Quality Institute
U ROCHESTER MEDICINE: LEADER FELLOWSHIP QUALITY IMPROVEMENT TRACK 2026
Dear Fellows, On behalf of the URochester Medicine Leader Fellowship Program leadership team, we extend our heartfelt congratulations as you approach the conclusion of your time in the Quality Improvemet track. It has been a privilege to accompany you on this journey of professional growth, innovation and interprofessional collaboration. Over the past eight months, each of you demonstrated a deep commitment to learning, curiosity and the pursuit of excellence in quality improvement. Whether through mastering DMAIC methodology, leading meaningful change, or developing thoughtful, data-driven projects, you have shown what it means to be leaders in a complex healthcare environment. We are especially proud of the creativity and discipline you brought to your initiatives. Your work not only contributes to the advancement of patient care and system performance, but also embodies the values of teamwork, accountability, and continuous improvement. Beyond the skills you’ve developed, what has made this cohort truly exceptional is your collaborative spirit. You’ve embraced the opportunity to learn from one another, share diverse perspectives, and support the professional development of your co-fellows. That collective energy is what drives sustainable and ongoing improvement across our system, and we are confident you will continue to model this in your future improvement efforts. As you graduate from the program, we look forward to seeing how you will continue to weave quality improvement into everything you do from advocating for your patients to leading teams, mentoring future quality improvement leaders, and shaping the future of healthcare. Thank you for your dedication, your hard work, and your willingness to challenge the status quo for the better. With pride and gratitude,
Irena P. Boyce, Ph.D. Chief Improvement Officer
Theresa Green, PhD, MBA, MS Associate Director Center for Community Health & Prevention
Andrea Perkins, MHA, RT(T) Director of Quality Improvement
Tina Sosa, MD, MSc Chief Quality Officer UR Medicine GCH
Trust the Process Follow the steps in order and resist the temptation to put the cart before the horse.
Engage Stakeholders Involve those affected by the process in co-creating improvement initiatives.
Integrate Equity from Day 1 There can be no quality without equity. Ensure that your project is identifying and seeking to eliminate any potential disparities.
MICHELLE VIGNARI RN, BSN, CIC
Director of Infection Prevention Highland Hospital Mentor: Joel Cornell, LSS, MBB
Michelle Vignari, RN, BSN, CIC, is an experienced registered nurse, certified infection preventionist, and current Director of Infection Prevention at the University of Rochester’s Highland Hospital. With over 30 years of clinical and leadership experience spanning acute, ambulatory, and long-term care, she is dedicated to patient safety, regulatory compliance, and quality improvement. Nationally recognized as an APIC Hero in Infection Prevention (2011) and a March of Dimes Nurse of the Year (2017), Michelle serves as President of the New York APIC Coordinating Council and on the NYSDOH Technical Advisory Committee. A published author in peerreviewed journals, she uses data-driven decisionmaking to collaborate with healthcare teams and improve patient outcomes.
My experience with the fellowship provided a valuable experience that I am so thankful for and helped transform how I approach quality improvement. I learned that meaningful and sustainable change requires more than identifying a problem, it requires understanding the underlying processes, engaging those closest to the work, using data to guide decisions, and developing evidencebased sustainable solutions. The fellowship strengthened my skills in critical thinking, systems improvement, and interdisciplinary collaboration. Most importantly, I learned that successful quality improvement is not simply about implementing a single solution, it is about creating meaningful and measurable change in patient care.
Reduction of Catheter Associated Urinary Tract Infections (CAUTI) A Quality Improvement Project by Michelle Vignari Catheter-associated urinary tract infections (CAUTIs) are a significant source of preventable patient harm, prolonged hospitalization, and increased healthcare costs. The Highland Hospital CAUTI Reduction Project is an interdisciplinary quality improvement initiative designed to reduce CAUTI incidence through standardized, evidence-based practices related to urinary catheter utilization, urine culture ordering, catheter maintenance, and timely catheter removal. A comprehensive gap analysis of current practices was conducted and cross-referenced with evidence-based guidelines to identify opportunities for improvement. Through collaboration among Infection Prevention, nursing, laboratory, and other key departments, initial gaps were identified in appropriate urine specimen collection, handling, and culture utilization. These findings informed targeted process improvements, staff re-education, and standardization of practices to improve adherence to evidence-based recommendations and reduce preventable CAUTIs.
