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Dr. Thomasine Gorry

Dr. Gorry Promotes Quality and Safety at Scheie

Scheie Vision Winter 2014

The Scheie Eye Institute consistently evaluates the quality and safety of its medical services.  Dr. Thomasine Gorry, MD, serves as the Co-Chair of the Clinical Practices of the University of Pennsylvania Quality Domain (CPUP-QD) with Steven Smith, Chief Operating Officer at Penn Family Medicine. This committee has representation from the entire health system and seeks to create a culture of quality improvement and safety.    

Dr. Gorry has a strong background in the quality domain, having studied health policy and earned her Master’s Degree at Johns Hopkins before medical school.  It was the launch of the electronic medical system embedded in healthcare reform that reignited her interest in this work at UPenn in 2010.  

“I had envisioned that the electronic medical system would make everything so much cleaner and easier, but that was not the reality,” Dr. Gorry explained.  “The transition introduced a new dynamic, which if not given the appropriate attention, can lead to mistakes or detract from the patient-physician patient interaction.  I started thinking: what makes this different, and how can I make it better?”

Today, doctors, nurses, administrators, information technology experts, and quality leaders comprise the Quality Domain and work towards one goal: improving quality care for patients.  The committee has worked to create a database of quality projects conducted at UPenn, to improve the integration of technology with clinical and managerial practice, and to educate all departments on this work.  The current focus of CPUP-QD is the ambulatory arena, which is currently a less well-developed quality arena, relative to inpatient quality world. 

“With inpatient care, the patient is immobile and in one bed, and everyone comes to the patient with a discrete task,” explained Dr. Gorry.  “But with ambulatory care, everything is different.  The patient is a moving target.  Just consider the sheer number of visits – Penn has more than 2 million outpatient visits per year.”  

How does one concretely analyze quality in the outpatient arena?  

“The committee is first trying to identify what a wide variety of departments are doing, by analyzing what works and what does not,” said Dr. Gorry.  “For example, the Dermatology Department has an outstanding way to manage urgent consults.  If we could bring that to our Department and others, I think it would improve access and quality.  The same may apply to other similar departments.  This sharing of best practices avoids each department starting from scratch and making the same mistakes.”  

Technology has radically changed medical care in the past decade, making it the first issue that Dr. Gorry tackled as CPUP’s Clinical Operations Quality Domain Chair.  She invited people who represent electronic medical records (EMR) to meetings.  Now, when the committee envisions a new idea, those skilled with EMR can respond with what can and cannot be realistically done.  

“Healthcare technology is evolving, but it should never distract from medical decision making,” Dr. Gorry said.  “Some fear that people will rely on technology and will replace thoughtful consideration of the problem and the unique patient features.  That’s not where we are going with this.  We are not arguing that medical care should be replaced with technology, but that it should be supported by technology.”  

One example of a program that uses technology to advance medical care is “Decision to Incision,” an efficient program developed by Dr. Gorry for enrollment in cataract surgery at Scheie.  

“The system gives you a check-list, so if you didn’t think about a certain issue in cataract surgery, it prompts you,” Dr. Gorry said.  “This is an example of a good use of technology, and it could be adopted by any surgical department.”    

Dr. Gorry encourages all physicians to attempt to engage in defining medical quality in a concrete way.

“It’s a really exciting time to be in medicine,” she concluded.  “It’s important that we, on the front lines, who care deeply for our patients, add our thoughts before someone else restructures medicine.

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