Mapping Healthcare Podcast: Global Healthcare Improvement Lessons

Dr. Ulfat Shaikh, Physician and Healthcare Quality Improvement Advisor
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Mapping Healthcare is a radio show and podcast where a medic with a map explores ways in which people around the globe improve the world of healthcare and what we can learn from them. Join us to explore healthcare improvement, health system innovation, and lessons from healthcare leaders around the world. Mapping Healthcare is the winner of the: 2025 Peter and Marion London Global Learning Expansion Grant, University of California Davis Global Affairs 2026 eHealthcare Leadership Awards, Platinum Award for Best Healthcare Podcast About your host: Dr. Ulfat Shaikh is a physician, medical educator, and researcher who leads programs to help health systems deliver high-quality healthcare. She is a pediatrician and professor at the University of California Davis, past Chair of the American Academy of Pediatrics' Council on Quality Improvement and Patient Safety, and a board member of the International Society for Quality in Healthcare. Dr. Shaikh has been a practicing pediatrician for 26 years and has a Doctor of Medicine, master’s in public health, master’s in clinical research, and is a fellow of the American Academy of Pediatrics.

  1. Oct 24

    44. Beyond Projects: Scaling Improvement Across England's NHS from East London

    A hospital team launches a promising healthcare quality improvement project, achieves great short-term wins, but as soon as the pilot ends or the champion leaves, momentum vanishes. Why do so many healthcare quality improvement projects stall after initial success? In this episode, Amar Shah helps us explore how health systems can move beyond isolated projects to build continuous improvement systems at scale. We trace the evolution of healthcare quality, from early inspection models, the Theory of Bad Apples, and the trap of projectitis, to building learning health systems across complex health networks. References: Baker GR. The Roles of Leaders in High-Performing Health Care Systems. The King's Fund; 2011.Batalden PB, Davidoff F. What is "quality improvement" and how can it transform healthcare? Qual Saf Health Care. 2007;16(1):2-3.Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med. 1989;320(1):53-56.Dixon-Woods M, Bosk CL, Aveling EL, Goeschel CA, Pronovost PJ. Explaining Michigan: developing an ex post theory of a quality improvement program. Milbank Q. 2011;89(2):167-205.Dixon-Woods M, McNicol S, Martin G. Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature. BMJ Qual Saf. 2012;21(10):876-884.Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966;44(3 Pt 2):166-203.Kaplan HC, Provost LP, Froehle CM, Margolis PA. The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement. BMJ Qual Saf. 2012;21(1):13-20.Lukas CV, Holmes SK, Cohen AB, Restuccia J, Cramer IE, Shwartz M, Charns MP. Transformational change in health care systems: an organizational model. Health Care Manage Rev. 2007;32(4):309-320.McCannon CJ, Berwick DM, Massoud MR. The science of large-scale change in global health. JAMA. 2007;298(16):1937-1939.Williams DM, Norman CL, Provost LP. Quality as an organizational strategy: building a system of improvement. Front Health Serv. 2026;6:1726688.

    44. Beyond Projects: Scaling Improvement Across England's NHS from East London

  2. Oct 10

    43. Beyond a Seal of Approval: Modernizing Healthcare Accreditation from Tennessee

    From the midnight burning of substandard survey records in 1919 to today’s digital health revolution, healthcare accreditation has shaped patient safety for a century. In this episode, we explore how rigid, box-checking audits are transforming into continuous, technology-driven quality improvement systems. Ken Grubbs and I break down why modernizing accreditation matters, how real-time data cuts administrative burnout, and what the future holds for patient-centered care. Tune in to discover how evolving clinical standards are improving healthcare from the bedside to the boardroom. References: Greenfield D, Braithwaite J. Health sector accreditation research: a systematic review. Int J Qual Health Care. 2008;20(3):172-183.Greenfield D, Pawsey M, Braithwaite J. What motivates professionals to engage in the accreditation of healthcare organizations? Int J Qual Health Care. 2011;23(1):8-14.Greenfield D, Pawsey M, Hinchcliff R, Moldovan M, Braithwaite J. The standard of healthcare accreditation standards: a review of empirical research underpinning their development and impact. BMC Health Serv Res. 2012;12:329.Hinchcliff R. Advancing the accreditation economy: a critical reflection. Int J Qual Health Care. 2021;33(4):mzab154.Hussein M, Pavlova M, Ghalwash M, Groot W. The impact of hospital accreditation on the quality of healthcare: a systematic literature review. BMC Health Serv Res. 2021;21(1):1057.Nicklin W, Engel C, Stewart J. Accreditation in 2030. Int J Qual Health Care. 2021;33(1):mzaa156.Patel R, Benson I, Engel C, O’Connor E, Braithwaite J. An AI-supported synthesis of the healthcare accreditation and standards literature. Volume 1: All literature available accessed from the start of the PubMed database to 31st December 2023. Australian Institute of Health Innovation, Macquarie University; 2025.Roberts JS, Coale JG, Redman RR. A history of the Joint Commission on Accreditation of Hospitals. JAMA. 1987;258(7):936-940. doi:10.1001/jama.1987.03400070074039World Health Organization. Health Care Accreditation and Quality of Care: Exploring the Role of Accreditation and External Evaluation of Health Care Facilities and Organizations. World Health Organization; 2022.

