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Restructuring Within an Academic Health Center to Support Quality and Safety: The Development of the Center for Quality and Safety at the Massachusetts General Hospital

Bohmer, Richard M.J. MBBCh, MPH; Bloom, Jonathan D. MD; Mort, Elizabeth A. MD, MPH; Demehin, Akinluwa A. MPH; Meyer, Gregg S. MD, MSc

doi: 10.1097/ACM.0b013e3181bfd09b
Quality and Safety

Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

Dr. Bohmer is senior lecturer, Harvard Business School, Boston, Massachusetts.

Dr. Bloom is resident, Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Dr. Mort is vice president for quality and safety, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Mr. Demehin is administrative director, Center For Quality and Safety, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Dr. Meyer is senior vice president for quality and safety, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Correspondence should be addressed to Dr. Meyer, Bulfinch 250, 55 Fruit Street, Boston, MA 02114; telephone: (617) 724-9194; fax: (617) 726-4304; e-mail: (gmeyer@partners.org).

© 2009 Association of American Medical Colleges