Quality and Safety

Patient Care and Experience

Columbia University Irving Medical Center (CUIMC) is dedicated to providing safe, high-quality healthcare while creating an excellent experience for the patients and families we serve. Under the direction of the Quality, Safety & Patient Experience Committee, we are innovating and expanding our already dynamic structure of practices, policies, and initiatives, from enhanced medical chaperone training to improved patient education and empowerment.

Clinical Care and Safety

CUIMC’s efforts to ensure safe, high-quality care span all departments and practices, and include the following areas of focus:

  • Chaperone policies and training: We are committed to our patients receiving safe, dignified, and comfortable care, including the use of clinical chaperones during exams, treatments, and procedures. The policies involving the use of a clinical chaperone were developed with experts in trauma-informed care and align with the policies of our health system partner, NewYork-Presbyterian. For certain procedures (such as female vaginal and pelvic exams), a clinical chaperone is required, while for other sensitive exams, treatments, and procedures, our providers must offer the option of a chaperone being present. In addition, a patient or a provider can request a chaperone during any visit at any time. All patients are notified of their right to a chaperone.
    Clinical chaperones at ColumbiaDoctors are regularly trained on patient-centered care principles, including protecting patient well-being during sensitive examinations; ensuring privacy and confidentiality; and verifying the content of clinical conversations and physical exams. Clinical chaperones are trained to identify and immediately report and escalate any concerns. Our non-retaliation policies mean that chaperones can report concerns without fear of repercussions.
  • Infection prevention and control: CUIMC upholds evidence-based practices and policies to protect patients and healthcare personnel from infection, in collaboration with our hospital partner NewYork-Presbyterian. This includes preventing healthcare-associated infections; regularly assessing the clinical environment to the highest standard of infection prevention; minimizing occupational exposures; managing any emerging infections; and educating patients, staff, and visitors about infection prevention and control measures.  
  • Medication administration: Our Medication Administration Policy established consistent processes for clinical staff regarding medication orders (including reconciliation), preparation, administration, documentation, and monitoring. In addition, CUIMC, together with Weill Cornell Medicine and NewYork-Presbyterian, has undertaken the Ambulatory Opioid Management Initiative (AOMI), which standardized the adoption of best practices related to policies for prescribing; patient and provider education; electronic health record optimization; and shared decision-making between patients and providers.  
  • Patient education and empowerment: We have undertaken several initiatives to strengthen patient education. In our Obstetrics & Gynecology practices, for example, we display “What to Expect” information in exam rooms which use QR codes to provide detailed explanations of sensitive procedures in order for patients to fully understand what their visit and treatment will involve. We have also implemented improved signage in Obstetrics & Gynecology practices to promote reporting - anonymously and non-anonymously - by patients or family members of any concerns regarding their experience and the care they receive. In addition, patients receiving care in Obstetrics & Gynecology receive a post-appointment text message as an opportunity to immediately provide feedback, share experiences, and report concerns.  
  • Professionalism and the PRIME program: Columbia and NewYork-Presbyterian together implemented an evidence-based, data-driven risk prevention system - the PRIME Program (Professionalism, Respect, Integrity, and Medical Excellence). In collaboration with the Vanderbilt University Medical Center's (VUMC) Center for Patient and Professional Advocacy, which developed the underlying tool, the PRIME Program aims to make medicine kinder, safer, and more reliable by identifying and addressing behaviors that undermine a culture of quality and patient safety. The program leverages evidence-based mechanisms and practices to respond to professionalism concerns that occur within our clinical work environments. By identifying professionalism issues and promoting intervention at early stages, the PRIME program works with clinicians before conduct continues or an adverse event occurs. The institutions deploy interventions based on the issues identified, ranging from an awareness conversation with trained peer messengers to formal investigations and/or disciplinary processes. This approach reflects our commitment to a workplace where respect, accountability, and professional integrity guide our actions and also supporting an environment where timely constructive feedback is expected and valued. 
  • Provision of care, treatment, and services: All ColumbiaDoctors sites abide by the highest regulatory standards of clinical excellence, including voluntary adherence to the Joint Commission’s guidelines and criteria that govern the quality and safety of care provided in outpatient settings. More specifically, QPS efforts include a range of distinct clinical projects and initiatives, including:
    • Patient Safety Champion Program: Our Safety Champions program identifies dedicated doctors, nurses, and other clinical staff members and trains them to serve as the “face” and “voice” of patient safety within their department. In turn, these Patient Safety champions seeks to improve a reporting culture, implement safety programs at the practice-level, and serve as the liaison between QPS and the doctors and staff taking care of patients.
    • Patient Safety Rounding: The Quality and Patient Safety staff regularly meet with ColumbiaDoctors physicians and staff in the physicians’ office, evaluate the needs of frontline staff members, provide training on patient safety principles, and escalate organizational trends to the QPSE Committee to develop an organizational-wide safety strategy.
    • Regulatory Compliance Program: ColumbiaDoctors is committed to its facilities and its staff delivering the highest quality patient care for every patient and family member presenting to one of its sites. In order to do so, Regulatory Compliance leadership at ColumbiaDoctors regularly travel on-site and coach the staff on how to provide the highest quality in domains such as Infection Prevention, Radiation Safety, and Fire Safety.

Patient Experience

From the coordination of ColumbiaDoctors appointments to the respect shown by providers, the CUIMC community makes sure each patient receives health services in an environment of professionalism, trust, cleanliness, and convenience. For example, in the Department of Obstetrics & Gynecology, a patient experience coordinator is responsible for monitoring quality reviews, documenting any areas for improvement, and following up with patients, providers, and staff.

  • As a patient-centered organization, we constantly seek feedback through patient experience surveys to understand our patient’s perspectives, what resonated well with patients, and what can be improved on. Based on over 2 million visits annually, over 94% of patients rate that they are extremely likely to recommend their provider at ColumbiaDoctors. Despite that success, the Patient Experience team continues to develop ways to address patients whose needs were not met, including escalation to practice leadership for service recovery.