Q&A with our team | Meet the Women of MEERQAT

Annie Curtin and Donna Cohen: the women of MEERQAT

In this dynamic world, female entrepreneurs are a significant contributor to economic development and social progress. Their business acumen, intelligence, and resilience are among the many reasons women make such an impactful contribution. And women are working side-by-side to establish their businesses, brands and start-ups in various industries, including publishing, technology, service delivery, etc.

In this article we introduce the Women of MEERQAT who, together with the men in our team, started the company in 2014. Read on to find out more about the two driven women of our company.

Meet Donna Cohen, Director of MEERQAT and Vice-President of Consultancy and Product Development

Donna Cohen, women of meerqat
Meet Donna Cohen, Vice-President Consultancy/Product Development at MEERQAT

Tell us a bit about yourself

When people meet me for the first time, one of the first questions they ask me is, “where is your accent from?” I have a very unusual accent. This is the result of having English parents, being born and raised until the age of 11 in the US, living in Australia until I was 26, then spending four years working just outside New York and finally returning to Australia from 1990 to the present day. I call my accent “trans-Atlantic-mid-Pacific,” which seems to cover all the angles.

After secondary school, I completed a Bachelor of Science with Honours in Biochemistry at the University of Sydney. By the time I finished Honours, I knew I wanted to do basic research in the biomedical sciences. I obtained a Commonwealth Scholarship to do a PhD at the Australian National University. Even though my project didn’t work out all that well, I loved doing research and that’s what I thought I would do for the rest of my working life.

Of course, life doesn’t always work out the way you think it will. So I ended up taking several paths very far removed from biomedical research.

The first major tangent was to explore my other great passion: drama and theatre. I left research to try life as a professional actor, which I pursued for about four years. I had some successes. Mostly with the one-woman shows I developed with my mum (a writer). We brought science and scientists to life for school kids and the general public.

In the end, that pathway was neither intellectually nor financially sustainable. I returned to study to find some new directions, completing a Masters in Public Policy and Management at Monash University. After that, I worked in the Victorian Department of Human Services for a couple of years. Then I returned to academia, leading a Strategic Projects unit in the Faculty of Medicine, Nursing and Health Sciences at Monash University. That four-year period turned out to be a preview of the next phase of my life, working as a consultant in the health and higher education sectors, which I am still to this day.

“I loved doing research, and that’s what I thought I would do for the rest of my working life.”

I’m pretty much at home performing, which is why I spent so much of my adult life doing theatre in some form or another. When I stopped performing in community theatre in my late 40s due to a back injury, I took up ballroom dancing, where I met my husband, Vitas. Having married late in life, I have no children of my own. However, I am an aunt to the two (now adult) kids of my brother Phil and a step-mum to Vitas’s three grown-up sons.

My interests are many and varied. I enjoy reading (particularly thrillers and courtroom dramas) and cooking (our recently renovated apartment has a wonderful kitchen!). Also, I take a keen interest in politics and public affairs. Moreover, I love to travel, having lived in numerous places around the world. I would love to try living in Europe someday.

I exercise regularly with Vitas and try different types of activities each day. We plan to stay fit enough to keep doing lots of adventurous things until we’re at least 90!

MEERQAT was set up in 2014…what did you do before MEERQAT?

After 25 years working in a wide variety of occupations, I finally embarked on the career path that ultimately led to MEERQAT.

Before setting up MEERQAT, I had been working as a consultant in the health and higher education sectors. This involved contract work for universities, government departments and agencies, professional colleges and peak bodies, hospitals, GP super clinics, community health services and research institutions. Projects included strategic planning, research and evaluation, grant and other funding applications, project management, stakeholder consultations and workshop facilitation.

Around the time I was embarking on my consulting career – i.e. the mid-2000s – was a significant time for health workforce issues. There was a lot of interest in this at both state and Commonwealth levels. Particularly once reports began to appear that predicted significant shortages in the medical, nursing and allied health workforces by 2020.

By early 2008, the Victorian State Government had started several initiatives to address health workforce issues. One Request for Tender (RFT) appeared precisely when I was leaving Monash. The RFT was to research and develop a framework to guide hospitals and other health services that provide clinical education and training placements for health professional learners, helping them create and maintain high-quality learning environments.

