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Magellan Health Spotlight: National Healthcare Quality Week

National Healthcare Quality Week is a vital time to recognize the dedication of healthcare professionals who strive to improve the quality of care. From October 20 through October 26, healthcare organizations can emphasize the need for innovation, collaboration, and accountability in healthcare practices. This week also serves as an opportunity to reflect on successes, address challenges, and foster a culture of quality improvement that benefits patients, members and communities alike. In honor of National Healthcare Quality Week, we’re spotlighting three Magellan Health employees:

  • Vivian Fain, senior manager, quality improvement
  • Brandi Smith, director of quality
  • Maria Brachelli-Pigeon, quality improvement director, Magellan Behavioral Health of Pennsylvania

Continue reading to learn more about Vivian, Brandi and Maria’s work in healthcare quality:

Are there any initiatives with healthcare quality that you’re currently working on?

Vivian: I am currently working on performance improvement initiatives related to the identification and submission of critical incidents. This is a major undertaking that unites local providers, care coordinators, and utilization management. This is particularly significant when it comes to securing the safety and welfare of the most vulnerable populations we serve.

Brandi: I am currently partnering with the continuous improvement team and the overall data management plan. I work with the data management and data analytics team to help identify the correct metrics and data elements to build out our scorecards. These scorecards will be essential to reporting our data with a higher consistency and quality. These scorecards will not only be accessible to the employer team but will be built with filters that will make other business units more accessible in Magellan and ensure consistency in reporting across the company.

Maria: As part of the quality team, we often have many healthcare quality related initiatives running concurrently. I appreciate that in my current role I have ability to help shape the scope of projects and measure outcomes of the activities. However, as a healthcare quality professional, I’d argue that most, if not all, discussions we step into benefit from a healthcare quality lens. This means that whether we’re participating in a single discussion or supporting a larger initiative, the principles of healthcare quality can be leveraged to support improvements internally and externally.

How did you get involved with the healthcare quality field?

Vivian: I didn’t seek being involved with the healthcare quality field; the field found me. After many years providing direct care service, I wanted to do something more. At the time, I had no insight into the functions of managed care and how it related to the behavioral health field I was passionate about. Eight years ago, I interviewed for a completely different position than what I’m in, and I was subsequently recommended for a position in quality, that change the path of my career and led me to do what I do today.

Brandi: I got involved with the healthcare quality field by accident. I went to school for accounting and when I graduated college, I got a job in the accounting field. That job wasn’t a great fit for me, so while I looked for my next big adventure, I took temporary jobs with a temp company. One of the temporary positions was at GreenSpring Health in Columbia, Maryland. That temporary job led to a permanent position at GreenSpring in the quality department in 1996. GreenSpring was purchased by Magellan. Since then, I have jumped around to some other departments, but have always returned to my roots in the quality department.

Maria: I was fortunate that another strong quality professional took a chance on me and extended me an offer for a position on the quality team. When I accepted the role I’m currently in, I had no formalized training in healthcare quality. The learning curve was profound. I say now with confidence that it was an excellent move for me. I can also share that before I started my employment at Magellan, that I was impassioned to have a larger role in finding way to improve our community behavioral health system. I worked many years as a clinician treating families and individuals with significant trauma and other behavioral health needs. This role granted me firsthand witness to momentous challenges that my clients experienced with the system, and I came to Magellan with a desire to help triage the barriers I’d observed. I initially joined Magellan as a member of the clinical team, and deeply appreciated what I learned working in that capacity, but feel I’ve found a home working in the quality field.

What are some of the most challenging and rewarding aspects of working in healthcare quality? 

Vivian: What I love about my job is seeing the changes made to direct care services secondary to the performance improvement initiatives my team rolls out. The systemic changes we request of providers/facilities, cascade benefits not only to the members we serve, but also have a direct impact for all patients who receive services from the facilities and providers we engage through the performance improvement process. The most challenging aspect of working in healthcare quality is the fast pace in which things take place.

Brandi: One challenge of working in quality are the audits that we do. Audits are a critical piece of work to maintain our excellent level of care that we give to our members and providers. These audits provide valuable feedback to our staff and supervisors allowing us to deliver the same excellent service no matter which person answers the phone. Audits are always evolving to meet the needs of our internal and external customers. For me, the most rewarding aspect of working in quality is when someone identifies an issue, and I can find a solution. I am a problem solver at my core. This is what makes quality such an interesting place to work. We get to be involved in both the front-end work and the back-end reporting and analytics. Identifying issues before they turn into larger problems provides a sense of accomplishment that isn’t always available in other departments. It’s satisfying to send that email that says this issue has been resolved. I love working in the employer world because of the amazing partnerships quality has with our front-end colleagues.

Maria: Addressing challenges can be one of the most rewarding aspects of working in healthcare quality. Quality engages many tools to tackle barriers: the five why’s to understand root cause, we use Pareto charts to decide where impact could be most profound, Gannt charts to build out projects, Lean Six Sigma and Kaizen methods to identify steps in processes that aren’t value-added and eliminate waste, etc. We can help develop rapid cycle projects using the plan-do-study-act model to assess impact of interventions. Making processes more efficient, measuring improvements, and highlighting successes is very rewarding.

