Stanford Health Policy’s Kathy McDonald — one of the nation’s leading experts in patient safety and health-care quality — has been named a distinguished professor at Johns Hopkins University, and will soon be leaving the Stanford Cardinal for the Hopkins Blue Jays.
McDonald, PhD, is the founding executive director of the Center for Primary Care and Outcomes Research at the Stanford School of Medicine and the Center for Health Policy in the Freeman Spogli Institute for International Studies (CHP/PCOR). She has spent 25 years at Stanford and says it’s tough to leave the Stanford Health Policy community, whose members are like family.
“CHP/PCOR has given me a community of close colleagues who care about each other and what we do together,” McDonald said. “And we’ve done a lot together over the years, much more than the usual academic products of grants, publications and courses. We have built a reputation for being ahead of the curve of health-system concerns. We also keep doing a fabulous job pushing the science envelope, and coming up with insights for everything from big policy to every day practice decisions, in the U.S. and abroad.”
McDonald soon heads East as the Bloomberg Distinguished Professor of Health Systems, Quality, and Safety. She will hold primary appointments in the Johns Hopkins schools of Nursing and Medicine and joint appointments in the Carey Business School and the Bloomberg School of Public Health, and affiliated with the Malone Center for Engineering in Healthcare. She will continue to explore what makes safe, affordable and high-quality health-care delivery systems, as well as the obstacles that prevent health organizations from achieving those goals.
McDonald told the Johns Hopkins University blog, the Hub, in a recent story that she intends to collaborate with faculty colleagues across the university and continue borrowing from other disciplines to optimize health-care delivery, just as she has done in her role at Stanford.
“All of us at CHP/PCOR owe Kathy an incredible debt,” said CHP/PCOR Director Doug Owens, who has worked alongside McDonald for more than a decade. “She helped found the centers, and we’ve benefited from her vision and extraordinary leadership for over 20 years. She is one of the top scholars in the nation in her areas of work, and her position at Johns Hopkins recognizes her exceptional accomplishments. We will miss Kathy greatly, but are thrilled with the opportunity she has to broaden her national leadership.”
For her PhD in health policy from the University of California, Berkeley, McDonald wrote her dissertation on diagnostic errors — an area McDonald believes is a critical blind spot of health-care providers. She was a member of the committee that issued a landmark report by the National Academy of Medicine, the medical arm of the National Academies of Sciences, which found that most Americans will get at least one faulty diagnosis in their lifetime. Despite dramatic improvements in patient safety in the last 20 years, the committee found, medical experts estimate that more than 12 million adults are misdiagnosed every year.
As Johns Hopkins pointed out in its release about her becoming the 46th Bloomberg Distinguished Professor, in addition to publishing more than 100 scholarly peer-reviewed studies and white papers, McDonald has published more than 40 government reports and developed tools for measuring patient safety and quality that have been used by private and public care providers alike. She was tapped by the federal Agency for Healthcare Research and Quality to create a series of reviews and seminal reports outlining practices for improving patient safety and health care quality, and also authored the Care Coordination Measures Atlas.
Her research team also worked on a set of standardized health-care quality measurements called Quality Indicators for the agency, which can be used to analyze administrative data from hospitals to identify potential quality concerns and track changes over time.
Those Quality Indicators from the AHRQ were implemented at the Johns Hopkins Hospital in 2012. According to a case study published in May, McDonald and her team's Quality Indicators helped Johns Hopkins Hospital improve its postoperative ventilator procedures and reduce the incidence of perioperative pulmonary embolism, hemorrhage, and hematoma.
“Kathryn McDonald’s ideas have improved the lives of the patients, including here at Johns Hopkins,” said Paul B. Rothman, CEO of Johns Hopkins Medicine. “We’re thrilled to welcome her to Johns Hopkins, where she can help us continue to develop and innovate health care delivery, here and across the country.”
McDonald is also the principal investigator of a project at the Society to Improve Diagnosis in Medicine that is addressing ways that a patient’s age, race and gender — particularly women, young adults and African-Americans — may contribute to errors in medical diagnoses and disparities in patient outcomes. And she’ll continue to examine how the growing time constraints on clinicians — conducting patient consults faster, logging results in EMRs sooner, keeping up with regulatory changes — are impacting patient safety as the shortage of health professionals sgrows larger each year in the United States.
In a study published last year in the American Public Health Association journal, Medicare Care, McDonald and her colleagues wrote that despite concerns about the impact of growing time pressures on clinicians and the delivery of health care, “scant evidence exists about types of time stress, the organizational factors that shape such stressors in routine care settings, and consequences for patients and practitioners alike.”
Focusing on Quality of Care for Patients, Best Practices for Clinicians
“Kathryn McDonald is a pioneer in bringing systematic and evidence-based approaches to the study of health care delivery,” Patricia Davidson, dean of the Johns Hopkin’s School of Nursing, told the Hub. “She has a track record of collaboration and innovation across disciplines and will bring with her new insights into the best practices for measuring health care outcomes to ensure patient safety for all people.”
McDonald told the Hub she believes it’s important to look at health care from a patient-centered point of view, where it’s often the easiest place to spot trends.
“There's a shift happening right now,” she said. “More people are accessing different entry points for health care, and we need to think about their journey to staying healthy or dealing with a health crisis.”