My new sole trader business – Darcy Associates – won the contract. I assembled a small team to develop what became known as the Best Practice Clinical Learning Environment (BPCLE) Framework. Little did I know that this one project would lead to four more BPCLE projects and continue to feature in my work for the next 12 years.

I also won a contract to help the government establish a new governance framework for clinical education and training across the state. Together with the BPCLE initiative, this project helped to establish me as a significant contributor to initiatives aimed at improving and expanding the clinical education and training capacity of Victorian health and social care services.

I still undertake consulting work through Darcy Associates. However, I have cut back on my consulting activities in the last couple of years to allow me to devote more time to MEERQAT.

How did you get from what you were doing before to online quality improvement tools?

The road to online quality improvement tools started with the BPCLE initiative. After winning the initial contract to develop the BPCLE Framework, I then won the next four BPCLE project contracts. The first project was to validate the framework. The second was to develop indicators to go with the BPCLE Framework. The third was to develop a resource kit for health services. Finally, the fourth project was to trial the implementation of the framework in a range of health service setting types.

The implementation pilot project was particularly challenging because my team (which included my brother Phil) and I had to develop prototype “implementation tools” that would – if successful – be used by all Victorian health services to assist them with implementing the BPCLE Framework.

We needed some tool that would guide health services through an “organisational self-assessment” of their current clinical education and training arrangements against the principles set out in the framework. I had the idea of using the program logic models we had created when we were developing the BPCLE indicators. It showed the inputs, activities, outputs and outcomes necessary to achieve the framework’s objectives. In essence, these program logic models were roadmaps for achieving the desired outcomes of the BPCLE Framework.

“If these roadmaps could somehow be made interactive, then health services could use the maps to rate themselves against the ideals of the framework.”

I mentioned this idea to Vitas, and he said he thought he could make that work in Excel, using the VBA programming language. He came up with a working prototype of the concept! So, we went ahead and developed the full suite of prototype tools in Excel. This including the map-based tool for structured assessment against the BPCLE Framework and another tool to help health services choose which indicators to monitor. We also worked on another tool to help health services develop an improvement action plan based on their assessment outcomes.

Donna Cohen_is_interviewed_for_ACHSM_TV
Donna Cohen is interviewed for ACHSM TV

So, the implementation pilot project team comprised Phil, Vitas, and me. We worked with 11 health services selected from across Victoria as they trialled the framework implementation protocols using the prototype tools. The 11 health services participating in the pilot project really liked the approach and the prototype tools. However, they warned us against using Excel-based tools to roll out the framework implementation across the state. So, we spent the next year working with a team of web developers to transform the Excel versions into an online tool called BPCLEtool.

Therefore, our first online tool was actually an implementation tool for a best practice framework, rather than a “quality improvement tool” per se. Of course, the whole point of implementing the BPCLE Framework is to improve the quality of clinical learning environments.

Interestingly, hospital Quality Managers sometimes attended the map-based sessions when we worked with the pilot project health services. One of them took us aside after one of the sessions and said, “This is a really great approach. Do you think we could use it to assess other work processes?” This got us thinking…maybe our map-enabled review idea could be more broadly applied! However, we had to put that thought aside since we needed to focus on the development of BPCLEtool in preparation for the statewide rollout of the BPCLE Framework in early 2014.

Once BPCLEtool was up and running smoothly, we could turn our attention back to the idea of a general-purpose “process review” tool. By this time, we worked with some new web developers, and we started to discuss how the map-enabled review technique could work for any business process. And so, we commenced the development of the Map-Enabled Experiential Review Quality Assessment Tool (MEERQAT). The big difference between BPCLEtool and MEERQAT is that, in BPCLEtool, the business process maps used in assessments are fixed and relate specifically to the six “elements” of the BPCLE Framework. In contrast, in MEERQAT, the user can create their own interactive assessment maps using our unique map building tool.

What’s your main role in MEERQAT?

I am one of the two company Directors of MEERQAT Pty Ltd. My title on the MEERQAT organisation chart is Vice-President Consultancy/Product Development.

