Bonus Episode: Quality, Patient Safety

This week we revisit the conversation with Dr. Scott Allen, UConn Health’s chief medical officer. Dr. Alessi digs deeper into what we mean by the terms “quality” and “patient safety,” exploring the patient experience as well as how to measure quality and how the increasing complexity of medicine makes safety such a priority. He also differentiates between internists and family medicine practitioners. Submit questions for Healthy Rounds: [email protected] Dr. Scott Allen: https://facultydirectory.uchc.edu/profile?profileId=Allen-Scott  UConn Today: Make It 10 Straight A’s for UConn Health’s Hospital Safety https://today.uconn.edu/2025/11/make-it-10-straight-as-for-uconn-healths-hospital-safety/  UConn Health Orthopedics and Sports Medicine https://www.uconnhealth.org/orthopedics-sports-medicine UConn Health: https://www.uconnhealth.org Grant support from Coverys: www.coverys.com Transcript Dr. Alessi: Welcome to the Healthy Rounds Podcast, where we provide you with up-to-date, timely medical information from national and international leaders in their fields. This podcast is brought to you by UConn Health, with support from the Department of Orthopaedic Surgery and a grant from Coverys. It is not designed to direct your personal health care, which should only be done by your physician. I’m your host, Dr. Anthony Alessi, and it’s great to be with you to really dig deep into some of the topics we discussed last week with Dr. Scott Allen. As you’ll recall, Dr. Allen is the chief medical officer here at UConn Health. He is an internist and specializes in primary care internal medicine, and was he went over his personal history, we can see that he’s always had a passion for improving the quality of medical care, and it has really evolved as, that’s almost as a subspecialty of medicine has evolved. But what was also interesting, and I wanted to clear up some things, is that he is a specialist in primary care internal medicine, and that differs from primary care family physicians. There’s different training involved. So family physicians are primarily people who do general medical care, but includes things like obstetrics and gynecology, different subspecialties may be doing some minor surgeries and other areas, so it’s a more broad field and it’s truly family medicine because they also treat children, so they treat the entire family. And it came about really in people in rural communities as well as now we see more and more this has developed to folks in bigger cities as well, where it’s hard to get access to care. So there’s a difference between primary care family medicine and primary care internal medicine, whereas internists treat adults only, and also a broad range of treatments for those adults. And among the things he talked about and that I really got out of this was the approach to quality of care and patient safety. These are things that I wasn’t familiar with in terms of how they relate to the patient. And as you’ll recall, he talked about the first of the three phases being the patient experience, followed by the quality of care and followed by safety. As he explained it, for patients who come to receive medical care, they want to be treated well; they want high quality care, so they want to get better; and more importantly, they don’t want to be hurt. So let’s talk about the patient experience itself. That’s a lot to do with actual having contact with the patient, that initial contact. And there are a lot of things that I’ve learned over the years that help that contact. So even today when I see a patient, I’m asking things like, “Who sent you here?” “What do you like to do?” try to make things conversational. At the same time. I’m trying to identify the patient, speaking to the checklist that we talked about with Dr. Allen. Things like what side is being affected, right versus left, instead of asking again for their date of birth. Now people ask the date of birth a lot ‘cause that’s a big identifier, but I’ll ask the patient’s age. I’ll try to make this part of a conversation. But by the same token, I’m trying to improve their experience as well as identify the proper patient and why we’re there. One other trick I learned, and it’s not really a trick, it’s actually something that speaks quite well to being in contact with patients, is when I would make rounds with patients and go into their room, often you have all these doctors standing around the bedside, right? So when, when I was the attending, I would primarily be the lead physician. I’ll have residents with me in the whole group. I always made a point of sitting down, whether the patient was in a chair or in bed. I wanted to sit down somewhere so that it wasn’t always this feeling of I’m looking down at them. It also gives the impression that I’m spending more time. I spent enough time to sit down and ask my questions rather than having it seem like I’m on the run, getting ready to get out of this room and get going. So there are those things that affect the patient experience. When it comes to quality of care, there are a lot of different measures, right? We measure outcomes, frequency of infection rate, how often does a patient have to be readmitted after being discharged from the hospital? So those are the quality issues, but safety is another issue. And we talked somewhat about why is safety more of a problem now than it was in the past. And I think from my standpoint, it’s clear that medicine has become much more complex. It’s really like the difference between flying a small aircraft and flying some huge jet liner. So there are a lot of things that can go wrong and it’s important to stay on top of those. And that’s where we got into the checklist and that’s why I used the flight analogy, because you always have these checklists. Now obviously when you’re on a huge jet, the checklist becomes much longer. As opposed to flying a small two-seater plane, and I think that’s what has happened now in terms of the evolution of medicine and its complexity with regard to computers and so many other things that are going on with the patient at the time care is being delivered. One of the things I wanted to mention, we have a grant to do these podcasts from a company called Coverys.  Coverys is an insurance company that provides medical malpractice insurance to physicians, and they’ve been my insurer for many years. What’s interesting is that, you think that, well, it’s insurance, they get the lawyer, and now you go through a process. But at Coverys, they spend a lot of time trying to improve quality by continuing medical education and requiring that continued medical education of the physicians, physician assistants, nurse practitioners who are all their insureds. And some of the courses they take are so important and I’ve learned a great deal from them over the years. So we really appreciate having them on board to support this podcast as we move forward. With that, I want to thank again Dr. Allen for his time that he spent with us. It was really enlightening overall. Next week we’re going to be chatting with Dr. Douglas Brugge. Dr. Brugge professor and chair of the Department of Public Health Sciences here at the University of Connecticut, and we spent a lot of time talking about public health initiatives and the effects that these folks out there who are against science have now really impacted public health, and it’s something we all need to be mindful of. If you have any questions or ideas for future programs, you can reach out to me at Healthy [email protected]. Jennifer Walker is the executive producer for Healthy Rounds. Chris DeFrancesco is our studio producer for the Healthy Rounds Podcast, and Tessa Rickert is in charge of our social media. Until next time, this is Dr. Anthony Alessi. Please stay healthy.