Leading Quality
Welcome to Leading Quality, the show that dives into the real-world stories and strategies of healthcare quality improvement leaders at all levels, from Frontline Champions to C-Suite Executives. Each episode uncovers how these dedicated professionals tackle complex topics in real healthcare environments. Discussion range from QI fundamentals, to leadership, technology, AI, and beyond. If you’re passionate about elevating patient care and want practical insights that go beyond the buzzwords, this podcast is for you. Tune in for inspirational conversations, innovative frameworks, and the behind-the-scenes details you won’t hear anywhere else, and discover how you, too, can lead quality improvement from wherever you stand in healthcare.
Leading Quality
Values in a Crisis: Trust, Transparency, and the Culture That Endures
What if the hardest part of quality isn’t finding the right answer, but making the right action unmistakable for the people who deliver care? That’s the thread we pull with Dr. Hilary Babcock—infectious disease physician, longtime infection prevention leader, and now chief quality officer helping steer a 12-hospital system of 33,000 people through transformation without losing its soul.
We talk about learning to lead beyond subject-matter expertise and how COVID pressure-tested every leadership instinct. Hilary shares how she and her team turned dashboards into decisions, building a centralized quality hub with deep resources and a one-page “top five” for each priority so busy managers could act today. She explains why outcome views must be paired with real-time process visibility—knowing not just that CLABSIs ticked up, but exactly who is overdue for a dressing change right now—so data becomes a map rather than a mirror.
We also go inside vaccine policy and trust. BJC implemented one of the nation’s earliest influenza mandates, treating it as a safety tool within a clear accommodation process. During the COVID rollout, transparency, values, and personal candor anchored tough choices about prioritization and access. The organization’s values—kindness, respect, excellence, safety, teamwork—moved from posters to practice, and a shift to centrally led, locally embedded quality teams helped spread best practices across hospitals while protecting local relationships.
If you care about healthcare quality, leadership, and culture, you’ll leave with practical tactics and renewed optimism. Hit play, then share this with a colleague who wants to turn analytics into action. If the conversation resonated, subscribe, leave a review, and tell us the one change you’ll try this week.
We were the second hospital or health system in the country to implement an influenza vaccine mandate. When you stop thinking of it as a mandate and you think about it as one of many tools that help to drive a high influenza vaccination rate among your employees, the literature and data is clear that the most effective intervention to drive high influenza vaccination rates among healthcare workers is with a mandate.
SPEAKER_01:I'm your host, Jason Meadows.
unknown:Dr.
SPEAKER_01:Hilary Babcock is one of those rare leaders who can hold complexity in one hand and deliver clear, doable next steps with the other. She trained as an infectious disease physician and hospital epidemiologist, led infection prevention and occupational health for years, and now serves as vice president and chief quality officer at BJC Health in St. Louis. An academic community system spanning a dozen hospitals and 33,000 people. During COVID, Hillary went from stay in your lane infection prevention to system-level incident command. Then into her CQL role, where she learned fast how to move from subject matter expertise to leading other experts. That shift shows up in how she works. Translate uncertainty with integrity. Make the right thing the easy thing. Turning dashboards into action, and then into one-page top fives a nurse manager can actually use, building a centrally led, locally embedded quality model without letting performance slip, and navigating contentious moments like vaccine policy by being transparent, values-anchored, and human. If you care about moving a health system without breaking it, this conversation is a masterclass. I like this episode because it's concrete and immediately applicable. We get into how to simplify without dumbing down, how to pair outcome views with process visibility, how to communicate when the evidence is evolving, and how to keep culture aligned to kindness, respect, excellence, safety, and teamwork. You'll also leave with a couple of gems from her bookshelf and a renewed sense that the people doing this work are the reason to stay hopeful. Dr. Hilary Babcock, welcome to the show.
SPEAKER_00:Thank you. Happy to be here.
SPEAKER_01:I wanted to get started with your background and just a little bit of the backstory and what's led you to this point. Your career started as an infectious disease physician and a hospital epidemiologist. Tell me a little bit about just how you've gotten up to this point.
