Jefferson Surgical Solutions


Under the direction of Vice Chair for Quality, Dr. Scott Cowan (center), current quality and safety initiatives in the department are managed by former Quality & Safety fellow Adam Johnson, MD, current Quality & Safety fellows Megan Lundgren, MD, and Kulvir Nandra, MD (not pictured), and surgical clinical reviewers Kathleen Shindle, RN, BSN, and Christine Schleider, RN, BSN.

Championing quality and safety is an institutional commitment and a critical part of day-to-day operations in the Department of Surgery. Scott Cowan, MD, FACS, Vice Chair for Quality in the Department, shares an update on current initiatives.

Fellowship research underway

In 2015, the Department launched a Quality & Safety Fellowship Program, with inaugural fellow, Adam Johnson, MD, conducting outcomes research for the Department and the hospital.

“In July 2017, Kulvir Nandra, MD, and Megan Lundgren, MD, began their one year terms as Quality & Safety Fellows,” Dr. Cowan says. “Dr. Nandra is focusing on telemedicine and patient ambulation, while Dr. Lundgren is concentrating on professionalism and on increasing the efficiency and feedback process of our error reporting system.”

The fellowship program offers surgical residents the opportunity to develop and implement quality and safety projects while earning a Certificate in Quality and Safety through the Thomas Jefferson University School of Population Health. The program was made possible through the generosity of a grateful patient, Tom Wiener, and his late wife, Felice.

“I am Patient Safety” Award

In 2015, Dr. Cowan and the general surgery residents initiated Quality Based Initiatives Research Teams (QBIRTs) to improve aspects of surgical quality, including reducing post-surgical re-intubation, decreasing surgical site infections in colorectal surgery patients and improving the process of patient information handoffs. This team-based method empowers residents to identify opportunities, design interventions and implement changes quickly and effectively. Earlier this year, the Pennsylvania Patient Safety Authority recognized Jefferson’s QBIRT program with the “I am Patient Safety” award. Jefferson’s program was one of 13 winners selected from more than 180 nominations.

Clinical reviews and education

Dr. Cowan also lauds Christine Schneider, RN, BSN, CNOR, and Kathleen Shindle, RN, BSN, CCDS, CDIP, for their work as surgical clinical reviewers (SCRs) for the Department of Surgery American College of Surgeons’ National Surgical Quality Improvement Program® (ACS NSQIP®). They regularly review patient charts, record data and follow up with patients about their progress, recovery and any complications from the time of surgery to 30 days post-op.

In addition to their roles as SCRs, Christine and Kathleen have been instrumental in promoting the iCough program—an initiative aimed at reducing pulmonary complications among surgical patients. As Christine explains, “We are actively involved in educating patients and providers about the importance of ambulation, using the incentive spirometer and other interventions to help prevent respiratory complications after surgery.”

The Surgical Quality and Safety team is inspired by the growing collaboration across Jefferson, Abington and Aria. Dr. Cowan explains, “We have some truly innovative teams working together to implement thoughtful improvements and provide the highest quality care for our patients. It’s a very exciting time!”