Navigating Quality, Safety, and Leadership in Healthcare

Christina Huitt is the Senior Director of Quality & Patient Safety at CaroMont Health, bringing expertise in clinical performance improvement, system quality, patient safety, infection prevention, clinical documentation, and regulatory compliance within healthcare environments. Her background reflects a strong focus on system-wide quality initiatives and clinical outcomes.

Huitt’s responsibilities include overseeing patient safety and quality at a system level. She has oversight of all clinical outcomes and reporting requirements for CaroMont’s two hospitals, two Ambulatory Surgery Centers, all HOPD locations, and CaroMont Medical Group, which comprises more than 50 outpatient clinics.

A Career Dedicated to Excellence in Patient Care

My career in nursing began in 1997 as a bedside nurse in a medical-surgical unit. Over the following 15 years, I took on leadership roles in case management and home health care. For the past 12 years, I have been responsible for system-wide quality—overseeing inpatient and outpatient quality initiatives, infection prevention, and clinical documentation improvement. In the last three years, I have also assumed responsibility for patient safety in both inpatient and ambulatory settings at the system level.

I’ve spent nearly my entire career at CaroMont Health. I briefly left to work in home healthcare but quickly returned—it’s truly been a wonderful place to work. The organization has always treated its staff well, and I genuinely believe in our vision: to be our community’s most trusted healthcare partner.

Through our ongoing quality and safety initiatives, I believe we’re living out that vision every day, doing our best in an ever-evolving healthcare landscape. The coming years will certainly be interesting, especially with potential administrative shifts under new federal leadership. It’s important to observe how national-level changes impact the healthcare market and our work.

Resilience in Action

One of the most common challenges in healthcare is staffing, which impacts both quality and safety. Since the pandemic, when bedside nurses were in high demand, staffing has become a global challenge for hospital systems. On a positive note, we have a collaborative relationship between the nursing, infection prevention, and quality teams, which enables us to work efficiently while keeping the patient at the center of all we do.

Thanks to proactive measures—such as infection prevention rounding on units to monitor Foley catheters and central lines—we are able to prevent hospital-acquired infections and keep our patients safe. It’s truly through the collaboration of all hospital disciplines that we provide exceptional, safe care, as evidenced by our Leapfrog Patient Safety Grade A scores year after year.

“At caromont health, we ensure every patient receives safe, high-quality care through collaboration, accountability and a relentless commitment to doing what’s right—no matter the challenge”

For instance, in 2023, we experienced an uptick in Central Line-Associated Bloodstream Infections (CLABSIs) due to high acuity and census. Nevertheless, we leveraged our expertise in infection prevention to increase patient rounding across all units. We focused on ensuring that staff consistently monitored line removals, maintained central lines and Foley catheters properly, and used appropriate PPE and isolation precautions. As a result, we recorded two CLABSI throughout the entire calendar year 2024—a testament to the effectiveness of proactive risk mitigation.

At the Crossroads of Care

At the core of everything I do is a commitment to putting patients first and making their safety the top priority. This often requires quickly shifting focus when unexpected issues arise. Proactively responding to emerging patient safety concerns—and taking swift action on adverse and sentinel events—has become increasingly critical. We strive to consistently deliver safe, high-quality care while also aligning with regulatory requirements from CMS and The Joint Commission, which influence key clinical outcomes such as sepsis, hospital-acquired infections, and stroke measures.

Balancing immediate patient care needs with long-term quality goals is complex. It’s a delicate act—allocating time and resources to areas of greatest impact while maintaining compliance and preparing for future challenges.

Our experience across these domains allows us to effectively set and adjust priorities based on both current demands and future needs. For example, if we notice an uptick in CLABSIs or Catheter-Associated Urinary Tract Infections (CAUTIs), we immediately shift our focus toward infection prevention strategies. These issues not only affect patient outcomes but also carry significant financial implications, such as potential Medicare penalties. It is imperative to evaluate the areas with the highest risks and potential for patient harm and adjust focus accordingly.

Proactive Leadership in a Regulated World

Staying current with literature and evolving regulations is essential for understanding both current standards and future expectations. We made a strategic decision to engage early, even though many quality and infection control measures were initially voluntary. For example, some CMS quality mandates include cataract measures and patient surveys on improvement. Although these began as voluntary, we proactively submitted this data. Early and proactive reporting on clinical outcomes allows us to identify and resolve issues in advance, ensuring a smoother transition when reporting becomes mandatory.

To stay informed in the regulatory space, I emphasize collaboration. The professional relationships I’ve built with peers across healthcare systems have been invaluable. One of my closest colleagues—who sadly passed away last year—was the Vice President of Patient Safety at ECU. We had known each other since our UNC Chapel Hill nursing school days, and over time, we built a strong professional bond, regularly exchanging ideas and insights.

I continue to engage with leaders in other systems, especially in the Charlotte and Raleigh areas, to share best practices and stay aligned with industry standards. Ultimately, staying engaged with regulatory changes and maintaining a strong professional network helps us stay ahead of the curve.

Building Accountability Through Coaching and Connection

I coach my staff to understand that while we play a critical role, we are not solely responsible for all outcomes. In infection control, for example, when infection rates increase, the team often takes it personally. But I consistently remind them that we are not the ones inserting or maintaining central lines. Our role is to support, guide, and collaborate with the clinical teams directly involved in those processes.

This is where influential leadership becomes essential—building relationships, facilitating collaboration, and helping frontline staff understand how their actions directly impact outcomes. In our quality work, I emphasize to my team that our job is to identify barriers, provide insights, and offer recommendations. The responsibility for implementing change ultimately lies with the operational leaders in the affected areas.

It’s a challenging position. I remember when I first transitioned into quality 13 years ago, reporting directly to the Chief Medical Officer. I would often become anxious and reactive when outcomes didn’t meet expectations. I’ll never forget what he told me—it stuck with me to this day:

“Christina, you have oversight and responsibility for reporting the data, but the outcomes are the result of many people’s work, not just yours”

That perspective reshaped how I lead.

Now, I instill that mindset in my team—understanding that our work is part of a larger, collaborative effort involving nursing, environmental services, and many others. It’s through that collective accountability and partnership that we can truly drive improvement.

The Power of Collaboration

My advice is to always remain collaborative and supportive of stakeholders, rather than adopting a dictatorial or authoritative approach. One of the most important lessons I learned early on is the value of having the right people at the table. Including the appropriate stakeholders in meetings and decision-making processes is critical—without them, you’re unlikely to achieve the outcomes you’re aiming for.

That would be one of my key recommendations for anyone looking to move into this level of work: always ensure you’re engaging the right voices from the start.