SPEAKER_00:Sure. I went into infectious diseases because I really like the variety and the variety on multiple levels, both like we see patients of all ages, um, from all different backgrounds and with all different kinds of problems in every organ system. And we have some patients, as you know, that we might follow for years, or we might be the primary care provider if they're an HIV patient. And we have some patients that they have a short-term infection, we treat them, we cure them, done, never see them again. And so it's a nice mix of things. Infection prevention is kind of similar to that. There are problems that go on forever. Um, there are more immediate problems, there are outbreaks and clusters of infections that need to be investigated. It has a lot of the same sort of approach that infectious disease and epidemiology have, where we need to ask a lot of questions, do a lot of sort of figuring out of what's going on, and then develop a plan to try to resolve what's happening, respond to what's happening, and keep it from happening again. So I think all of those things together really brought me into the infectious disease and infection prevention world. Um, and I did some clinical research as well earlier in my career. And again, sort of similar, like why do these things happen? How can we keep them from happening again? Try to define that on a larger scale in ways that might be helpful for other people.
SPEAKER_01:Yeah. And so you you led, if I'm correct, uh you led infection prevention and occupational health for nearly two decades, I think 16 years at your current institution. How did that role kind of evolve over time? What experiences or insights uh during those years ultimately led you towards the chief quality officer role?
SPEAKER_00:Sure. So I started with infection prevention and occupational health, more in the occupational health world to start with, and then infection prevention, doing it more at a hospital level initially, and then moving into a system role where I was helping to guide and direct and advise about infection prevention across a multi-hospital system here where we are in St. Louis, in Missouri and Illinois. And I really enjoyed that work. You work with a great team of people, um a lot of infection prevention specialists, a lot of other physicians who were interested in the same thing and all working together. So it had definitely a team sport feeling about it, which was good. And there's really sort of never a dull moment in infection prevention because there's always something that's bubbling up or going on. So I really enjoyed that role. I actually thought that that would probably be my role for the rest of my career. I would probably retire from that job. I enjoyed it. I was very happy in that role. And then we had this small disruption of a global pandemic that arrived sort of unexpectedly in the middle of all those things, and really obviously was a big disruptor for everyone in a lot of different ways. And um doing that work, working with the system in the system incident command center really gave me an opportunity to work with a broader group of people, advise on sort of a broader range of issues, and connected me with leaders across the organization in a different way than I had in my previous role. And so the chief clinical officer of our system um came to me and said that they were gonna split. They had sort of a combined CMO and CQO role, and they were gonna split that into two roles and have a CMO and make a true CQO role. And would I be interested in that role? And when they talked to me at the time, um and my division chief and ID, they said, we feel like you're kind of at this career split where you could decide do you wanted to go in an academic leadership role and do um division chief and department leadership and those kinds of things, or you could decide do you want to be more on the operational side and stay in more of a hospital and health system-based role. And I had really enjoyed the operational work during the COVID pandemic work. And so I said that I would be more interested in staying in that lane rather than going back into a more purely academic role. And I also feel like the pandemic was, you know, terrible for a lot of us on a lot of different ways and a lot of different levels. And it didn't seem possible to me, really, to just think that at the end of that, I would just go back to what I had been doing before. It just didn't seem like it, it seemed almost like a disrespectful or like a dishonoring of the degree of disruption and all the things that had happened during that time. So I was very appreciative of being given an opportunity to do something new and different moving into this quality space.
SPEAKER_01:It sounds like the pandemic forced you to see even more broadly, perhaps, than you'd been used to, kind of the entirety of the health systems that you were working in. Is that fair to say? Did you become more of a systems thinker than than you were before as a result of that? And was that a new experience?
SPEAKER_00:I think so. We did a lot of sort of system work and trying to move towards acting more as a system within the infection prevention world, but we also had a clear sort of mandate, like your lane is infection prevention, and you should sort of stay in your lane of infection prevention. And during the, not in a bad way, like most infection prevention people want to stay in the infection prevention lane. That's where we want to be. During COVID, being sort of the ID specialist advisor and the infection prevention person meant that it was working across like outpatient, inpatient, lab, just you know how it was, like everything, everything that we did needed, like sort of an infectious disease review. So that you really did see, like outside of your lane of infection prevention, sort of saw a broader view of what all was happening. So I feel like some of the systems thinking is similar in this role, but I added so many lanes to my highway that are in my portfolio that I am responsible for. So I continue to have infection prevention as one of my lanes, but I am also responsible for patient safety and regulatory accreditation, our patient experience team, our clinical analytics team. So that's not the full list, but the it gives a sense of the more lanes that are in the portfolio now.
SPEAKER_01:I mean, that's it's a hugely broadened portfolio. And and just to take you know a step back and zoomed out, can you give me a kind of a broad overview of what BJC healthcare uh looks like in terms of its numbers?
