Executive Takes: Jeremy Goodman, M.D., M.B.A.
Perspectives and insights from a system quality officer who says that near misses are the errors that matter most.
Jeremy Goodman, M.D., M.B.A., is Senior Vice President and System Quality Officer at Baptist Health in Jacksonville, Florida.
Time on the job: Three years
First role in healthcare: Volunteer EMT in high school
Prior roles: Abdominal transplant surgeon, Chief Medical Officer of Banner-University Medical Center Phoenix
Ten Takes from Dr. Goodman
Why he changes bedpans: "My first job was as an ER tech, working for nurses. I emptied bedpans. Today, if a patient says, ‘Hey, can you take this bedpan out?’ for many physicians the instinct is to get a nurse. I have no trouble emptying a bedpan. I don't believe in the hierarchy."
Why he left transplant surgery for quality: "I was the junior-most member of my group, so anytime they needed compliance review or an EMR build, my division chief asked me to take it on. And I ultimately found that as much as I loved surgery and taking care of individual patients, my brain was happiest tackling bigger problems that could potentially help the whole hospital and the health system."
How to get physicians to prioritize quality: "They have to be the ones leading the effort. You can't have someone who's not practicing saying, ‘This is how you're going to take care of sepsis patients.’ And you have to show people why it’s worth it, and make it easy. Then they’re doing something that’s better for them.”
Who is responsible for quality: "Historically, the answer would be, ‘Well, the quality team does that.’ So we’re transitioning away from that, and today it’s about making quality improvement part of every clinician’s responsibility. Our team’s job is to help make sure we’re all doing what we said we were going to do.”
On the importance of near misses: "Near-miss reporting is actually the most important thing you can report—otherwise, nobody knows about it except for the people involved and we may not be able to get ahead of issues. We started the year with 9-12% of all patient-related reports being near misses, and we've now got it up to about 25%."
On tying quality to physician pay: "People are going to move toward incentivized behavior. But it can’t just be a health system priority—you have to tell a story about the patient impact. And if it’s not a large enough percentage of someone's salary, then it's not an incentive anymore.”
Brain space currently dominated by: "Developing and delivering a model for clinical pathways that reduces variation through a shared set of processes, protocols, and a shared approach to taking care of common problems for which there's evidence. But there's a lot of resistance, because it appears to be, ‘Oh, you just want to tell me how to practice.’"
What keeps him up at night: "The variation that we have. And for legitimate reasons. But what I worry about is that patients who come into different emergency rooms with the same problem may get different care versus similar care. How can we improve if we all do it differently?"
Contrarian opinion: “What if the future of healthcare depends less on clinicians processing every piece of information independently and more on effectively using AI-driven insights to make decisions in moments of information overload? If that's the case, our education and operating systems will need to adapt to this new reality.”
Very enthused about: "The increased attention to patient and workforce safety. It’s previously been taken for granted. We didn't say it out loud. Now I hear more places leading with safety.”
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