What does Healthcare Quality Week mean to you? Is there anything else you’d like to highlight about healthcare quality?

Vivian: I appreciate the recognition for what those in the field of healthcare quality are tasked to accomplish. The continuous quality improvement process we seek to replicate is no easy task for those resistant to change and is often misunderstood, while the benefits are far reaching and often taken for granted. Further, I would like to highlight the unseen nature of what we do, operating in the background of direct care, to ensure the direct care provided to patients is backed by high expectations.

Brandi: Healthcare quality week means that people get a small glimpse into the world of quality that not everyone gets in the normal day to day. Raising awareness of quality is important, as quality collaborates with every department in the organization. Quality can’t be successful without that collaboration, and whether you realize it or not, you have likely contributed to successful quality outcomes.

Maria: Healthcare Quality Week creates a dedicated time and space to reflect on how incorporation of quality principles in our work can be impactful for our staff, our customers, and our business. For me, this week is a time to extend appreciation to the individuals that are working in the background to improve workflows and outcomes. The quality teams across Magellan Health are extremely collaborative and supportive of one another. We are fortunate to have developed this network of professionals. I’m grateful to have kind and caring coworkers to partner on projects. In general, you’ll hear quality professionals share proclamations like, “quality is everyone’s job.” While it is important for a few of us to have knowledge/expertise on the quality framework to help drive strategies, all staff can have a role in quality.




Spotlight Magellan Health: National Healthcare Quality Week

National Healthcare Quality Week, observed on October 15 to 21, celebrates the many healthcare quality professionals who tirelessly work toward ensuring that quality service is delivered. This week is also a time to spread awareness of the importance of quality healthcare services and create policies that facilitate the safety of both patients and healthcare professionals.

In honor of National Healthcare Quality Week, we’re spotlighting Magellan Health’s Allie Kelley, quality specialist. Some of Kelley’s responsibilities to ensure quality healthcare include managing certain member notifications, generating internal reports for customer requirements, and assisting with EAP record requests within our Employee Assistance Program (EAP) provider network. Continue reading to learn more about Kelley’s work in healthcare quality:

What sort of projects are you currently working on?

I am brand new to the responsibility of running a Quality Improvement Activity (QIA) so I’m learning responsibilities such as barrier analysis, which examines limitations or obstacles to the efficiency of a process or desired outcome, investigating root causes, developing, and discussing interventions, and ongoing monitoring are my biggest tasks right now.  I am very excited about how this process can improve the level of service we provide to our members. It is awesome to have different department leaders come together to talk about barriers and interventions to improve identified metrics and then be able to measure the success of these interventions.

Why is Magellan Health the best place to do this project?

Magellan’s values include integrity, accountability, knowledge, collaboration, caring, creativity, and results. Every one of those values is critical to the success of any QIA. Leadership also shows great support of the overall QI department, and ultimately Magellan as a whole.

What are your thoughts on the culture here at Magellan?

I have been a part of Magellan Health for 25 years and have had the opportunity to work in many different roles. I have seen this company grow in the healthcare industry, and I have never once doubted how much Magellan cares for and believes in their employees. Magellan has been an industry leader when it comes to diversity, equity, and inclusion, and offering comprehensive employee benefits.

Beyond that, the member lives we cover, especially the most vulnerable populations, have always been the most important thing to me in every position I’ve held here. Magellan’s philosophy and mission have always aligned with this. Positively influencing the health and wellbeing of our members has always been a top priority throughout this organization.

How did you get involved with the Healthcare Quality field?

My heart and my passion have always been with our members and working to make sure they are receiving the best care possible. I am a social worker at heart, so when I read the job description for my current role, it was very clear to me that the role in a strong Quality Department is not at all separate from what my mission in the clinical department had always been! I became excited about the possibility of stepping out of my comfort zone while keeping in mind what I came here to do, which is to help people.

What are some of the most challenging and rewarding aspects of working in Healthcare Quality?

Some of the more challenging aspects have been learning the more technical side of things, while the most rewarding part of being in this department has been being a part of a team so committed to integrity, accountability, and data driven results. This is demonstrated in the preparation of the annual Trilogy documents, where everyone on the team comes together to work toward a common objective. Trilogy is our annual evaluation of the QI Program that evaluates outcomes, reviews effectiveness, assesses goal achievements, evaluates the deployment of resources, documents, and trends input from advisory groups. Seeing that final document come together was amazing. I was so proud to have contributed to that and we are getting ready to do it all over!

What does Healthcare Quality Week mean to you? Is there anything else you’d like to highlight about Healthcare Quality?

Healthcare Quality Week to me is a time to raise awareness of the positive impact healthcare quality professionals have in our organizations and communities. At Magellan Health, healthcare quality is organized around the positive influence of the health and wellbeing of individuals by identifying gaps in care and service, improving clinical outcomes, assuring patient safety, and adding value through efficiency. In healthcare quality we’re also focused on enhancing services and the individual’s experience of care. We also work to assure that all core business processes are innovative and meet or exceed contract, regulatory, and accreditation guidance while leading to system and cost efficiencies.