A better health care system is possible. This vision, and the question of how we can all, within our varied and siloed systems, help to better meet the whole of a person within and outside of clinical care is at the root of our work at the Foundation for Health Care Quality.

Last year at this time, I reflected on the necessity of guarded optimism appropriate for our day and age. This idea continues to hold true as we saw 2021 bring the magnificent and lifesaving introduction of multiple COVID-19 vaccines that was met with sadly precedented vaccine hesitancy. Just as I believe that better is possible, I believe that those of us in possession of knowledge have an ethical obligation to help educate our friends, neighbors, and those with whom we share this world. This starts with our own understanding of the current state, an honest look at how we all deliver and pay for clinical care, but also how we move through this world as people who present with different skin color, race, gender, class, age and the multitude of other factors sloshing around within our identity.

In support of a better, more true understanding of clinical care, our work continues to revolve around core functions of using data to drive improvement, educating our community, developing clinical best practices and community standards, and working to transform clinical practice. This past year I was especially proud of our:

• Latest deep dive into racial, ethnic, and financial disparities in spine surgery that show differences in preoperative management and postoperative outcomes, suggesting disparities among minority groups still exist in spinal surgery in Washington State and our opportunities for improvement.
• Publication Birth Outcomes for Planned Home and Licensed Freestanding Birth Center Births in Washington State that found “Rates of adverse outcomes for this cohort in a U.S. state with well-established and integrated community midwifery were low overall.”
• Individualized clinician reports as part of our PCI Bleeding Reduction Initiative sent to every interventional cardiologist in Cardiac COAP with volumes >10 – we saw significant variation in bleeding events, indicating room for improvement and we know that bleeding events have a huge impact on mortality and major adverse cardiovascular events.
• Guidelines to identify, track, measure, and follow-up on social needs and build clinical systems that support equitable health care delivery – read our summary here.
• Sidney Dekker’s presentation at the 18th Northwest Patient Safety Conference: Expanding Our Boundaries on Just Culture, Human Factors and Safety Science.
• Evaluating variation in enhanced recovery for colorectal surgerypaper that increases the body of knowledge around enhanced recovery after surgery (ERAS) protocols.

Join us in 2022 as we build our focus on equity, transparency, person-centered quality improvement, and value. If you or your networks are interested in joining our collaborative workgroups or clinical outcomes assessment programs, please reach out to us at fhcq@qualityhealth.org