Massachusetts Association for Healthcare Quality (MAHQ)

Fall 2016 Newsletter

President's message

It’s hard to believe that fall has arrived; I hope everyone had a wonderful summer!
October 16-22 is National Healthcare Quality Week.  This celebration is dedicated to the work and contribution of healthcare quality professionals and the influence they provide in the field of healthcare by improving patient outcomes. If you have a quality achievement you would like to share we would love to highlight this achievement for all members.  You can email me at .
To continue to provide educational offerings board members and volunteers have been busy planning upcoming programs and events and will provide more details as they become available.
MAHQ relies on skilled volunteers with diverse experiences in healthcare quality who dedicate their time to support and promote the Association’s mission and activities. Volunteering not only provides opportunity for  business and professional growth, enhancing skills or competencies, personal recognition, but also giving back through service to others.  If you know a colleague or student, encourage their participation. For details about volunteer opportunities, please go to our volunteer webpage or contact me directly. 

Cheryl Hafela

Back to Top

Treasurer Report

For complete details quarterly financial statements are posted for your review on our Chapter News webpage.

The current assets of MAHQ as of Sept. 30, 2016 are $44,738.05.  Total income through the end of September for 2016 is $18,309.66.  This income was generated by CPHQ program fees, membership dues, webinar income and our career corner. Total expenses for this same time period were $11,939.90.  MAHQ expenses are related to administrative, programs, operations, networking and marketing expenditures.  The net income for 2016 as of Sept. is $6,372.76.     

In Q3 2016, the finance committee paid out one of our 2015 Professional Grants.  We are excited to have sponsored Kathryn Nordstrom in her pursuit of her CPHQ certification.  

We are pleased to announce that we will be accepting Professional Grant applications in Oct. 2016.  We look forward to giving back to our members and reviewing your applications. 

Respectfully submitted,
Anne Boffa, MPH, CPHQ

Back to Top

Kudos Corner

We are now featuring a Kudos Korner to recognize and share the professional accomplishments of our members. Please send us your information about presentations, publications, promotions, awards, etc.
In July, Eileen Hession-Laband, RN, MBA, NE-BC CPHQ, was a co-author for an article in Hospital Pediatrics. The other authors, Preetam Cholli, Elaine C. Meyer, PhD, RN, Marguerite David, RN, Marilyn Moonan, MSN, CPN, Judith Mahoney, MSN, NE-BC, David Zurakowski, PhD, and Sigall K. Bell, MD are colleagues of Eileen from Boston Children’s Hospital.

The article, Family Perspectives on Whiteboard Use and Recommendations for Improved Practices, examines different ways patients, families and staff used the whiteboards by their children's bedside. The authors also identified reasons for non-use. The article outlines parent recommendations for better utilization of whiteboards as tools for patient-centered communication and family engagement. The authors found that parents informed of the whiteboard were more likely to use it actively, highlighting the importance of education and suggesting a gap in harnessing the whiteboard's full potential for communication.

Back to Top

MAHQ Professional Enhancement Grant

Is 2016 the year you plan to become CPHQ-certified?  Do you already have your CPHQ, but find budget cuts are keeping your employer from sending you to that “must attend” conference?  If you answered yes to either of these questions, apply for a MAHQ Professional Enhancement Grant today! 

This grant provides financial assistance to MAHQ members to obtain the Certified Professional in Healthcare Quality (CPHQ) credential or, for members who already have this certification, attend a regional or national conference.  There are restrictions on how the monies can be used and details can be found on the MAHQ website.  What do you have to lose in checking it out?  Let MAHQ assist you in your 2016 professional development goals.

MAHQ will be accepting applications through November 15, 2016 and grants will be awarded on December 15, 2016.   Click here for more information and to complete the application.


Back to Top

Membership Committee Update

Our 2017 Membership Drive will soon be underway. Watch your email for an invitation to renew your membership or join MAHQ for the first time!

Back to Top

Article:  High Reliability in Today’s Health Care Environment

High Reliability in Today’s Healthcare Environment
Tricia Ide, RN, MS
Executive Director Quality and Patient Safety
New England Baptist Hospital

Mark Chassin and Jerod Loeb’s groundbreaking article High Reliability Health Care: Getting There from Here, outlines the current state of quality and patient safety and the impact of leveraging high-reliability science into health care.  Despite decades of focused improvements that are unsustainable and prolonged excellence throughout an organization unattainable, embedding the learnings from high reliability organizations will allow hospitals to attain higher levels of quality and patient safety which is desirable for us all.

What is high reliability science?

Learning from other industries provides opportunities to test best practice ideas in a healthcare setting. Partnering with commercial aviation, nuclear power, military operations and university professionals to push the boundaries of what is possible in healthcare is taking place today. This is a new and rich source of learning for hospitals of all sizes, specialties and focus.

The journey toward becoming a high reliability organization (HRO) focuses on improving reliability through better process design, building a culture of reliability and leveraging human factors by creating intuitive designs that help people do the right thing.  For many, the drive to become an HRO originates with safety, but many realize this work will improve the performance in multiple if not all areas.