    43. Beyond a Seal of Approval: Modernizing Healthcare Accreditation from Tennessee

  3. Sep 26

    42. I-PASS Explained: Improving Clinical Handoffs from Philadelphia

    What happens when a patient’s care is transferred from one clinician to another? In this episode, UC Davis medical students Ian Marquez, Nicholas Le, and Marco Oliveras explore I-PASS, a structured approach to safer, clearer clinical handoffs. They speak with Daniel West who explains how I-PASS helps healthcare teams build a shared mental model and communicate reliably under pressure. Their conversation examines communication failures, culture change, and the future of safer, more reliable healthcare. Discover how better clinical handoffs are a critical patient safety intervention. References DeRienzo CM, Frush K, Barfield ME, et al. Handoffs in the era of duty hours reform: a focused review and strategy to address changes in the Accreditation Council for Graduate Medical Education Common Program Requirements. Acad Med. 2012;87(4):403-410.Franco Vega MC, Ait Aiss M, Smith M, et al. Improving handoff with the implementation of I-PASS at a tertiary oncology hospital. BMJ Open Qual. 2023;12(4):e002481.Huber A, Moyano B, Blondon K. Secondary analysis of hand-offs in internal medicine using the I-PASS mnemonic. BMC Med Educ. 2024;24(1):1046.Khan A, Spector ND, Baird JD, et al. Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ. 2018;363:k4764.Shahian DM. I-PASS handover system: a decade of evidence demands action. BMJ Qual Saf. 2021;30(10):769-774.Sheng J, Manjunath S, Michael M, et al. Integrating handover curricula in medical school. Clin Teach. 2020;17(6):661-668.Soares DRA, Rodrigues D, Carmona F. Implementation of a standardized handoff system (I-PASS) in a tertiary care pediatric hospital. Rev Paul Pediatr. 2023;41:e2022123.Starmer AJ, Spector ND, O'Toole JK, et al. Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study. J Hosp Med. 2023;18(1):5-14.Starmer AJ, Spector ND, Srivastava R, Allen AD, Landrigan CP, Sectish TC; I-PASS Study Group. I-PASS, a mnemonic to standardize verbal handoffs. Pediatrics. 2012;129(2):201-204.Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803-1812.

    42. I-PASS Explained: Improving Clinical Handoffs from Philadelphia

  4. Sep 19

    41. Less is More: Preventing Medical Overuse from Salt Lake City

    Healthcare bills in the United States contribute to over half of all personal bankruptcies, and unneeded care is a major driver. In low- and middle-income countries, the impact is even more severe. More healthcare isn’t always better medicine. In this episode, we look at the diagnostic cascade and the problem of medical overuse. Brent James helps us explore how over-testing and overdiagnosis compromise patient safety and drive healthcare waste, and how innovative systems pioneer clinical stewardship. Discover why less is more through shared decision-making and learn how we can start choosing wisely. References: Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516.Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world. Lancet. 2017;390:156-168.Cassel CK, Guest JA. Choosing Wisely: helping physicians and patients make smart decisions about their care. JAMA. 2012;307(17):1801-1802.Chassin MR, Galvin RW; National Roundtable on Health Care Quality. The urgent need to improve health care quality. JAMA. 1998;280(11):1000-1005.Elshaug AG, Rosenthal MB, Lavis JN, et al. Levers for addressing medical underuse and overuse: achieving high-value health care. Lancet. 2017;390:191-202.Morgan DJ, Dhruva SS, Wright SM, Korenstein D. 2016 update on medical overuse: a systematic review. JAMA Intern Med. 2016;176(11):1687-1692.Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ. 2012;344:e3502.Müskens JLJM, Kool RB, van Dulmen SA, Westert GP. Overuse of diagnostic testing in healthcare: a systematic review. BMJ Qual Saf. 2022;31:54-63.Oakes AH, Radomski TR. Reducing low-value care and improving health care value. JAMA. 2021;325(17):1715-1716.Segal JB, Sen AP, Glanzberg-Krainin E, Hutfless S. Factors associated with overuse of health care within US health systems: a cross-sectional analysis of Medicare beneficiaries from 2016 to 2018. JAMA Health Forum. 2022;3(1):e214543