SPEAKER_00:Sure. So BJC um is a health system that is um sort of along the Mississippi River in St. Louis between um Missouri and Illinois. And we recently merged with another health system on the western side of the state and St. Luke's health system in Kansas City. So we are still sort of aligning, but are largely still separate in the clinical spaces between what we now call the West region and the east region. So when I talk about BJC health care, is part is the east region of BJC Health System now. So BJC Healthcare, which is where I've spent most of my career, is um, depending a little bit on how you count it, about 12 to 13 hospitals, ranging in size from a small 35-bed critical access hospital to our largest academic hospital, which has about 1,250 beds. We have about 33,000 employees across those organizations. So it's a pretty sizable. Our large academic hospital is, I think, the sixth largest hospital in the country. So it's a pretty big academic footprint. And we also have a freestanding children's hospital, as well as then a range of community hospitals in both Missouri and Illinois.
SPEAKER_01:Wow. So that's a real, it's an understatement to say that you've you've broadened your scope of responsibility.
SPEAKER_00:Yes. I also like when I started, before I started in this role, I think like many in academics, I had really not had direct reports that reported to me. I had worked with some research coordinators who reported to me and a couple of other people, you know, and worked with a lot of people, but not as direct reports that I was directly responsible for. And when I started in this role at the system level, I started with four direct reports and then I added like two direct reports, and then we went through an integration process where different functions came under me, and we also integrated those functions across the organization so that our infection prevention teams don't report locally at their hospitals. They're embedded locally and work at their local hospitals, but they report up through a system infection prevention director who reports to me. So in the last three and a half, four years, I guess, almost four years that I've been in this role, I went from having no direct reports to having four direct reports. And now I have uh um eight direct reports and uh a department of about 225 people. So it's been sort of a rapid evolution. And I have been very lucky with the team leaders that I have, the directors and executive directors that I have working for me are all really wonderful, very strong, very good at their jobs, real deep subject matter expertise in their functions. Because the other thing that I think is kind of interesting that was interesting for me about this transition is that I had always felt that my leadership role was really based on my subject matter expertise. I was asked to be a leader in those spaces because I knew a lot about infectious diseases and about infection prevention. But I came into this role and I am not a deep subject matter expert on each of the functional areas that report to me. And because I picked a lot of them up in a very short period of time, it was not possible to follow what probably would have been my default setting, which was to try to become a deep subject matter expert on each of those different functions. That's really not possible when you add like seven functions at the same time. So I got actually a really good piece of advice from uh the chief nurse executive who was um here at the time when I started, who has since retired. And she said, when you reach this level in the administration and an executive leadership role, you're not really being paid anymore for your subject matter expertise. You're really being paid for your leadership, for your ability to build a team with subject matter expertise, to lead and support them, to navigate for them and help them and grow them. That you can't be the expert on everything anymore. And that was a very helpful advice because that was a big mind shift for me.
SPEAKER_01:I can imagine you went from being such a technical expert to being a system leader. What helped you make that transition from evidence to influence?
SPEAKER_00:I really do think that the process of leading through COVID did sort of build confidence in your ability to say, this is what we know now, and these are the principles and philosophy that we work on, and therefore these are what we should be doing next, and we may need to adjust because things may change. So when it started, none of us was a deep subject matter expert on COVID because nobody was, because nobody knew anything. So I think that was helpful. And then starting in this role, again, really having a great team that I was very lucky to step into who had that knowledge base and could really sort of let me not have to be that person because I knew that they would know and that they could help and support me. And that the leaders I worked for also recognized that I had a good team and that they could trust that I could find the information, bring back good advice and recommendations if I didn't have them off the top of my head in a, you know, at any given moment.
SPEAKER_01:Yeah, so many great questions I can think of to uh to delve more into your your time, you know, your CQO role kind of crystallizing uh during COVID. What was that whole period like for you?
SPEAKER_00:COVID or the transition to CQO or both, or yeah.
SPEAKER_01:So maybe I can maybe I can hone my my understanding of the timeline. The I think you became CQO after the COVID pandemic started, right?
SPEAKER_00:Yes. So COVID started in early 2020, and I was offered this role in November, um, or started in this role in November of 2021, and then um, which was immediately followed by the Omicron wave of the beginning of 2022. So, in some ways, my new role felt a lot like my old role for its first four to six months, where it was still really managing through that wave. So, really kind of started for real in like the spring of 2022. And things were sort of getting a little more manageable and a little more predictable in the COVID space around then.