Key principles of reliability science:

•Designing reliable, standardized systems that support staff decisions, opportunities for feedback, ongoing learning and change

•Learning to be more mindful of decisions and actions using HRO theory (see below)

•Improving situational awareness – the concept of reliably identifying at-risk patients, lessening their risk and escalating risks until the patient is safe

•Managing by prediction and having robust plans in place for the expected and the unexpected

•Looking at human factors – how we relate to the world around us and how learning more about how we work and interact, and designing systems that take human factors into account, can help us better keep patients, families, employees and visitors safe

High Reliability Theory:

1. Preoccupation with Failure

Everyone is focused on errors and near-misses, learning from them and figuring out how to prevent them from happening again. Attention to detail is crucial. Finding and fixing problems is everyone’s responsibility and is encouraged and supported by leadership.

2. Reluctance to Simplify Interpretations

Requires constantly asking the “why” question and inviting others with diverse experience to express their opinions. The belief is that the more you’re immersed in something, the harder it is for you to objectively observe and question things that need questioning.  Leverage new thinking to get the right answer!

3. Sensitivity to Operations (an HRO Distinguishing Characteristic)

An ongoing concern with the unexpected. Hallmark actions include closing loopholes in processes where there is potential for patient harm, maintaining situational awareness, developing teams that speak up and paying attention to the frontline – which in hospitals is primarily nurses, patient care attendants, techs and support staff.

4. Commitment to Resilience

The concept that things will go wrong that we can’t predict; mistakes will be made, and we will get into trouble. But we will quickly identify issues and have structures in place so we can immediately respond and minimize the harm. Errors won’t disable us.

5. Deference to Expertise

Finding and using experts for the given problem in the given time. More specifically, it means recognizing that those closest to the frontline are the experts and empowering them to make decisions when a critical issue arises results in quicker mitigation of harm.

In HROs, senior leaders are conducting frequent walk-rounds to reinforce safety behaviors and find and fix critical safety issues. They’re also meeting in daily operational briefs where they look back to learn from failures and look forward to predict and lessen risk or harm.

Hospitals can make substantial progress toward high reliability by undertaking several specific organizational change initiatives. Further research and practical experience will be necessary to determine the validity and effectiveness of this framework for high-reliability health care.


Chassin, Mark,R.;Loeb, M. Jerod. High Reliability Health Care: Getting There from Here. The Milbank Quarterly, Vol. 91, No. 3, 2013 (pp. 459–490)c 2013 The Authors. The Milbank Quarterly published by Wiley Periodicals Inc. on behalf of Milbank Memorial Fund
Managing the unexpected: Assuring high performance in an age of complexity. University of Michigan business school management series.
Weick, Karl E.; Sutcliffe, Kathleen M.
San Francisco, CA, US: Jossey-Bass Managing the unexpected: Assuring high performance in an age of complexity.(2001). xvi 200 pp.


Back to Top

Performance Improvement Corner
by Taruna Banerjee, MPH

In this issue of the MAHQ newsletter, we are highlighting the Process Map. Please email us with suggestions for future tips, tools or techniques to include.

Process Map:
Also known as process flow chart or a detailed flowchart, it is a pictorial view of the separate steps ofa process and how they all fit together.  Elements included in a process map are sequence of actions, inputs and outputs, decision points and people involved at each step.  


When to Use a Process Map:

  • To define a process and understand how a process is done.
  • To understand “gaps” or areas of improvement.
  • To communicate within a team or between teams how a process is done

Important Symbols to Know Before You Start a Process Map:

  • Elongated Circle - the start of a process 
  • Circle - end of a process
  • Rectangles - process step
  • Diamonds  -  decision points
  • Arrows - flow

Process Map Diagram Procedure

  • Gather the team and define the process to be diagrammed. Write it at the center top of the flipchart or whiteboard.
  • Discuss and decide on the boundaries of the process.  When/where does the process start and end? What is the level of detail you want on your process map?
  • Brainstorm the activities and write each one on a sticky note. Arrange these in a proper sequence. When all activities are correctly included, draw arrows to show the flow of the process.

Source: American Society for Quality 

Back to Top

MAHQ Newsletter Content

Do you have a quality event happening that you would like your fellow MAHQ members to know about? We are interested in original content about a successful project, recent promotion and any other quality news you would like to share. Please submit articles for approval and posting to


Back to Top

Connect with MAHQ!

MAHQ is on Facebook - connect with us here: for updates on programs and other opportunities. You can also keep up with MAHQ, including job postings, through our LinkedIn account:

Back to Top

Websites of Interest

HealthLeaders Media
Health Leaders Media Magazine is a monthly look at the issues and trends that are shaping the business of healthcare today
View all the covers and read all the cover stories.
HealthLeaders Media Staff, for HealthLeaders Media, December 31, 2014.

The Commonwealth Fund
The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

Centers for Disease Control & Prevention
In public health settings, performance management and quality improvement tools are being promoted and supported as an opportunity to increase the effectiveness of public health agencies, systems, and services.

Back to Top