Leading Medicine with Houston Methodist

Setting a Vision for Quality Through the Board of Directors | Quality Time with Dr. Schaal

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Ms. Mary A. Daffin discusses her impact on Houston Methodist's quality and patient safety initiatives as a member of the board of directors and how her deep Methodist faith underscores her commitment to her role.

Expert: Mary A. Daffin, JD Of Counsel, Barrett Daffin Frappier Turner & Engel, LLP, Vice Chair Board of Directors, Houston Methodist Hospital System and chair of multiple committees including the executive committee of the Houston Methodist DeBakey Heart and Vascular Center, quality and patient safety and system quality integration

Notable topics covered:

  • Understanding the role and reach of a board of directors
  • Centering quality as strategic goal of health care institutions
  • Bettering patient outcomes with innovative technology

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DR. SHLOMIT SCHAAL:

Welcome to Quality Time, a Houston Methodist leading medicine podcast. I'm your host, Dr. Shlomit Schaal, a Clinician Scientist and a Retina Specialist, and I serve as the Chief Physician Executive of Houston Methodist, located in the world-renowned Texas Medical Center. I passionately believe that quality is the heart of healthcare and a commitment to quality is essential for every healthcare system. Join us each month as we discuss the latest advancement in quality in healthcare with clinicians, researchers, physicians, industry experts, and thought leaders who are as passionate as I am. Today, I am extremely honored to welcome Mrs. Mary Daffin, attorney and councilor at law, and a member of the Houston Methodist Hospital System Board of Directors. Mrs. Daffin serves as the Vice Chair of the Board of Directors, the Chair of the Quality and Patient Safety Committee, the Chair of the System Quality Integration Committee, the Chair of the Executive Committee of the Houston Methodist DeBakey Heart & Vascular Center, and is a member of several more committees. Mrs. Daffin is a proud HBCU, Historically Black Colleges and Universities graduate, having earned her undergraduate degree summa cum laude from the Alabama State University and her Juris Doctor degree cum laude from Thurgood Marshall School of Law at Texas Southern University. Mrs. Daffin is a lifelong Methodist and has been a member of First United Methodist Church Houston for over 45 years. Welcome Mrs. Daffin.

MRS. MARY DAFFIN:

Thank you. It is my honor to be here with you this morning and talk about something that is so near and dear to my heart. So, thank you for the invitation.

DR. SCHAAL:

Tell us a little bit about yourself.

MRS. DAFFIN:

Well, you've said a lot about me. There's not much more to tell but I will say something that I am extremely proud of and that is my husband, who is an attorney also and my two children, my son who is an attorney and my daughter who has her doctorate degree and teaches nursing at the Prairie View A&M College of Nursing. I have five grandchildren, five. And they are great also. So, I get to do so many things with them and also all of the work that I love to do, of course, here at Houston Methodist and throughout the community as I feel like it is absolutely my responsibility to give back to our community.

DR. SCHAAL:

So, how did you get to join the Houston Board of Directors?

MRS. DAFFIN:

Well, as you indicated, I am a Methodist by faith, in my denomination, and the board does consist of members who are Methodists. And my pastor at the time was Dr. William H. Hinson, and I think he was instrumental in getting me on the board, along with a current member of the board, Judge Ewing Werlein, who is also a Methodist.

DR. SCHAAL:

So, how long ago did you join the board?

MRS. DAFFIN:

Oh my goodness. Since you have given all of those long years, I guess I can go back and say I have been on the board of Houston Methodist now in excess of 20 years.

DR. SCHAAL:

So, for our listeners who may not be familiar with the role of the board, what does the board do?

MRS. DAFFIN:

Well, the board of directors has ultimate responsibility for ensuring the quality of care of patients at Houston Methodist. That responsibility belongs to the board of directors. And we are able to discharge that responsibility in several different ways. And some of those ways, what we do is that we review performance improvement plans, we make sure that those plans are in place and that they are being followed. Now, what we do as a board though, we actually delegate the implementation of those plans to our executive officers and to the medical staff. But in terms of oversight, the board still has that. It has oversight of the quality that is being carried out here in our hospitals. Now, the thing about the board and how it does those responsibilities is quite interesting. If you know anything about Houston Methodist, Houston Methodist is a large system. We are composed of eight hospitals and numerous emergency care centers. And at my last indication, we had over 30,000 employees. So, when you look at that and compare to the board trying to discharge its responsibility, it's a humongous task because the board of directors is only composed of 26 members. Twenty-six members when we are completely populated. But we have an amazing system. We are structured in such a manner that we can take care of our responsibility for quality. And I really want to tell you about that structure and some of the things that we are doing to ensure quality here at our hospitals.

DR. SCHAAL:

So, you chair the Quality Committee of the board.

MRS. DAFFIN:

That is --

DR. SCHAAL:

How did you get to be that and then what does this committee do?

