The Exec: New CMO of Lifepoint Health Focused on Quality Care

The core elements of promoting quality care include three things, says this CMO.

Quality care is going to be a primary focus of the new CMO of Lifepoint Health.

Last month, Chris Frost, MD, was named senior vice president, chief medical officer, and chief quality officer of Lifepoint. He has served in two other leadership roles at the Brentwood, Tennessee-based health system: chief medical officer of Lifepoint Communities and national medical director of hospital-based services.

Frost says the core elements of promoting quality care include three things: a leadership component, a process improvement component, and a culture of safety.

“Those are the framework components of our Lifepoint National Quality Program,” Frost says.

The leadership component includes the recognition of the importance of leadership in every aspect of the organization, according to Frost. It also includes engagement of all the quality stakeholders and an accountability process.

For process improvement, he says Lifepoint has a checklist of ten critical components for performance improvement such as huddles that clinical care teams use to focus on clinical workflows, learning whiteboards at every clinical care unit to identify opportunities for improvement, and tracking data that demonstrates progress or regress.

The culture of safety at Lifepoint includes the engagement of patients and their families as well as fostering an environment where all team members experience psychological safety and have a voice in the safety process, according to Frost.

Frost says the Lifepoint National Quality Program, which started in 2010 and is a combination of both quantitative and qualitative criteria, will be one of his main areas of attention.

“We have a deliberate focus on reduction of patient harms such as catheter-associated urinary tract infections and central line-associated bloodstream infections,” Frost says. “We have demonstrated significant progress since starting the national quality program, including a 65% reduction in our overall patient harms.”

Lifepoint has also recognized that there are external barometers of patient safety and quality of care such as The Leapfrog Group and Centers for Medicare & Medicaid Services Star Ratings, according to Frost.

“We have deliberately focused on integrating components of Leapfrog and CMS Stars into our national quality program,” Frost says. “The point is that quality and the definition of quality have tried and true components that you see year-over-year, but it is not a static process. It is a dynamic process that requires evolution.”

Chris Frost, MD, is senior vice president, chief medical officer, and chief quality officer at Lifepoint Health. Photo courtesy of Lifepoint Health.

Engaging a clinical staff

There are four facets of clinical staff engagement, according to Frost.

First, a CMO must make a deliberate effort to deconstruct historically hierarchical models of care, says Frost, who adds physicians have had an outsized influence in healthcare in the past.

“One of the success measures for engaging clinical staff is making sure that the definition of clinical staff is not limited to physicians,” Frost says. “It includes physicians, advanced practice providers, nurses, physical therapists, pharmacists, and other clinical professionals.”

Second, a CMO must leverage data and analytics, according to Frost.

“Data and analytics are related to the mantra of ‘that which can be measured can be managed,'” Frost says. “Analytics allow us to convert raw data into a clinically meaningful narrative—how data demonstrates how our clinical workflows impact our patients.”

Third, a CMO must manage quality-focused process improvement, according to Frost.

“You want to use a plan, do, study, act (PDSA) cycle,” Frost says.

Fourth, a CMO must engage in change management, according to Frost.

“For process improvement to take root and to be sustained, you must have clinicians and staff willing to do things differently,” Frost says. “Change management is the people side of change.”

Prepared to lead

Frost says his clinical background in internal medicine and pediatrics provides a solid foundation for working in the CMO role.

Combined internal medicine and pediatrics training is usually a four-year program. Physicians do two years of internal medicine training and two years of pediatrics training, then they are eligible to become board certified in both specialties.

“The training allowed me to understand the social and clinical needs of the patient population from cradle to grave,” Frost says.

Frost served as a hospitalist for nearly two decades, and he says his hospital medicine background is also beneficial in his new role.

“That experience has been incredibly helpful for the CMO role because I have an intimate understanding of the continuum of care of the patients,” Frost says, “from the ambulatory setting to the acute care setting, to the post-acute care setting.”

Challenge in Lifepoint markets

A key challenge at Lifepoint is serving nonurban communities, according to Frost.

“One aspect of Lifepoint’s mission to make our communities healthier is allowing community members in nonurban settings to access care close to home,” Frost says. “The challenge here includes physician recruitment and nurse recruitment.”

To address these challenges, Lifepoint has been leveraging telehealth as a way to have critical clinical services offered to nonurban community members, according to Frost, who adds the health system has established nurse residency programs as a way to help train and introduce nursing team members to nonurban communities.

Another important aspect of serving patients in nonurban communities is addressing social determinants of health, according to Frost.

“We have seized on partnership opportunities with community organizations to address social determinants of health,” Frost says. “This includes food insecurity, housing insecurity, and interpersonal safety. The health system is not necessarily positioned to address all social determinants of health, but partnerships with our community organizations have been meaningful work for our team members.”