I have a major role in the development of program/process logic maps for the MEERQAT Basemap Library. For example, we have a suite of basemaps corresponding to the National Safety & Quality Health Service (NSQHS) Standards. I have been the main developer of those maps. Also, I assist clients with basemap development when they need help or guidance.

Moreover, I have a major role in aspects of marketing, such as writing thought leadership blogs on various subjects. I usually front the short videos we use to raise our profile on social media and deliver introductory presentations on MEER/MEERQAT. I am also usually part of the team that “pitches” to potential clients.

Tell us about the highs and lows of your journey at MEERQAT

I would say there have been two major challenges for me. The first has been to find enough time to devote to business development, particularly in the early years. Like other team members, I had to continue with other work to make a living and pay for the initial development of the MEERQAT application. So, I couldn’t devote as much time to MEERQAT activities as was really needed.

The second major challenge has been my own personal lack of experience in marketing and promotion. I think this is a really key activity, particularly for a new business. I have made lots of mistakes and perhaps wasted some good opportunities while slowly learning what we should be doing.

The most satisfying moment, without a doubt, was when the data analysis for the trial of MEER/MEERQAT at Epworth Hospital was completed. There was a statistically significant 34% reduction in adverse events in the two participating units compared to the rest of the hospital. The thrill of this result was only surpassed when the research paper describing the trial was accepted for publication in one of the top international peer-reviewed journals, BMJ Open Quality.

I had always known that the MEER approach at the heart of MEERQAT and BPCLEtool was an excellent technique. Everyone who had ever used the approach told us what a great approach it really is. But it was certainly fantastic to have some actual hard data to back up the anecdotal feedback.

Probably the best part of working at MEERQAT is that I really love working with my family members! It’s great to work with my brother Phil and his wife, Annie. And Vitas is my best buddy, who loves Excel as much as I do (maybe more)! He also provides a really complementary focus and skill set to everything we do.

The main reason I keep going with MEERQAT is because I see SO many opportunities for the MEER approach to be used in various sectors, organisations and work contexts. I also see that many managers now realise how important it is to connect with their staff meaningfully. We have a really clever app to help them establish and sustain that connection. This can potentially transform workplaces and change organisational culture in important and valuable ways. The possibilities are really endless!

In the end, what motivates me is my desire to be part of the solution, not part of the problem. Ultimately, I would like to do some good, solve some problem, or fix something that hasn’t worked.

Who has been your greatest inspiration?

I am most inspired by people who do good for others or their community. People who overcome hardship or difficult circumstances, or who set a good example for others to follow. Those people inspire me to try harder, be a better person and generally be grateful. I am fortunate that my immediate and extended families include such people. I don’t have to look too far for inspiration.

Meet Annie Curtin, Manager of Clinical Liaison and Client Support

Meet Annie Curtin, Manager of Clinical Liaison and Client Support

Tell us a bit about yourself.

I come from a large and loving family. I was born in Adelaide – the second oldest of four sisters – and spent some of my early childhood in the UK and Europe. When we returned to Australia, we went to live in Canberra, where I completed my schooling. During those years, I was a keen basketballer and netballer and represented ACT in both sports.

Phil and I married in 1998 and we have two grown children, Sam and Charlotte, both currently at Monash University. Aside from working with MEERQAT and as a nurse, I coach basketball to junior females. This is something I have been doing since 1995. I have a keen interest in Japanese and I also enjoy swimming and reading.

MEERQAT was set up in 2014…what did you do before MEERQAT?

I have worked as an educator, clinical nurse, hospital coordinator and researcher across several hospitals in my nursing career. In the mid-’80s, I was one of the last groups to go through a hospital-based training at Royal Prince Alfred Hospital in Sydney. My post-graduate years at Calvary Hospital, Canberra, with the Little Company of Mary, was where I really learned the art of “nursing”.

In the early ’90s, I was fortunate to work in a public hospital in Japan. I did it while studying for my BA at the University of Canberra. I moved to Melbourne in the mid-90s and worked in Sexual Health and Emergency. In 2005, while working at Epworth Richmond ED, I completed my Postgraduate Certificate in Critical Care at Melbourne University. I have worked in Emergency Departments and Cardiac Catheterisation Laboratories for the last 15 years.

How did you get from what you were doing before to online quality improvement tools?