MRS. DAFFIN:

Well, the Quality and Patient Safety Committee carries out the responsibility that is for the board. When we look at the board, it is formatted in the committee structure. And one of the real important committees, all of them are very important. I think we have maybe 12, 13 committees. But as chair of the Quality and Patient Safety Committee, you know, I'm real biased. I think that that is probably the most important committee that the board has as a standing committee. And I got to be chair of that board, I've been chair now for probably about 12 years, 12 years or more. And Judge Ewing Werlein was the chair of the committee. And when he was elected as chair of our board, then I was placed in the position to chair the Quality and Patient Safety Committee. I had been part of that committee, I had been following quality throughout the hospital. And when he was elected to become our board chair, then I became chair of the Quality and Patient Safety Committee.

DR. SCHAAL:

So, in this committee, what exactly the committee does and how does it ensure quality over the entire Houston Methodist system?

MRS. DAFFIN:

Well, one thing that it does, and again, giving a plug to our board, when we have our board meetings, our board meetings are monthly, the board is insistent that quality is the first committee report that it hears. Finances are important, bricks and mortar, you know, that's important, but that is not the first committee report. Quality and patient safety report is the first report -- committee report that comes to the board. So, how do we look at quality and how do we try to keep up with that's going on in our hospital? As I said, we do review performance plans, performance improvement plans. One of the things that I'm really, really proud of is that the committee has been able to have all of our chairs come before us. The chairs who are responsible for the department, the service lines that are here at the hospital, they appear before us and they give us a report. We look at their metrics, we see how they are doing within the department. And not only do we have the chairs come before us, we have the division leaders that come before us, must give accountability. They must take ownership of what's going on, and we see that each time that they are before us. We are very, very insistent on looking at their quality metrics and where there are action plans that need to be put in place to deal with anything that may not be up to where they want it, where the hospital wants it, and where our patients deserve it. Then we are looking at action plans, following through on those action plans to see whether or not they are being adhered to, to see whether or not they are making the progress that they tell the committee that it will take. So, we are constantly looking at quality metrics, we are looking at what our mortality index, what our length of stay. We are looking at all of those things that deal with the quality that we are charged with giving our patients who come through our doors.

DR. SCHAAL:

How did you get so passionate about quality of care?

MRS. DAFFIN:

Well, I fervently believe that every patient that is coming through our doors, it's a sacred trust. They are entrusting their lives to us. And I know that as I would walk through that door and say,"Here I am, I need your care," I would expect the very best, and I cannot live any moment without knowing everyone deserves that. Everyone deserves that. The very best that we can give them. Not because of who they are, not because of any status, not because of any ethnicity. None of that matters. None of it matters. So, when you come through our doors, I fervently believe that you are a person of sacred worth, and that we have to give you the very best that we can. And I am so thankful that that really is the culture of Houston Methodist. For me, it is such a fit because I see it every day. I see it in all of the different committees that I am part of. And you are so right, if I'm not sitting in a Quality and Patient Safety Committee, I still want to know what the other committee members are doing. That will impact on the outcome of our patients and the kind of care we're giving to our patients, and what they are receiving here at Houston Methodist irrespective of which one of our facilities they may land at.

DR. SCHAAL:

You know, Mrs. Daffin, I was recently in a Vizient conference where the top healthcare systems in the country came together, it's called Top Performance. Really, these are the healthcare systems that have the highest ranks in terms of mortality and all quality metrics that actually you mentioned. And one thing that they said it's really helpful to have the board of directors focused on quality. So, I know that's actually not the case everywhere. I know there are certain healthcare systems, you know, understandably that are struggling with finances, and maybe finances are the top of their concerns. What would be your word of advice to those healthcare systems and how they can refocus their board of directors on quality and why that matters.

MRS. DAFFIN:

Well, I would hope that anyone, doesn't matter which healthcare facility that they are in, that they will be focused on quality. But if perchance, they have lost that yearning, they have lost the focus of it, just think about who's coming to you, that they're coming to you because they are in need, they need care. When we think about healthcare, we want to have improved access, we want to improve quality, and if you are on the board of any institution, focus on quality. Focus on quality. Now, I really believe that if there are financial struggles, that it will help with the finances. It will also help with how you are viewed in the community. When we think about the care that we give, these are people that are coming in and out of the community. So, I think your reputation, although that should not be the focus for us, the patient is the center, and I would hope for any healthcare facility, the patient would be at the center of their focus and the center of everything that they do that it evolves around the patient. So, whatever the issues are, whether they are financial, whatever they may be, just depend on quality being your leader and that's the way we look at it.

DR. SCHAAL:

I love this concept that really health is not what happens in the hospital. We all, as human beings, our lives are outside the hospital. Nobody wants to be inside a hospital. And how might we, as healthcare providers, really realize that, and how might we develop strategies to make sure that the patients that we take care of inside the hospital actually do well when they are discharged, actually go back to their lives and be part of the community. Love that concept. In your time at Houston Methodist, what have you seen in quality and patient safety that said,"Wow, I'm so proud to be part of Houston Methodist?"

