By: Carla Pugh, MD, PhD, FACS
Dr. Pugh was the inaugural fellow for The Joint Commission’s President’s Fellowship for Healthcare Quality and Safety, a prestigious program for a highly qualified healthcare professional to collaborate with The Joint Commission to advance healthcare outcomes globally.
When I was first inaugurated into The Joint Commission’s President’s Fellowship for Healthcare Quality and Safety, my primary goal was simple: to learn. While other physicians may enter with plans to lead a specific initiative or bring sweeping changes, my approach was different. I came in with an open mind, ready to explore how this influential organization transforms its mission of improving healthcare quality for all into tangible outcomes for hospitals and patients worldwide.
Given my background in data science, artificial intelligence and metrics research, I was particularly curious about how these areas intersect with The Joint Commission’s work. This fellowship provided not only an opportunity for my professional growth but also a chance to explore the intricacies of healthcare systems around the world, accreditation standards and the processes that drive institutional excellence.
Collaborating to Improve Patient Safety and Quality of Care
Early in the fellowship, I engaged in conversations with leaders at the American College of Surgeons (ACS), which is also devoted to improving patient safety and quality of care. We explored potential synergies between our two organizations to advance our missions and drive institutional excellence.
I also collaborated with Joint Commission teams to explore the potential of video-based assessments in operating rooms. The goal was to integrate video recordings, patient vitals and team communications into a single system, providing immediate insights and allowing for later analysis of surgical performance.
To kick off this project, we interviewed companies and health systems already using these technologies. Our aim was to understand their implementation strategies and the benefits they were experiencing.
Through our interviews, we discovered that this technology has the potential to significantly improve surgery quality and operating room efficiency. For example, predictive analytics could evaluate the complexity of a surgery, helping teams adjust schedules, prepare equipment and allocate staff more effectively. Video data combined with patient vitals could guide surgeons during procedures by highlighting unusual patterns or suggesting alternative techniques based on past cases. Additionally, these tools could inform new certification standards, fostering continuous improvement. While the project is still in its early stages, its implications are profound.
Reflecting on the Fellowship Journey
For me, this fellowship has been invaluable, not just for what I learned but for how I learned it—by immersing myself in the organization and working alongside the teams who drive its mission forward. It’s one thing to read about accreditation, certification and quality improvement, but it’s entirely different to witness firsthand the collaboration, care and thoughtfulness that go into shaping these processes. Through my time as a fellow, I have been equipped with new perspectives that I’m confident I will bring to future clinical work.
For those stepping into this role, I’d suggest treating this fellowship as an invitation to explore, to challenge and to reimagine how you approach the work of creating better systems and outcomes. The true takeaway from this experience is a renewed commitment to understanding and improving the systems that impact care on every level.
Carla Pugh, MD, PhD, FACS, is the Thomas Krummel Professor of Surgery at Stanford University and Director of the T.E.C.I. Center. Specializing in Acute Care Surgery, her research employs cutting-edge technologies to redefine clinical skill assessment. Dr. Pugh holds several recognitions. In 2011 she was awarded the Presidential Early Career Award and in 2021 she was inducted into the National Academy of Medicine, making her a leading figure in medical innovation.