SPEAKER_01:Okay. I guess getting in getting to something specific that I know you talked about before, uh, you've spoken about taking complexity and uncertainty and providing clarity and simplicity without losing, you know, integrity or reliability. That's a hard needle to thread, as it were. And uh, I'm wondering if you can share an example of when you had to do that in in real time, maybe during the COVID pandemic.
SPEAKER_00:I think that uh there are lots of possible examples. I think, well, I can't think of a great detailed example necessarily. We had to do a lot with what kind of PPE recommendations we had. We all had to navigate around what was available for PPE recommendations. And in the background, you know, we did a lot of outreach to other organizations. What are you doing? How are you managing this? What do you have available and how are you bringing that forward? And then we, the team sort of brought together this will be our plan. This is what we'll work on, this is what we're going to recommend. And then we needed to be able to go to our large team, to like all of our employees, and say, this is what we know so far about the way COVID is transmitted. This is what we recommend for you to wear. We think this is safe because of the research that we've done and what we know from other places. And if we have to make adjustments, we will. And I feel like that so much of quality work is that kind of distillation of what do we really need to convey to a frontline employee about what it is that they need to do to support the quality outcomes that we're trying to achieve. And because that frontline person is balancing so many things that so many people want them to do for so many different outcomes while still being a caring and compassionate person interacting with a patient, that it doesn't, it's not reasonable to say, like, I'm gonna give you all of the literature and I'm gonna give you all of the background and I'm gonna give you everything. At the end of the day, what I need you to know is that it's critically important that you do the chlorhexidine, put a chlorhexidine dressing on every central line and it that it's clear and it's simple, and you can follow with the why, right? We we need you, in order to prevent infections that put our patients at risk, we need you to put a chlorhexidine dressing on every central line every time you do a dressing change. And that's really in some ways all that is needed. But to be ready, if there are questions like why do I do that and how why is that better than if I already cleaned it with chlorexidine, why do I have to put that dressing on? Your team has to be confident that you have all of those answers behind the recommendation that you've given them so they can get to that if they need it. But at top of mind, they just have to know like this is what I need to do right now. And I feel like that is a constant quality struggle, but is a really important goal for all of us is to try to make those things simpler. One of the things that we did since I've been in this role, we started a quality and safety hub, an online website for our employees where they can go and find information about some of our key outcomes. So there's a CLAB C title, a Caldi tile, there's a glucose management tile, there's a patient experience sort of tile on the um website. And each one of them has loads of information and great guidance and tools and resources. And we got that all together and I was super excited and very proud. And then I said, you know what we actually need? We need like just a top five for each one of these things, like a very simple like, here's the top five things you can do to prevent CLABSY. And here's the top five things you can do for patient experience. Because for a unit that is trying to get better in their patient experience or in their CLABS, it's great to have all that information. I want that all to be available to them. But for a busy nurse manager who's like, I need to get my CLABSY rates better, just look at this top five, see which ones you think you're doing well and which ones you're not, and work on the ones you're not. Here's the other information if you want it, if you need it, resources, posters, like all kinds of stuff, background literature, guidelines, papers, all the things. Do these five things. And so I think that that's been part of our messaging is to try to take all of that complexity and make it easy for the frontline person who's the one who actually actually do the thing, know what the thing is, and know how to do it.
SPEAKER_01:Well said. I couldn't have said it better. Um, you know, to have that that crystal clarity, it's it's almost like your first draft contains all of the background work you did, and the final draft just includes the the essentials. So I love that. You also helped lead and communicate uh an employee vaccine mandate at BJC. And I remember watching a video about you communicating about this actually online. And uh, this is a leadership and a communication challenge. I know it probably felt even more sensitive at the time than than maybe it it might today in a in a less tense atmosphere. How did you and your team approach that decision? How do you feel about it today?