MRS. DAFFIN:

We have really evolved, and over the years that I have been here, I've witnessed that evolution, and I've seen quality just rise higher and higher. Ever since I walked through the doors, I was really impressed about the care that we give to our patients. But as I see healthcare evolving, we have really begun to be the leader, leading in that evolution, leading in innovations, and the kinds of things that we are doing now in quality, I really never thought of them, I won't say 20 years ago, I'll say 5 years ago. DR. SCHAAL: Give us an example. Well, you know, we are doing so many things in our whole innovation center all towards the view of improving outcomes, improving the quality of care for our patients. Some of those things that we are doing, we are moving to what we are calling a smart hospital, a smart hospital where we are actually using ambient intelligence to do more in the care of our patients, to do more to help with the different processes, to improve the efficiency of the medical staff. And all of it is geared towards outcomes, better outcomes for the patients that come to us. And there are so many innovative things that we are doing here that I think will, you know, as I said, I never thought of them just a few years ago, just a few years ago I had not even thought about these kinds of things where we're looking at giving our medical staff opportunities to not have to spend as much time, but be able to spend more quality time with a patient. To be able to spend more quality time and take away those procedures that can be taken away that they don't need to be at the bedside doing. And so, we're looking at all of those kinds of things. We're looking at how do we make sure that our patients are safe? What are we doing to ensure that there are no falls in our hospital? How do we monitor that? How do we know when a patient comes to us that there is a high degree of falls? So, with our innovation and the different things that we're looking at, we're able to really, really make some great headway with those kinds of things.

DR. SCHAAL:

I love this notion that we never reached our goals. And you talked about the fact that you've never believed, right, that the things that are happening today, we just talked with several leaders, and you know, we talked about our mortality rate, and you know, we know that we see numbers that are really astonishing. Very, very, very low numbers of mortality in our hospital all around the system. And so, this idea of, you know, what we are now, we are never satisfied. And in the future, it might be better, and we're gonna use technologies and innovation to make that happen for our patient. I have to ask you, we are a spiritual healthcare system, and you said that you're a Methodist. How does this spiritual fact, or the fact that we are spiritual in, really, designation, how does this affect quality?

MRS. DAFFIN:

Well, we live by what we call our I CARE values. We have been a hospital that really, as I said, believe in a holistic approach to healthcare, and the spiritual component is a very, very important component of that healthcare. In our spiritual department, we always are looking at ways that we can enhance one's life here spiritually. It does not matter what faith community they come from. I said we are Methodists. For me, I am unashamedly Christian, but that does not mean that I do not have respect for other faith communities. And we carry that through here in our hospital. We do have different prayer rooms for different faiths, and what we do is where one might request a chaplain to come and visit, we provide that kind of service here, always in keeping with whatever faith that patient might have. If they don't want that, then it is not pushed on them, not in the least bit. But it is open because we do believe that the spiritual component is very valuable. We believe that our I CARE values. And I'll say this, when we look at whether or not someone is going to become part of Houston Methodist, they have to live up to our I CARE values. They have to have the kind of culture that we try to emulate here every day. We try to model it. So, the things that we are doing, we want our employees to speak of who we are. It is not a plaque on the wall, it is not just a mission statement, but it is carried out through each and every one of our employees as they minister to the hospital patients that come here. And we want our employees to know, whether they are clinical, whether they are in housekeeping, whether they're in food service, but they are here for the patient, they're here for the patient. And their business is taking care of the patient. Doesn't matter what role they have. So, we make sure that when someone is onboarded here, that that's the kind of person that we're getting.

DR. SCHAAL:

I cannot think of a better person to model the I CARE values than you Mrs. Daffin. So, to conclude our conversation, I'll ask you something that I ask all my guests here. What does quality mean to you?

MRS. DAFFIN:

Quality to me means seeing the patient, seeing the patient, making sure that what the needs are for that patient, they get the best outcomes, the best outcomes that can be delivered to that patient as an individual. And that's what we look at. These are individuals that come to us, so we have to look at that patient as an individual who brings different things, different aspects of life, different needs healthcare-wise, and we have to be able to deliver that in the best fashion that can ensure the best outcome for that patient.

DR. SCHAAL:

Wonderful. What an inspiring way to end our conversation today. Thank you so much for being our guest, Mrs. Daffin.

MRS. DAFFIN:

It was my honor. I have loved every moment of it. Thank you for the invitation.

DR. SCHAAL:

And thank you for listening. Quality Time is part of Houston Methodist's "Leading Medicine" series of physician-led podcasts. So that you never miss an episode, subscribe to Quality Time. New episodes will download to your podcast device. If you enjoyed our conversation today, please consider rating this episode and sharing it with your colleagues. I appreciate your support. Thank you, and until next time, I am always listening.♪ ♪