Armed with a background in engineering, Sheri Chernetsky Tejedor, MD, SFHM, had already adopted a mindset of system reliability and design improvement when she began her journey in hospital medicine at Johns Hopkins University in Baltimore.
After completing her studies there, Dr. Tejedor was quick to find a place at Emory Healthcare in Atlanta and began working toward a future in health care quality improvement (QI).
“I gravitated early on toward what was essentially quality improvement work,” Dr. Tejedor told The Hospitalist.
Dr. Tejedor worked with two mentors at a community hospital associated with Emory University who helped influence her success in QI: Mark V. Williams, MD, FACP, MHM, who is now the director of the Center for Health Services Research at the University of Kentucky in Lexington, and Jason Stein, MD, SFHM, who is currently a hospitalist at Emory University Hospital.
“They wanted to develop quality improvement expertise and get some of us trained,” she said. “These advocates, or mentors, were critical for me. They are people who went above and beyond to help with career planning and thinking through possibilities.”
Dr. Tejedor and Dr. Stein traveled to Intermountain Healthcare, a not-for-profit health system based in Salt Lake City that focuses on medical innovation, to participate in a rigorous quality training program.
“It was extremely intense,” said Dr. Tejedor. “You worked over several months to get a certificate from the Institute for Healthcare Delivery Research, and it’s all focused on quality improvement methodology.”
After completing this program, Dr. Tejedor continued on her quality improvement path by focusing on research while also simultaneously working part time and taking care of her three young children. During this phase of her career, Dr. Tejedor and her colleagues publishedon idle central venous catheters, which became a primary reference for of the ABIM Foundation’s Choosing Wisely® campaign.
Dr. Tejedor said that, in addition to research, she explored different leadership roles, such as taking charge of central line teams and nurses working on device insertion practices. Her successful projects drew notice, and soon Dr. Tejedor and Dr. Stein helped to implement a stronger focus on quality improvement at their organization.
“Our health system was very entrenched in that QI culture,” Dr. Tejedor said. “After Jason and I went to Intermountain, many of the Emory Healthcare leadership also got trained in Utah, and we ultimately built a quality course at Emory that mirrored it.”
Dr. Tejedor’s research evolved to intersect with clinical informatics. She leveraged the organization’s electronic medical record to test her work.
“[The EMR] is ubiquitous, and that was a good way to reach staff, test interventions, and get data,” Dr. Tejedor said. “I built a lot of tools that were helpful for the health system.”
One of these tools was a device to monitor central line infections that was linked with clinical informatics as part of a large grant project. This led to another leadership opportunity: She assumed the role of chief research information officer and director for analytics at Emory Healthcare in 2013.
In 2014, Dr. Tejedor began working with the Centers for Disease Control and Prevention as the first hospitalist and informatics specialist on the Healthcare Infection Control Practices Advisory Committee, where she continues to hold a position. She is also a medical advisor for the CDC’s Division of Healthcare Quality Promotion, focusing on electronic quality measures.
For those hospitalists pursuing QI, exposure to formal training is essential, Dr. Tejedor said. That may not mean flying to Utah, she noted, but garnering a deeper understanding of informatics is crucial.
When it comes to leadership, Dr. Tejedor recommends that those looking to take charge develop social skills and embrace parts of medicine that may be unfamiliar yet essential.
“Learn a little bit about the business side, which you may not know much about as a doctor taking care of patients,” she said. “Learn just enough to understand what goes into people’s decision making when they are choosing what projects get approved.”
Dr. Tejedor encourages hospitalists to focus on developing relationships because that was one of the keys to her success as a quality improvement leader.
“It’s about gaining the trust of the staff, mutual respect, working with the nurses, and getting to know the leadership and the people who make the financial decisions,” she said. “Even if you have the money for a quality improvement project, it will fail if you don’t work with the various teams to understand their needs and how to make it work for them.”