SPEAKER_00:We were the second hospital or health system in the country to implement an influenza vaccine mandate when we implemented that mandate in 2008. And at the time, we had had a lot of discussion about it and conversation with our health team and our leaders, and really just felt like it it was the right thing to do. We had seen that another place had been able to do it, and really felt like we had a very clear justification in terms of all of the things that we had done already in terms of that tried to drive up that influenza vaccination rate. And we had done, you know, all the incentives and the cheerleading and the um support and the raffles and the roving carts and everything you can think of. And when you stop thinking of it as sort of a mandate and you think about it as one of many tools that help to drive a high influenza vaccination rate among your employees, the literature and data is clear that the most effective intervention to drive high influenza vaccination rates among healthcare workers is with a mandate. And so we set out to say, like, we've done all of these things, and we just really need to say that based on our value of safety, we need every employee to be vaccinated against influenza. We had, as you might imagine, a lot of conversations. We had a lot of um presentations, we had a lot of discussion, we had a lot of work around process in terms of how people could request um medical exemptions, how people could request religious exemptions, what the process would be for review and how that would evolve. But we really, overall, it went very smoothly. We definitely had a lot, people had a lot of concerns, and we had to talk through a lot, a lot of support for managers and leaders to be able to have those conversations with their staff. But at the end of all of that, it did actually go fairly smoothly and has now been in place with really not, it's really just kind of the background now here. So it's it's not a big discussion every year. Every year we're just like this year the date is November 17th, and everyone needs to be vaccinated. And we send out reports and we tell everyone what they need to do, and we give the information to leaders and we tell them what the process is. We did, like I think a lot of places did, we initially required the COVID vaccine when that was sort of an OSHA thing that you should and a regulatory thing that you that you needed to have everyone vaccinated, and then did not maintain that requirement as things got more contentious in discussing vaccine politically going forward. One thing that did happen because of those conversations, our process for um religious accommodations became more flexible than we had been traditionally. And I think following sort of some of the court cases that occurred and some of the rulings that happened, like really felt like that needed to be a little bit more of a flexible process. And that has increased our number of religious accommodations and people that are not vaccinated because of that over the last couple of years since COVID as well. We do require people who are not vac vaccinated to wear a mask when they are in the um healthcare facility to be sure that people are still protected as best that they can be.
SPEAKER_01:And and it was a time I I can imagine where um during COVID where where tensions and emotions might have run high. And I remember the theme of just broadly uh trust being being a big issue, you know, throughout North America and beyond. How did you manage trust? And were there a lot of of challenges with maintaining trust that that staff had in the face of all of this, including the vaccine mandates?
SPEAKER_00:I don't think we got everything perfectly right every time, but we tried as much as possible to be as transparent as we could be about what we knew and what we didn't, what we had available and when we thought we would have more. There was a lot, uh, you know, when the vaccine first came out, it's hard to remember now with the way people feel about the vaccine now. But of course, there was a lot of pressure and concern about like who would get it in what order, how soon would we get more, like when could we get it? Those were terrible, you know, conversations to have to have and to manage through. And in the in the end, we did get it rolled out fairly quickly and it was available to everyone in in fairly short order. But in those first week or two, there was definitely a lot of concern as we tried to balance like who's at highest risk of a terrible outcome if they get COVID, but who is at highest risk of exposure to COVID in the hospital and where they're working. And that ended up meaning that we prioritized older employees first based on their risk of bad outcomes, which was not a popular decision with our, you know, trainees and with our residents who are the front line of that, you know, interaction with patients a lot of the time. And the the delay was really fairly short. It was, you know, within the days to a week or a week and a half between when we started and when everyone could get, but that didn't feel great for people at the time. And we really did have to, you know, try to message and be sure that we had stuff available as soon as possible and open things up more quickly as we got a little more vaccine in. We did uh have a lot of conversation and again tried to be very transparent and very open about the value of the vaccine and what we saw. And we had people, myself included, who had lost family members to COVID before vaccine was available. And we talked about that in videos that they made for, you know, for people to be able to see that like what it meant to us to know that other people were able to get this vaccine, that our family members were not, and that that that drives the importance for us of recommending vaccine and trying to be sure that people can can get vaccine. And I think that that kind of sort of vulnerability and openness about like what personally it really meant for me and for some other folks who participated in that, I think also helps to build that trust. Like I'm not just saying this like as just like a policy statement, that it's really personal to me, how important I think this is.
SPEAKER_01:Yeah. I mean, that's that's so well said, and sharing a little bit of yourself goes a long way with that. Were you also leading culture change? I mean, was that one of the upshots of this that you were ultimately leading some some elements of culture change at BJC? And and have there been any positive, enduring aspects of that culture change that that are still around today?