    41. Less is More: Preventing Medical Overuse from Salt Lake City

  5. Aug 29

    40. Narrative Medicine and the Power of Story from Northern California

    Science tells us what the disease is, but the story tells us what the illness means to the person living it. We explore the field of narrative medicine, where healthcare meets humanity. This episode reveals how storytelling isn’t just an art. It’s a biological necessity that releases oxytocin and fosters deep empathy. Rebecca George and I discuss how narrative medicine evolved and provide practical tools to build resilience and combat burnout. Whether you're a clinician or a patient, learn how embracing “data with a soul” can bridge divides and transform clinical care into a collaborative journey of healing. Link to Medicine Story's website: https://medicinestory.org References: Charon R. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286(15):1897-1902.Hurwitz B, Bates V. The roots and ramifications of narrative in modern medicine. In: Whitehead A, Woods A, eds. The Edinburgh Companion to the Critical Medical Humanities. Edinburgh University Press; 2016:560-576.Loy M, Kowalsky R. Narrative medicine: the power of shared stories to enhance inclusive clinical care, clinician well-being, and medical education. Perm J. 2024;28:23.116.Olson ME, Smith ML, Muhar A, Paul TK, Trappey BE. The strength of our stories: a qualitative analysis of a multi-institutional GME storytelling event. Med Educ Online. 2021;26(1):1929798.Palla I, Turchetti G, Polvani S. Narrative medicine: theory, clinical practice and education - a scoping review. BMC Health Serv Res. 2024;24(1):1116.Remein CD, Childs E, Pasco JC, et al. Evaluation of narrative medicine programs in academic medicine: a systematic review. BMJ Open. 2020;10(1):e031568.Zak PJ. Why inspiring stories make us react: the neuroscience of narrative. Cerebrum. 2015;2015:2.

    40. Narrative Medicine and the Power of Story from Northern California

  6. Aug 15

    39. A Labor of Love: Delivering Free Maternity Care in Kenya

    Explore the transformative journey of Kenya’s free maternity care policy. We trace the policy’s evolution from the historic 2013 presidential directive to the modern Linda Jamii program. Why did hospital deliveries surge by nearly 100% while frontline clinicians and healthcare staff faced near collapse conditions? From delays in hospital reimbursements to the hard reality of bed-sharing, Lydia Okutoyi and I discuss the implementation gaps behind the well-meaning promise. Our look at maternal health and Universal Health Coverage has lessons for policymakers, healthcare leaders, and the public. References: Lang’at E, Mwanri L, Temmerman M. Effects of implementing free maternity service policy in Kenya: an interrupted time series analysis. BMC Health Serv Res. 2019;19:645. doi:10.1186/s12913-019-4462-xMusee CM, Mweu JM, Okutoyi L. Perceptions of Healthcare Providers on Quality of Services and Their Satisfaction During Implementation of Free Maternity Services Policy in a National Referral Hospital, Kenya. East Afr J Health Sci. 2025;8(2):134-148. doi:10.37284/eajhs.8.2.3306Orangi S, Kairu A, Malla L, et al. Impact of free maternity policies in Kenya: an interrupted time-series analysis. BMJ Glob Health. 2021;6(6):e003649. doi:10.1136/bmjgh-2020-003649Oyugi B, Audi-Poquillon Z, Kendall S, Peckham S. Examining the quality of care across the continuum of maternal care (antenatal, perinatal and postnatal care) under the expanded free maternity policy (Linda Mama Policy) in Kenya: a mixed-methods study. BMJ Open. 2024;14(5):e082011. doi:10.1136/bmjopen-2023-082011Oyugi B, Audi-Poquillon Z, Kendall S, Peckham S, Barasa E. Policy formulation and actor roles in the expanded Kenyan free maternity policy (Linda Mama): A policy analysis. PLOS Glob Public Health. 2024;4(11):e0002796. doi:10.1371/journal.pgph.0002796Pyone T, Smith H, van den Broek N. Implementation of the free maternity services policy and its implications for health system governance in Kenya. BMJ Glob Health. 2017;2(4):e000249. doi:10.1136/bmjgh-2016-000249Tama E, Molyneux S, Waweru E, et al. Examining the implementation of the free maternity services policy in Kenya: a mixed methods process evaluation. Int J Health Policy Manag. 2018;7(7):603-613. doi:10.15171/ijhpm.2017.135

