Herb Diamond, MD

Dr. Herb Diamond volunteers as a member of VIM’s Quality Assurance Committee.

Quality Assurance (QA) is “the systematic monitoring and evaluation of the various aspects of a project, service, or facility to ensure that standards of quality are being met.”  It is an ongoing part of any organization that delivers healthcare.

Dr. Diamond recently spoke to FACES of VIM Editor Tricia Bevan.

What is your background? “I’m a rheumatologist.  I was originally in academia, starting out as a researcher.  As time went along I became more and more involved in administration.  I was a division chief at SUNY Brooklyn for some years – a very large hospital.  From there I was recruited to Long Island Jewish Hospital as Chair of Medicine, and later held that same position at West End Allegheny Hospital in Pittsburgh.  I then joined the staff at West Penn for 19 years…and lived in Pittsburgh until I retired.  For the first four years of my retirement I was Professor of Medicine at the University of Pittsburgh, then we moved back to New York, and eventually up into the Berkshires where we bought a house in 2012 – and we love it here.”

Tell me about VIM’s Q.A. Committee:

“It is more than Quality Assurance – it goes way beyond that – it is quality improvement.  VIM has always been concerned about quality.  What the QA committee has done is to create a more formal structure. Within that structure there are board members, staff, clinicians, and volunteers who know what needs to be done. The Committee reports directly to the board. Because of my previous administrative experience, I had knowledge and interest in this field.

The committee has embarked on a wide variety of initiatives…each year we establish goals that we plan to accomplish. For instance, we have developed a set of policies and procedures for starting new programs; a reorganization of dentistry staff; and put a revised triage system for telephone calls in place. We are in the process of updating the policy and procedure manual and improving error reporting.

Meeting Federal and State regulations is a minimum.  Having met those standards allows us to be much more focused on continued improvement with the goal of providing the highest quality of medical care in the most efficient and cost-effective way.

The staff has been very positive about any changes recommended by the QA Committee.  They have really taken all improvements on with tremendous enthusiasm, and as a result we are making major progress. The Board has been extremely supportive too, taking a very active role in making this happen.

We are a young organization and have grown tremendously over a relatively short period of time – the physical plant has grown, the number of volunteers and programs has also grown.  New programs – for instance the Shared Medical Appointments – have made for a more complex organization. As you become more complex, you need to develop governance structures and more sophisticated systems to ensure a smoothly functioning organization.  We have concentrated on defining the needs of the population we serve and then developing services they require.   I’m focused right now on how we perfect what we are doing.

We are developing more formal ways of getting feedback…we need to know if patients feel we have done something wrong.  If so, we want them to let us know that, either anonymously or otherwise, so we can work on making improvements. We will eventually have more formal patient satisfaction surveys in place, and that will help us to identify gaps in service. We get lots of positive feedback from patients, but we want negative feedback, too! We want to be told when we’re not doing something right, because that’s the only way we can improve.”

What led you to VIM?  “I became involved with VIM about a year and a half ago when they were looking for a Medical Director – but because I am only here part-time, I thought it was too much to take on. I told them: ‘I won’t take on the whole job, I’ll take on about half of the administrative side of things.’  We now have a Medical Director – and a superb one at that – so I focus more on the quality side of things…our goal is to see that this clinic continues to be a terrific organization.”

How would you describe your successes and your challenges?   “We have implemented new electronic medical records in medicine, and for the first time, in dentistry.  This is a tremendous improvement.  We have new procedures for tracking outside appointments and lab tests that are more efficient than the methods used in the past.

A couple of the things that make a place like this more difficult to manage are the transient lives of some of our patients, and the fact that most of our volunteers are part-time.  We’ve structured the program so that our Medical Services Director is always available for follow-up.

VIM is made up of volunteers who have a lot of enthusiasm – people are doing this not because it’s a job, but because they want to do it. VIM has a very strongly motivated staff – and that makes it easier.  The most important thing to understand is that this is a high quality organization that is interested in continually improving, and that we have a dedicated group of people working specifically on how to make this organization better.

I think patients in general are extremely happy and satisfied with the care they receive and the way they are treated at VIM… the most positive thing is that we are providing care for people who would otherwise be without it.”

“Quality is never an accident.  It is always the result of intelligent effort.”

John Ruskin