As the Chief Medical Officer at Yale New Haven Hospital, my position relates to two overriding goals of the institution.
The first is responsibility to make our care as safe as humanly possible and to create a milieu where patient outcomes are the best imaginable. The second is to ensure that our 90-some residencies and fellowships provide professional training worthy of the status of this great medical center. And these two goals are highly interdependent.
YNHH provides outstanding patient care, and there is considerable evidence supporting that claim. As published on the Internet by Medicare, for example, mortality of our patients with myocardial infarction, heart failure and pneumonia is significantly lower than national averages; fewer than 20 U.S. hospitals have comparable cumulative outcomes. The Institute for Healthcare Improvement, moreover, has looked at trends of our observed overall risk-adjusted hospital mortality and compared it, year over year, with expected mortality. Again, we distinguish ourselves.
There are many other attributes of YNHH worthy of mention. Nursing care is superb: We are one of only two hospitals in Connecticut designated a Magnet Hospital by the American Nurses Credentialing Center. The level of hand hygiene compliance at YNHH, regularly exceeding 90 percent, is unachievable in most U.S. hospitals. We have participated for several years in the National Surgical Quality Improvement Program (NSQIP) and have executed focused programs to improve surgical outcomes. Our GME trainees have been immersed in these and many other efforts, learning first-hand how organizations systematically improve their safety and clinical outcomes.
Our residents and fellows are directly involved in the care of the majority of our patients, so they have enormous impact on the outcomes. There is a maxim held by all academic medical centers: "As go the residencies, so go the clinical services." When residents are enthusiastic, caring, communicative and feel integral to care teams, things go well. When residents feel supported and believe their clinical service is matched by the educational benefit of their experiences, that is reflected in the diligence and accountability they bring to their work. Most critically, when residents know their attending faculty is fully available to them — overseeing their care, dedicated to their training and welfare, and committed to their development as specialists and subspecialists — residents bring this same level of commitment to the care of our patients.
Be assured, the YNHH culture is collegial, supportive and intolerant of abusive and mean-spirited behavior. Our rules and regulations embody a code of conduct that clearly stipulates the consequences of aggressive and disruptive actions. Residents and fellows at YNHH are respected and valued, and together with Yale medical students are at the heart of this academic medical center. I remain dedicated to ensuring that our current trainees will enjoy a similar occurrence.
