Value-Based Healthcare Delivery Course

Faith Makka, MSN, MPH

Deland Administrative Fellow

May 30. 2019

During my time at Brigham & Women’s Hospital as a Deland Administrative Fellow, I was afforded several opportunities to participate in educational sessions offered through the Centers of Expertise (COE). My fellowship year was enriched by these experiences which enabled me see the big picture and connect the dots in the complex ecosystem of healthcare.

The Value-Based Healthcare Delivery course offered by the Harvard Business School and taught by world-renown economist and business strategist, Professor Micheal Porter allowed me take a step back to view healthcare from the business lens. The interactive case-based sessions gave me an appreciation for the shifting landscape of health care and the drivers necessary for lowering costs and improving outcomes. The Health Policy course allowed me better understand the dynamic interplay between payors, providers and patients while also highlighting the importance of issues around health equity and disparities. These sessions were great in parallel with the various operational and strategic projects I was involved in, during my fellowship year and I was able to draw on both didactic and experiential learnings concurrently.

I recall a Quality & Safety dinner session where our focus was on medical mistakes from the perspective of providers who were most proximal to the event – the ‘second victim’ as the term has been popularly coined. As a group, we discussed strategies to provide support to providers involved in serious safety events. Insights from our discussion that night lingered in my mind. This and many other experiences re-affirmed to me that I wanted to pursue a career in health care administration that combined a unique synthesis of the following elements: systems thinking, quality improvement, process re-design, operational management, patient safety, human factors engineering and psychological resilience.

Since the completion of my fellowship at BWH, I have gone on to assume the role of Director of Patient Safety at a large medical center where I get the privilege of advancing the culture of safety, facilitating debriefs after serious safety events, conducting analyses to identify root causes of safety events/medical errors, making improvements to care management processes that lead to safer, higher quality care utilizing principles of high reliability (sensitivity to operations, preoccupation with failure, etc). My role exists, in part, to create processes that make it difficult for people to do the wrong things and easy for them to do the right thing using human factors engineering, predicated on the concept that ‘to err is human’. I also am charged with ensuring that there is care for the caregiver and that the proverbial ‘second victims’, who find themselves at the sharp end of health care, are given the care and resources necessary to be successful.

I’ve heard it said before, “You don’t know what you don’t know” –with a deeper level of exposure to the various facets of health care, this affords trainees (residents and fellows) the ability to identify the nexus of their strengths, abilities, interests and passions as they consider the next steps in their career. It’s important to step out of one’s silo and see healthcare through another lens. This leaves us with a new perspective to see how our current or future work will be potentially affected by policies, the regulatory environment, shifting societal trends, emerging technology, psychology, behavioral economics, consumer trends/insights, ground breaking research and the list goes on…. I can confidently say that my participation in the COE sessions have made me a better informed, well-rounded health care administrator who is aware of where I fit into the grand picture of healthcare.