Editor’s note: This new series highlights the professional pathways of quality improvement leaders. This month features the story of Kevin O’Leary, MD, MS, SFHM, chief of hospital medicine at Northwestern University Feinberg School of Medicine in Chicago.
Kevin O’Leary, MD, MS, SFHM, chose a career path in hospital medicine for the reasons that attract many to the specialty – a love of “a little bit of everything, clinically” and the opportunity to problem-solve a diverse range of professional challenges on a daily basis.
Fresh out of residency on the new hospitalist service at Northwestern University Feinberg School of Medicine in Chicago, it wasn’t long before Dr. O’Leary began to connect many of the obstacles he encountered at bedside to larger, systemic issues.
“I was frustrated with our internal inefficiencies, and motivated by wanting to provide optimal care to patients,” Dr. O’Leary said, recalling his entry into the world of quality improvement. “It was the first time as a physician that I felt like quality was a problem that I owned – and if anyone was going to address it, it would have to be a hospitalist.”
That epiphany 16 years ago led Dr. O’Leary, now chief of hospital medicine at the same institution, on a path of enacting change. He began volunteering on small improvement projects around the hospital, which led to an invitation to chair the Quality Management Committee in the hospital medicine department. He continued to build his skills by enrolling in Six Sigma training and in Northwestern University’s Master in Healthcare Quality and Patient Safety program.
“That was transformative,” Dr. O’Leary said. “The master’s program, coupled with performance training, changed the trajectory of my career in quality improvement.”
While he encourages anyone with an interest in QI to seek additional training opportunities, he says personal qualities – tenacity, curiosity, and a willingness to collaborate—are better predictors of success. For those wondering how to get started, “look for a niche, an unmet need that is valuable to your organization, and fill it,” he advised. “You don’t have to be an expert in that area, but you can become one.”
Making strong connections within the hospital system is essential. Reach out to the contacts you know, he said, and if they are not the ones to help you solve the problem, they often know who can.
“That’s key to quality improvement success, as well as career success,” he said. “Find a mentor. It might be someone who is more senior within the hospitalist group, in medicine, or even outside the hospital. Meet with them regularly and ask them for feedback on your ideas.”
Newcomers to QI should embrace opportunities to change care and not get discouraged when a project has unintended outcomes.
“Failure is when a team never gets to the point of implementing the intervention or when a team doesn’t know whether the intervention has actually changed results,” he said. “Learning why an intervention isn’t effective can be as valuable as implementing one that is. If every project is successful, it just means that you’re not taking enough risks.”
Dr. O’Leary spends about 25% of his professional time providing clinical care, and another 15% meeting his responsibilities as division chief. He uses the other protected time in his schedule to lead QI and teach QI skills in programs like Northwestern Medicine’s Academy for Quality and Safety Improvement (AQSI).
As a former faculty member in SHM’s Quality and Safety Educator’s Academy (QSEA), he has trained medical educators to develop curricula in quality improvement and patient safety. He says both AQSI and QSEA are especially effective because they encourage interaction, which is valuable to professionals at all levels looking to advance their skill in QI.
“Even in a teaching capacity,” he noted, “what I learned from other faculty and participants in QSEA was critical.”
Residents and junior hospitalists often have the impression that they lack the skills to lead quality initiatives, but Dr. O’Leary says medical school provides the nuts and bolts – analytical skills, statistical knowledge, critical thinking. He encouraged hospitalists to move ahead, even without formal QI training.
“If you have strong interpersonal skills – the willingness to make friends and build connections – you will be successful,” he said.
It’s also an excellent way to learn about the ins and outs of the hospital system and the work of other departments and specialties. Dr. O’Leary especially enjoys that aspect of his work, as well as the ability to address systemic issues that he values.
“I get the greatest fulfillment from the opportunity to be creative … and to implement projects that are important to me and help patients,” he said. “As long as the projects align with organizational goals, I can usually find the support we need to be successful.”