Q&A with Margaret Flanagan, LMSW

Margaret Flanagan doesn’t like the spotlight. But in her roles as Disability Assistance Project Manager to Director of Compliance, her service over 13 years has been critical to securing critical funding, becoming statewide leaders in SOAR, maintaining Joint Commission accreditation and National Commission on Quality Assurance recognition, improving safety practices, and keeping our clinics open during the global pandemic. Now, with her recent promotion to Senior Director, Margaret has big plans for Quality Assurance in 2022.

After 13 years here, what keeps you so dedicated to your work?

Working at Health Care for the Homeless has been a transformative time. I honestly cannot imagine working anywhere else (partially because I haven’t!). The people who work here are tremendous. The amount of care and passion that goes into the work, and our joint efforts to provide high-quality care and end homelessness, keeps me engaged.

How have you seen the role of quality assurance evolve during your time at the agency? How has it changed as a result of the pandemic?

When I first started, we only had a Performance Improvement Director. No compliance, population health, or quality assurance teams existed! Watching our agency grow these teams has been so exciting. It stems from several factors: our desire to provide the best care possible, our desire to transform and maintain our patient-centered medical home status, and ultimately our commitment to improve our systems. It is exciting to watch a team of one grow into a team of seven. We have been able to focus on patient and staff safety, risk management, incident reporting, and so much more. It has been fun to help build up those teams and systems—and learn from everyone around me.  

In this new role of Senior Director of Quality Assurance, you now oversee Performance Improvement in addition to Compliance and Public Grants. What benefits or opportunities do you see resulting from that  integration? 

I’m excited to see how we can integrate our quality work, including how we use data to drive changes, identify opportunities for improvement, and collaborate to improve our systems. That means thinking through how we conduct and use our client experience data, identify risk management goals and how those overlap with performance improvement. From there we can focus on improving our quality indicators and optimizing our systems. It’s a deeply collaborative process, and its important that we continue to communicate closely with the departments actually doing the work! We also use root cause analysis to identify system failures, so we can do better as an agency to improve and reduce the likelihood of an issue happening again. This includes areas such as referrals and training on emergency procedures (such as code blue).

How is racial equity and inclusion shaping the goals of the department?

I want to ensure that REI is involved at every step of the process, including how we identify, set, and approach our goals. The Quality department is a data heavy area! Data is so important to so many elements of the work. This includes how we gather and present it. When we visualize data, we want to include demographic information, so that we can more closely track and address disparities. This year we are really trying to figure out how to visualize data in a meaningful way. The new health disparities dashboard is a good example; it is helping lay the foundation for new performance improvement measures that can be even more intentional and informed. We are also spending time thinking about how to better approach policies and procedures. For example, how do we get more staff input on certain procedures, and what questions should we be asking from a REI perspective to ensure our procedures are equitable and inclusive? We are also thinking about how we capture incident reporting data, and how incidents impact different staff. It is work that is long overdue and will only improve our quality programs.

What are the primary projects or goals for the Quality Assurance division this year?

It is a long list! Each department focuses on different goals and priorities that drive the work. For grants, we have our HRSA competitive grant renewal, which is our largest grant and what makes us a Federally Qualified Health Center. We are focused on maintaining that funding! For compliance, we are focusing on our risk management plan, our medical malpractice renewal application, and our annual renewals for the National Commitee of Quality Assurance (NCQA), which is our patient-centered medical home recognition. We are also focused on improving compliance-related communication with our compliance corner on the portal, and by doing more on-the-ground initiatives such as patient safety week. For PI, we are focusing on the hitting the goals in our 2022 PI goals and growing a culture of quality and safety. This includes changing the way we conduct our client experience survey, moving towards real-time feedback that we can act on more swiftly. We hope this helps to increase client voice in our services, and address client feedback in a more comprehensive way.

For population health, we are focusing on re-establishing registries, preventive screenings and chronic disease management, and awareness campaigns throughout the year. We are also learning more about value-based care programs, which can provide some incentives for the wonderful work already happening to improve quality of care. REI is going to look different across different departments and projects. Our first step is to make sure that in everything we do, we are actively incorporating REI in ways that are tailored and appropriate for each department.

What helps you find balance outside of work?

My family and son. He is almost one and makes my whole heart happy. I am really looking forward to summer fun with him. I also love to run, which helps to reduce stress and brings me joy!

Extend a warm congrats to Margaret next time you see her!