I was fortunate to work with Donna while she, Phil and Vitas were developing what became known as BPCLEtool. At the time, and as a frontline clinician, it was clear to me that this self-assessment method through interactive process maps was an ideal way to genuinely engage frontline staff in reflecting on the quality of their work. This approach also taps into a largely unexploited source of ideas for improvement. It brings specialists, allied health and other staff together to discuss their work contributions to the overall objective of best patient outcomes.

And what’s your main role in MEERQAT?

My “official” role is Manager of Clinical Liaison and Client Support, which is two separate but related roles. The Clinical Liaison role involves providing clinical knowledge and expertise to assist Donna with development of MEERQAT Library Basemaps that are based on NSQHS and other clinical standards. The Client Support role involves training and supporting hospital staff as they use the tool. This includes developing resources that clinicians will find useful for working with MEERQAT. I also work on providing virtual and in-person support as an ongoing service to clients.

I was also the principal investigator of the 2018 study at Epworth Hospital that looked at MEER as a novel approach to engaging frontline staff in quality improvement. This clinical trial demonstrated a reduction in the number of adverse incidents, as well as an improvement in frontline staff engagement with quality activities.

Tell us about the highs and lows of your journey at MEERQAT

I think the biggest challenge for me has been reconciling the fact that, despite hospitals advocating for evidence-based practice throughout medicine, they don’t apply the same standard when it comes to continuous quality improvement methods. As a result, a lot of what is done in the name of quality improvement is not necessarily evidence-based.

On the other hand, there have been many satisfying moments. Fairly obviously, publishing the Epworth Hospital study in BMJ Open Quality was pretty rewarding. But I would have to say the most satisfying moments have been witnessing the MEER tool in action and all the quality conversations and ideas that it brings. Throughout the study, nurses told me they had never had so many quality conversations before. They also said their practice had changed because of those conversations. I saw nurses who would never normally speak up do so, and nurses that would never normally listen also do so. Moreover, I noticed nursing, pharmacy and other staff contributing to the development of solutions to issues. Some solutions were very simple, but others were quite complex. I saw medical staff support nurses’ initiatives. I also saw doctors wanting to improve their own clinical handover.

“When we used MEERQAT, nurses told me they had never had so many quality conversations before. They highlighted their practice had changed because of those conversations.”

Most importantly, I saw a reduction in harm to patients. I have also seen the long-lasting effect of using MEERQAT. In the Cath Lab, staff continue to have one of the best recycling programs in the hospital, developed following a MEERQAT conversation.

I like working at MEERQAT because it is on the leading edge of quality improvement; it is life-changing and life-saving as well as cost-saving. The team at MEERQAT come from very diverse backgrounds: engineering, biomedical science, sociology and nursing. As someone who has been involved in the medical world all my life, I appreciate and welcome the injection of different perspectives into the quality improvement area within healthcare. Especially when those perspectives are evidence-based and incorporate human factors. We have fascinating and dynamic work sessions which I really enjoy.

Annie Curtin receives a grant from the Epworth Research Institute
Annie receives a development grant from the Epworth Research Institute in 2017

As a clinician, I really enjoy working with Donna. With her background and methodical approach and my clinical knowledge, we are able to translate the objectives of the national and clinical standards into process maps. This helps me think about my own nursing practice in a different way. When these maps are used in MEERQAT, they allow clinicians to easily identify areas that are working well and not so well. And the linked action planning tool helps teams translate the issues they identify into ideas for quality improvement.

As for the future, I am looking forward to our first hospital-wide rollout of MEERQAT. It will be great to work with very progressive nurse leaders and their teams who are excited about all the good that will unfold with this new approach.

In the end, I am motivated by a fundamental belief that you should always leave things better than you found them.

Who has been your greatest inspiration?

My family and my husband’s family continue to be an inspiration to me. My father was the first non-clergy leader of a Catholic parish that was a resounding success. He has always and continues to advocate for female leaders in the Catholic church and society. He has reminded me that even though the solution may be obvious, it may take time for others to see it.

We hope you enjoyed this Q&A to meet the women of MEERQAT. Let us know your impressions of Donna’s and Annie’s stories. Do you relate somehow to them? If you have a start-up, what have been the biggest challenges you have faced?

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