Moore School of Nursing at UC Davis.
As the featured speaker at the 2016 Betty Irene Moore School of Nursing at UC Davis Lecture Series: Leading Change, Advancing Health, Fineberg shared with attendees the dimensions of quality, areas in which safety issues arise and how the problems should be addressed.
“What the Institute of Medicine concluded ― and what is the bulwark of the approach that has been advocated ever since ― is thinking about the problem as a systems problem,” Fineberg said. “Health care results from a very complicated system that involves many people, many pieces of equipment, many different drugs and devices and many different institutional surrounds. Together, those contribute to the results we actually experience.”
Fineberg currently serves as president of the Gordon and Betty Moore Foundation, which, in 2009, committed $100 million to enable the creation of the School of Nursing at UC Davis. Prior to joining the foundation, Fineberg led the Institute of Medicine (now the National Academy of Medicine). During his term, the institute issued its landmark report on the Future of Nursing. Fineberg has devoted most of his academic career to the fields of health care policy and decision-making with research focused on the process of policy development and implementation.
“What was true about the system of care 50 or 100 years ago is not at all relevant any more to the kind of complex, multiple-laden systems that together today produce and deliver the care that people ultimately receive,” Fineberg said.
As part of the lecture, “Safety and Quality of Health Care: the Role of Nursing,” a panel of health care providers and educators engaged in conversation with the audience. Panelists included J. Douglas Kirk, chief medical officer for UC Davis Medical Center, Carol A. Robinson, chief nursing officer and chief patient care services officer for UC Davis Medical Center and School of Nursing Assistant Professor Elena O. Siegel.
“In nursing homes, not unlike other health care settings, these systems are not hard-wired for quality and safety. We rely heavily on individuals, not systems, to improve quality and with that reliance on individuals, we’re vulnerable to so many things that can get in the way, regardless of intention,” said Siegel, whose research focuses on building capacity of nursing home management teams to improve quality and value. “I would suggest that failed quality improvement efforts send a message across the setting that quality improvement is optional.”
“The role of nursing in quality and safety really emanates from the role of nurses as partners with physicians in the hospital, which has long been a pillar of the medical care team,” Kirk said. “Today, multiple partnerships have been formed around this nurse-physician quality dyad in managing units and expanding roles to include the patient experience, an important pillar of quality.”
The Betty Irene Moore School of Nursing at UC Davis Lecture Series brings nationally recognized leaders to the UC Davis Sacramento campus to illuminate academic, research and clinical topics that advance health, ignite leadership and promote bold system change. This year’s lecture was sponsored by the Nursing Science and Health-Care Leadership Master of Science Class of 2015.