SMART AIM Reduce house-wide CAUTI incidence by 54% by December 2026 through evidence-based catheter use, maintenance, and removal practices.
Michelle entered the fellowship as an established leader with deep expertise in infection prevention, strong analytical skills, and significant organizational credibility. What distinguished her throughout the program was her genuine desire to learn. She consistently sought feedback, listened carefully, and incorporated new improvement methods into her leadership approach. Her thoughtful processmapping strategy brought diverse participants into the work and helped the team recognize meaningful variation among units without reducing differences to right or wrong practices. When a specimen-collection change raised immediate concerns in Perioperative Services, Michelle addressed them directly, quickly convened the right people, and resolved the issue in one focused conversation. Throughout the project, she combined composure, inclusiveness, and professionalism with a clear drive for results—implementing meaningful quick wins while maintaining focus on the larger CAUTI effort. The fellowship added a powerful improvement toolkit to an already exceptional leader, further strengthening Michelle’s ability to lead complex, hospital-wide change. — Joel Cornell
AKUA ASANTE, MD
Assistant Professor of the Department of Pathology and Laboratory Medicine Division of Transfusion Medicine Mentor: Kyle Mark, BS
"The fellowship provided a valuable framework that enabled a more deliberate and thorough approach to problem identification. By emphasizing a deeper analysis of underlying issues and structural deficiencies before solution development, and by integrating the methodologies learned, it fostered profound insights from peers and cultivated a more collaborative path toward achieving shared goals."
Dr. Asante was born in Ghana and raised in Westchester, New York. She completed her undergraduate studies at Cornell University and earned her medical degree from the American University of the Caribbean. After completing a pediatric residency in Illinois, she relocated to Rochester for a fellowship in Pediatric Hematology-Oncology. Dr. Asante currently serves as an Assistant Professor of Laboratory Medicine at the University of Rochester Medical Center, where she is a key member of the Transfusion Medicine Division. Since joining the division, she has actively collaborated with pathology residents and technical staff, strengthening her commitment to improving the work environment and fostering a more efficient, supportive culture for all.
Enhancing Transfusion Medicine Consultative role Through Data-driven PBM A Quality Improvement Project by Akua Asante Akua Asante’s Quality Track Fellowship project seeks to strengthen the Transfusion Medicine (TM) Service’s consultative role across the health system, optimize blood product utilization, and advance patient care. A root cause analysis identified limited awareness of the blood bank’s clinical services and 24/7 physician consultation, as well as communication barriers and concerns that stewardship review may delay patient care. The initiative addresses these gaps through unit-specific education; enhanced electronic health record processes, including updated transfusion indications and clinical documentation; and, ultimately, a blood product handshake stewardship rounding model, soon to launch in the Adult SICU to provide real-time, collaborative guidance and bidirectional education. Key outcomes include blood product utilization trends and transfusion appropriateness, clinician-initiated TM consultations, and acceptance of stewardship recommendations. By repositioning TM as an accessible clinical consultant and collaborative partner rather than a gatekeeper, the project aims to promote evidence-based transfusion practices while enhancing workflow efficiency and staff satisfaction. An equity-focused approach will additionally evaluate gender-based differences in transfusion practices to identify opportunities for more equitable patient care.