    39. A Labor of Love: Delivering Free Maternity Care in Kenya

  7. Jul 25

    38. The Words We Wear: Clarifying Professional Identity in Healthcare from Vermont

    Is your job title just a label or a signal of trust? In this episode, we go beyond the word "provider" to explore the ethics of naming in modern medicine. From the 1965 Medicare origins of the "P-word" to the complex journey of Professional Identity Formation, we discuss how titles like Physician, Nurse Practitioner, and Physician Assistant shape team-based care and the therapeutic relationship. Jan Carney tells us how the ethics of names and labels can change healthcare from a commercial transaction back into a human calling. Discover why clarity is a form of kindness for patients and why reclaiming professional identities is vital for clinician wellbeing and resilience. References: Beasley JW, Roberts RG, Goroll AH. Promoting trust and morale by changing how the word provider is used: encouraging specificity and transparency. JAMA. 2021;325(23):2343-2344.Sulmasy LS, Carney JK; ACP Ethics, Professionalism and Human Rights Committee. Physicians are not providers: the ethical significance of names in health care: a policy paper from the American College of Physicians. Ann Intern Med. 2026;179:556-558.Cornett M, Palermo C, Ash S. Professional identity research in the health professions—a scoping review. Adv Health Sci Educ Theory Pract. 2023;28:589-642.Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. Reframing medical education to support professional identity formation. Acad Med. 2014;89(11):1446-1451.Goroll AH. Eliminating the term primary care “provider”: consequences of language for the future of primary care. JAMA. 2016;315(17):1833-1834. doi:10.1001/jama.2016.2329Mangione S, Mandell BF, Post SG. The language game: we are physicians, not providers. Am J Med. 2021;134(12):1444-1446.Mayer M, Newton D. Primary care “provider” and professional identity [letter]. JAMA. 2016;316(13):1411-1412.Monrouxe LV. Identity, identification and medical education: why should we care? Med Educ. 2010;44(1):40-49.Sternszus R, Steinert Y, Razack S, et al. Being, becoming, and belonging: reconceptualizing professional identity formation in medicine. Front Med (Lausanne). 2024;11:1438082.Wald HS. Professional identity (trans)formation in medical education: reflection, relationship, resilience. Acad Med. 2015;90(6):701-706.

    38. The Words We Wear: Clarifying Professional Identity in Healthcare from Vermont

  8. Jul 11

    37. Minding the Leadership Communication Gap in Healthcare from São Paulo

    We invest millions in health technology, redesign workflows, and publish protocols grounded in the best available evidence. Yet many healthcare improvement efforts stall or never fully take hold. Not because the idea was wrong, but because the message didn’t land. Camilla Covello shares how somewhere between the boardroom and the bedside, communication breaks down and frontline teams are left to interpret change on their own. We explore communication gaps in healthcare leadership, what the evidence tells us about why healthcare improvement fails, and how we can get it right. References: Edmondson AC. Psychological Safety and Learning Behavior in Work Teams. Admin Sci Q. 1999;44(2):350-383.Frankel A, Graydon-Baker E, Neppl C, et al. Patient Safety Leadership WalkRounds. Jt Comm J Qual Saf. 2003;29(1):16-26.Ginsburg L, Easterbrook A, Geerts A, et al. ‘We listened and supported and depended on each other’: a qualitative study of how leadership influences implementation of QI interventions. BMJ Qual Saf. 2025;34(2):146-156.Singh A, Yeravdekar R, Jadhav S. Investigating the influence of selected leadership styles on patient safety and quality of care: a systematic review and meta-analysis. BMJ Leader. 2024;8(4):208-214.Tawfik DS, Adair KC, Palassof S, et al. Leadership Behavior Associations with Domains of Safety Culture, Engagement, and Health Care Worker Well-Being. Jt Comm J Qual Patient Saf. 2023;49(3):156-165.

    37. Minding the Leadership Communication Gap in Healthcare from São Paulo
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About

Mapping Healthcare is a radio show and podcast where a medic with a map explores ways in which people around the globe improve the world of healthcare and what we can learn from them. Join us to explore healthcare improvement, health system innovation, and lessons from healthcare leaders around the world. Mapping Healthcare is the winner of the: 2025 Peter and Marion London Global Learning Expansion Grant, University of California Davis Global Affairs 2026 eHealthcare Leadership Awards, Platinum Award for Best Healthcare Podcast About your host: Dr. Ulfat Shaikh is a physician, medical educator, and researcher who leads programs to help health systems deliver high-quality healthcare. She is a pediatrician and professor at the University of California Davis, past Chair of the American Academy of Pediatrics' Council on Quality Improvement and Patient Safety, and a board member of the International Society for Quality in Healthcare. Dr. Shaikh has been a practicing pediatrician for 26 years and has a Doctor of Medicine, master’s in public health, master’s in clinical research, and is a fellow of the American Academy of Pediatrics.

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