SPEAKER_00:I think like a lot of organizations, during COVID, we we are already an organization that um speaks freely about our values. And we have five values that we talk about a lot kindness. At the time it was compassion, and we've recently rebranded into kindness, um, respect, excellence, safety, and teamwork. And we talk about our crest values a lot. And it is one of the things that I really enjoy about working for this organization is that people Just we talk about that all the time. So just in meetings and in groups, people will be like, well, leaning into our value of safety, I really think we need to do such and such, like invoking our value of teamwork. We really need to, you know, look at the way this team is working together. You know, we're we want to be excellent. So, and so that I think set us up actually really well to going into COVID. Everyone really did pull those values to the forefront, come together, really work as a team. Everyone chipped in. People from the ORs and Periop areas that when all of our ORs closed down, they many of them came over and helped us stand up an occupational health call center and you know, develop our policies and processes for our employees to be able to call in and get guidance about what they should do. And one of our ID doctors who really does um a lot of parasite research in um other countries, he had been an EIS officer in the past. And he essentially came up to me and was like, How can I help? Put me in, coach. Like, where can I go? And I was like, could you, could you run the standing up of this occupational health call center and all of the scripts that we need and the guidance that we need? Like I can say, here's what we need and what we're gonna do. And then can you check me that that's right? And then can you make that all happen? And he was like, Yep. And he totally did. It was, it was a wonderful thing to see. And he did a great job. I think for for us, as for a lot of others, as we came out of COVID, it's been hard to maintain that sort of focus because it's easier to get everyone to like get on board and do something quickly when we are all doing the same thing. Fighting one common enemy with one common goal is easier than when, you know, in our usual state where we have a lot of priorities and a lot of things going on. And it's easy to get bogged back down into like constant consensus building and trying to get more and more people on board and approving things and moving the losing a little bit of the ability to move fast. So we look back to that COVID time often and say, we need to pull out like that ability to move fast. We proved we can. So we need to do that again for this particular thing or for whatever it is. The other cultural issue or cultural change, I think that we've seen while I've been in this role is we have been, as I talked about a little bit when I talked about my number of people on my team, is we've gone through this integration process and moving to a more um centrally reporting, locally embedded, centrally reporting sort of model. And that has gone actually really well. But as we started that work, there was a lot of um resistance might be too strong a word, but there was a lot of concern, there was a lot of reluctance, there was a lot of fear about loss of control, about loss of um connection to your local team. I had multiple leaders say to me, like, you can't break anything. Like, we can't have quality get worse. And I kept saying, like, I'm the quality officer. Like, I am not interested in having quality get worse. Like I share your goal and that commitment is mine. Like, yes, totally with you. We cannot have anything go in the wrong direction. So it has actually gone really well. And I think now people really do speak about the value of having these more integrated teams, about having some, some of our quality leaders at the director level support more than one hospital in what we now call sort of a micro region. That has really helped share practices across and allowed us to flex some staff when needed. If there are people that are out or people who leave, that we can really support the hospitals better in this model. So that has really been a cultural shift for us. We always talked about being an integrated academic health system, but we had really started as kind of a loose affiliation of hospitals. And it was through some of this process, which wasn't just in the quality space, was also happening in HR and finance and some other functions, that they moved into more of this model has really driven us more to really living that system structure and culture a lot more than we were before. Still not a hundred percent like all integrated perfectly, but a lot closer than we were before.
SPEAKER_01:Yeah. It's good to hear that there's some, you know, some aspects of of that COVID learning, because it feels so far away sometimes now. But I know that, you know, even as I was digging a little more into uh the research for this episode, seeing just how how vividly, even more than the rest of us, how vividly that was a part of your your day-to-day life for that that period of time, and and then shifting roles uh as it was unfolding, it's really remarkable. In your role in infection prevention, you were using a lot of of data, I'm I'm guessing. And then I imagine there was a scramble to to incorporate that as much as possible into the work during COVID, knowing that the data would be you know sometimes incomplete or provisional based on evolving clinical trials, etc. And then now we've had kind of a return to to normal for a little while now. Has the the way that you think about, use, and communicate data changed?