SMART AIMS 1. To increase the number of consults initiated by Adult ICU by 25% by April 2027, thereby decreasing evaluation time and the number of evaluations required in our prosepctive blood product order review process 2. To reduce the number of blood product order evaluations by 25% by April 2027 to improve job statisfaction while optimizing transuion practices. Throughout her Quality Track Fellowship, Akua was an absolute pleasure to work with. I have a lot of respect for the huge undertaking her project entailed. Her project aimed at not only improving interdepartmental processes, but changing the culture as well. Not an easy thing to do. Regardless, she remained creative and tenacious throughout the whole process. Her openness to feedback and willingness to learn was admirable. Her continuing dedication to educate others in the name of improving patient care is what ICARE and MELIORA are all about. I have no doubt that she has done great things for the Medical Center, and will continue to do so as she pursues excellence” Kyle Mark
SHASHA CUI, EdD, MBA
Assistant Professor of Dentistry
Eastman Institute for Oral Health Mentor: Erin Panter, BSRT Dr. Shasha Cui is an Assistant Professor of Dentistry at the Eastman Institute for Oral Health (EIOH), University of Rochester Medical Center. She leads educational innovation focused on improving patient-provider communication, AI in dental education, and quality improvement initiatives. Her work spans curriculum design, faculty development, and implementation of evidencebased communication models to strengthen patient engagement and treatment adherence. Dr. Cui collaborates closely with interdisciplinary teams across URMC to address no-show rates, dental anxiety, and culturally responsive care. A dedicated educator and mentor, Dr. Cui is committed to building learning environments that empower both trainees and patients. She aims to advance high-quality, equitable oral health care through innovation, collaboration, and compassionate communication. .
The fellowship helped me recognize that meaningful improvement does not always begin with a large intervention. Sometimes the most important progress comes from understanding the existing process, clarifying who is responsible for each decision, and creating a practical structure that the team can sustain. I also valued the opportunity to learn from colleagues across the medical center and apply quality improvement tools to a real operational challenge in oral health care
Improving No-show in Perinatal Dental Clinic Perinatal Dental Clinic A Quality Improvement Project by Shasha Cui My quality improvement project focused on improving no show rate and productivity in the Eastman Institute for Oral Health Perinatal Dental Clinic. The project examined the patient pathway from teledentistry triage to in-person dental care and identified barriers related to missed appointments, clinic capacity, staffing transitions, and unclear workflow responsibilities. Using quality improvement tools such as SMARTIE aim, process map, fishbone diagram, run chart and pareto chart, the project evolved from a primary focus on reducing no-shows to developing a more reliable and sustainable clinic workflow. The work demonstrates how clearer roles, standardized processes, and stronger coordination can help improve clinic operations and access to oral health care for pregnant patients.
SMART AIM We will reduce no-show rate in perinatal clinic from 30% in January 2026 to 25% by December 2026
It has been an absolute privilege to mentor Shasha on the Perinatal Dental Clinic project. Understanding the current state is the most crucial step in change management, but it rarely comes without hurdles. Despite facing many obstacles, Shasha tackled every challenge with empathy and perseverance. Her deep dive into the root causes of clinic no-shows not only creates immediate value, but her analysis also leaves behind a lasting roadmap for future improvement initiatives.- Erin Panter
REBEKAH PRASAD, NP, MS
Lead Green Team APP Golisano Children’s Hospital Pediatric Practice Mentor: Jan Schriefer, MBA, MSN, DrPH Assistant Director of Finger Lakes Children's Environmental Health Center (FLCEHC), Assistant Clinician for Rochester Lead Poisoning Resource Center, and Advanced Practice Provider Lead for the green team at GHCPP. She has a Bachelor's of Science from Cornell University, and a Master's from Harvard School of Public concentrating in maternal and child health, as well as a Master's of Science from Simmons College where she trained as a nurse practitioner. She grew up in Dryden, New York, and has worked as a pediatric primary care nurse practitioner in the city of Rochester for the past 10 years. Her areas of focus/interest include environmental health screening, environmental justice, and health equity with a focus on lead poisoning prevention and treatment.
The QI fellowship gave me hope and tools to be the change I wish to see in the world, changing it from an I to a we.
Improving Continuity for 0-3 Months of Age in the GCHPP for Well-childcare A Quality Improvement Project by Rebekah Prasad While continuity of care is known to improve health outcomes for children, at the GCHP resident this has not been provided as an option for caregivers since the clinic’s inception. This fellowship focused on improving continuity of care for 0-3 months old at clinic. Bringing together a multidisciplinary team of scheduling, nursing, care coordination, and providers to work together through multiple pdsa cycles with the goal to raise the continuity rate for well child care from 3 percent to 40 percent over a six month periods. Utilizing the tools of the fishbone diagram, sFMEA and Pareto Chart we identified no appointment availability as the primary driver of a lack of continuity. We focused our pdsa cycle, on widening the window for scheduling, getting rid of rules for scheduling that prevented access, and right sizing provider panels for the clinic of 50 providers. While PDSA cycles continue to be ongoing this led to system sustained change with improved rates on continuity and more importantly, happy families
SMART AIM Improve continuity of care for patients 0 to 3 months of age at GCHPP over a6month period with the goal that patients are seen by the same provider for 2 of 3 well visits for 40% of patients this age up from baseline of 2% by assuring no inequity in improvements from 3/18/2026 to 9/18/2026).