SPEAKER_00:We I would say we're sort of already moving towards trying to make data more visible and available to teams, but the COVID work really did accelerate that. We have um really amazing clinical analytics group and a um business intelligence and design systems group that build a lot of our um dashboards and reports. And during COVID, all of a sudden, like everyone wanted to be able to see a lot of different things all the time and really learned like how quickly we can turn those around, stand those up, get that visibility. And growing from that, we have increasingly built dashboards for other outcomes and for other things that we want to track and now sort of house them all together. We have a My Analytics website where you can go to My Analytics and you can go through, like here are the clinical dashboards, and you can see pretty much all the quality outcomes have different individual dashboards that you can find the information for, and that most people can get to that data so they can answer a lot of questions for themselves about what is going on and what is changing, what is better, what is getting worse, what do we need to do. And then we also then took that data and recognized that for a nurse manager, for example, it is a lot to ask a nurse manager to go to 10 different dashboards to see what your performance is and then be able to have sort of a gestalt of how are we doing. Um, so they also made um we call a my IQ dashboard that has sort of little insets, 10 little insets that show like here's your CLBsy rate and is it red, green, or yellow? And is it going up or down and a little trend line? And then there's CLBsy, caughty, falls, pressure injuries, you know, with several other metrics. I think there are 10 little tiles on there. So that has been a real help as well. We're still working to try to get something similar to that for process measures in a way that nurse leaders and nurses can use to say, of all the patients in my unit or department right now, who is overdue for a dressing change, who is overdue for being turned, who is overdue for, you know, didn't get their glucose adjusted and they're, you know, likely to get hypoglycemic. So we're still working on making that more visible, those sort of process pieces, but we've made a lot of progress on the outcome pieces, which is which has been great.
SPEAKER_01:It sounds, as I'm hearing it, almost like the same principle you applied with conveying simple directions to people during COVID was the is the principle you're trying to apply with data to the front lines.
SPEAKER_00:I think so. We we are, as an organization, we love data. And we, I think many organizations are like this, but we sometimes say that we are drowning in data, but we don't know what to do. So we have been trying more and more, and our analytics team more and more to take the data is available. Everyone can go look at dashboards and everyone can can use it. But how can we make it look actionable? How can we tell you, how can we tie this data to those top five things that you can do if you see things moving in the wrong direction? Um, and for our analytics team members who used to just sort of, you know, say, here's some data, um, but now also to have them say, here's some data, and here is what the data says, here is what it shows from a trend perspective, here's where your opportunities are, and may we refer you to this hub and to these other places to see what tactics you need to follow. So I think yes, we are trying to take the data and tie it more directly to actions that people can take and to try to make those actions sort of clear and easy.
SPEAKER_01:And this is something that I've I've spent a lot of time thinking about and talking about with other quality leaders because it is a unique challenge. We think, you know, that the that building the dashboard, seeing the the data will will translate into both inspiration and action. And uh it really does neither of those things.
SPEAKER_00:It does not. It does not. Yes, it's true. It can it can, and sometimes it does. Yeah, but right.
SPEAKER_01:Yeah. But yeah, that is a it's a universal challenge. Um you know, you helped lead through what we hope is a once-in-a-generation challenge through COVID. And I want to look ahead for you and for healthcare quality more broadly. And so, uh, you know, how has the the CQO role changed since you entered it? And what new capabilities will tomorrow's CQOs need, do you think?
SPEAKER_00:Um, having not been in the role for a super long time, I feel like the changes, the things that have changed in the role since I came into the role are mostly to do with um being sort of the strategic thinker, like trying to take recognizing the subject matter expertise and the leaders that work for me and with me to let them do their work and to really try to stay for myself a little more one more level up at the strategy level and the broader strategy level, because each of them are doing strategic thinking for their specific function area. But for me to try and think about how do we put that all together? And I think that that ability for quality officers to take all of the many things that we are trying to work on and improve and um drive forward and to try to look at them holistically. How can we make that kind of work for the people, again, that are the ones that have to actually do the things? How can we make that as simple as possible and as easy as possible for those people to do that? The number of things that we need to track and follow, the impact of changes in payment systems, the potential changes in insurance status for folks, like things are not gonna get easier in healthcare. And so I feel like our job is to try to make the work that our frontline folks need to do as simple and as easy as we can make it, knowing that there are just gonna be constant headwinds and competing demands and other things going on. And and to the extent that we can again take all of that and distill it to all of these things are happening, but what but we all need to do right now is this hopefully more simple, easier to understand, um, you know, list of things or activities and and goals that we need to be working on. So I think that kind of skill set is just gonna continue to be. I think it's important for quality officers now, and I think it's just gonna be continue to be put to the test over the next few years.
SPEAKER_01:Knowing that, if you were to advise, I guess, your your past self on on that, where do you go to learn that? How do you seek that out, other than just getting it through through experience and and trial and error and and the difficulty of of everyday you know work life?