I had the distinct privilege and honor of mentoring Rebecca Prasad in her Health Equity Quality Improvement fellowship. Her project focused on continuity of care for newborns being seen in our large general pediatric practice. Bekah accomplished so much and exceeded the goal she set in her smart aim. Bekah excelled in her use of QI tools. She also presented 2 academic posters on the project - one at the June 2026 Better Team Better Care symposium and the other at the July 2026 Strong Children's Research Center (SCRC) meeting. Bekah welcomed my SCRC summer student to help with the project and I am so appreciative for that. Congrats Bekah on a great fellowship QI project and your success now you can work on publishing it! - Jan Schriefer
ELIZABETH RIGHTMIER, PharmD, BCPS
Quality and Accreditation Manager Strong Memorial Hospital, Specialty Pharmacy Mentor: Kristi Filmore, MS, RN, ACNP-BC
The fellowship provided invaluable knowledge of DMAIC methodologies, including practical templates and tools that are highly beneficial to my colleagues and me. Instructor and mentor feedback significantly enhanced my skillset. The program also offered a unique interdisciplinary networking opportunity, fostering fresh perspectives and connections. I look forward to applying all that I've learned to quality improvement efforts within my team and the institution. I am so grateful for this experience!
Elizabeth Rightmier, PharmD, BCPS, earned her Doctor of Pharmacy from Albany College of Pharmacy and Health Sciences (2009) and completed PGY1 Pharmacy and PGY2 Infectious Diseases residencies at Strong Memorial Hospital. After practicing as an internal medicine and infectious diseases clinical specialist and working with the multiple sclerosis team, she transitioned in 2020 to managing the Specialty Pharmacy’s URAC and ACHC accreditations. In this role, she chairs the Specialty Pharmacy Quality Management Committee to drive quality improvement initiatives. She also serves on the Resident Advisory and Well-Being Committees, precepting PGY1 and PGY2 residents on rotations and research focused on medication safety and quality.
Specialty Pharmacy Growth Support A Quality Improvement Project by Elizabeth Rightmier Continuous growth in patient volume and expansion to additional prescribing clinics present a challenge in streamlining Specialty Pharmacy patient care processes. Recent legislation changes have significant financial implications for the Specialty Pharmacy, necessitating more efficient workflows to allow for continued growth without impacting the provision of high-quality specialty pharmacy services and patient care. Our core team identified that the intervention to test impacting multiple key drivers would involve specialty medications eligible for buy and bill or prescription insurance. Patients taking Xolair™ (omalizumab) may fulfill via buy and bill with Allergy Clinic for in-clinic administration or through prescription insurance with Specialty Pharmacy for home administration, but not all patients transition to Specialty Pharmacy fulfillment once home administration is an option. Increasing Xolair prescription growth contributes to overall Specialty Pharmacy growth. We aim to increase the percentage of patients filing with Specialty Pharmacy from 48% to 53% by 2/28/27, while considering patient barriers to clinic versus home administration
SMART AIM We will increase the percentage of patients filling Xolair with Specialty Pharmacy from 48% to 53% by 2/28/27, while considering patient barriers to clinic versus home administration.
What a pleasure it has been working with Liz throughout the Quality Track Fellowship! Liz showed an eagerness to learn, seeking feedback and demonstrating thoughtful application of improvement science methodology and tools. Liz guided her team to distill a complex process so they could focus on the areas of highest impact and fostered a positive and collaborative environment for identifying meaningful solutions. Her leadership has set the stage for success on this and future projects within Specialty Pharmacy. -Kristi Filmore