SPEAKER_00:Yeah, if you find a great answer for that question, I would love it if you would share that with me. Um I do feel like the you know, the the way that we met through the IHI course, I think that um Visiant has some executive networks as well. I do think that a lot of it for me is those conversations and being able to have a peer group of folks who are working through the same things is really the most helpful in thinking about strategy and sort of forward looking because you can hear and incorporate and think about what that means for you locally. There are, I do read like leadership books. There are lots of leadership books that are helpful on like specific skills and specific ways to think about things, but I have not found a great thing that sort of teaches me how to do that sort of strategic gestalt overall view of everything.
SPEAKER_01:Right. Just thinking that thinking one or two layers above.
SPEAKER_00:Yeah. If you know one, let me know.
SPEAKER_01:You know, I I that you've you've put the you've put the ball right back in my court. Since you mentioned the the books, um, are there any that you've read that have been impactful or that you'd recommend to others?
SPEAKER_00:So I will share one of my favorite books of all time from in a nonfiction perspective, is a book called 4,000 weeks, Time Management for Mortals. Um and I don't know if you've read that book, but I love this book. It's by a guy named Oliver Berkman. He calls himself a recovering productivity guru. And it's really, and it's not just about work, it's really about life in general. And it's 4,000 weeks is the average human lifespan. Um, and when you put it in weeks, it does just sort of sink in a little differently. So, like I'm 57, so I'm definitely more than halfway through. So 2,000, 1,500 weeks is like that's what I have left to go through. So you start to think about like what really matters and what do you want to spend your time on? And the other thing he said that I really appreciate is that there is always more to do than you will be able to do. You will never actually be able to catch up, you will never be able to do it all. This was also a critical learning for me from COVID because before COVID, I actually felt like I could mostly get everything done. COVID made clear that that was not, in fact, possible. You cannot get everything done. And so you always have to prioritize, and then you do want to be sure that like you're doing the most important things. So that is a really, really good one. And I am recently not all the way through, but I've started reading Crucial Conversations. And that's a really good one. I love the structure so far about thinking about what level in a conversation you want to be, how not to be pulled into somewhere else that you need to. And just had a conversation earlier this week where I thought, you know what? I wish I had finished that book before going into this conversation because that did not go in fact the way that I wish that it had. So I think that's gonna be a really helpful one for me as well.
SPEAKER_01:That's great. I've I've heard of both the crucial conversations recommended uh to me by another guest as well. So I'm yeah, I'm grateful for that. I'll put those in the show notes so that other people can uh can find them. Looking forward, what makes you most hopeful about the future of healthcare quality work?
SPEAKER_00:The people. The people. So the people who are dedicating their lives all the time to trying to make things better at all levels within the quality arena. So the other quality officers that I work with, the other healthcare leaders that I work for, and then the the frontline team members as well and the day-to-day, like the work that they put in, the commitment that they show. Like, I think it's easy to get discouraged. There are a lot of headwinds. There's a lot of things that we struggle with, but seeing the commitment and the energy that people bring to doing this work and to making things right for our patients and putting the patient at the center every day, all day, that's what gives me the most hope.
SPEAKER_01:I love it. It's the same reason we go to uh the IHI conference is why we we meet online and discuss ideas because it's uh it it is that shared kind of human endeavor of working together towards uh a better healthcare quality future.
SPEAKER_00:Yes. Yes, absolutely.
SPEAKER_01:Well, as we come to the end of this conversation, um, for listeners who'd like to uh follow your work or connect, what's the best place for them to do that?
SPEAKER_00:I mean, I think people should probably could email me. That's probably the best way to reach out directly. I am on LinkedIn. Um, I am on uh Blue Sky. Um, so I I am there as well.
SPEAKER_01:Great. So we can we can link your LinkedIn and your and your Blue Sky if you're uh willing to share in the in the show notes as well. That's great. Well, uh so we'll we'll link to those. So Hillary, uh Dr. Hilary Babcock, thank you uh so much for translating all this the comp the complexity of of science and COVID into clarity and trust. Um, this is one of the most powerful conversations I've had. I really appreciate your time. Thank you.
SPEAKER_00:Thank you, Jason. This is really fun.
SPEAKER_01:Thanks so much for listening to today's episode of Leading Quality. If you enjoyed the show, please take a moment to like, subscribe, and share it with someone who might find it useful. You can find all our episodes at leadingquality.buzzsprout.com or in your favorite podcast app. The show was written and hosted by me, Jason Meadows, edited by Milan Milosavievich, and produced by Thrive Healthcare Improvement. See you next time.
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