Meet Michigan Medicine: Quality Department
Providing safe, quality care for patients and their families is at the heart of what drives faculty and staff across Michigan Medicine. Often, this important work is supported “behind-the-scenes” by Quality Department staff members and their colleagues.
“The work that our department does impacts nearly all of our employees, patients, and their families — often in ways they wouldn’t even recognize,” said Linnea Chervenak, MHA, administrative director for the Quality Department. “We are striving to create an environment of continuous improvement in which our colleagues always have access to the tools and resources they need to provide our patients with safe, quality care.”
Restructured in 2016, the Quality Department now includes many of the teams that had previously been working independently to improve the quality and safety of patient care.
“Bringing together all of the units responsible for quality and patient safety is really a credit to the great work that was being done by those teams,” said Chervenak. “Our department now has seven units focused exclusively on continuously improving the work of the health system and eliminating preventable harm to our patients.”
Creating a culture of safety
As part of the 2016 restructuring, the Office of Patient Safety was created to develop and maintain a structured, coordinated and collaborative strategy to provide the safest possible patient care. The office utilizes continuous process improvement and high-reliability principles to carry out its efforts at eliminating preventable harm to patients.
The office houses the Patient Safety Event Team, whose responsibility it is to evaluate harm events, manage the institutional response, and develop a plan to ensure that similar events do not happen again. This team performed more than 50 such reviews in FY17, and is currently in the midst of optimizing the event response institutionally.
The office is also conducting a “Culture of Safety” survey, which was distributed to faculty and staff across the organization.
In addition to patient safety, Quality works with teams from across the organization to improve the value of patient care. For example, department team members recently partnered with the Emergency Department (ED) and the electrophysiology division in cardiology to review how patients with atrial fibrillation (Afib) should be treated in the ED to enable them to be sent home instead of admitted to the hospital.
The multidisciplinary team developed a protocol that would allow clinically-stable patients to be discharged home with a referral to see a nurse practitioner at a new electrophysiology clinic within 72 hours. Using historical data to understand the number of patients who would be eligible for this type of discharge enabled the department to add a nurse practitioner to help staff the clinic. The team then worked with MiChart specialists, the Emergency Medicine Consult Request Service and the cardiology call center to develop a process for patients to be scheduled at the new clinic.
Thanks to these efforts, Michigan Medicine was able to send approximately 96 patients to the clinic in the last year, avoiding potentially unnecessary admissions and enabling patients to go home instead of spending the night in the hospital.
Another initiative supported by Quality is the Daily Management System (DMS), launched earlier this year in all 43 inpatient care units. Members of the Quality Department, including project managers from the Program Management Office, worked with local leaders and others throughout the organization to develop and implement the system.
The data and metrics for the DMS boards are provided by the Quality Analytics division as part of the team’s executive priorities dashboards, which enable leadership to track quality improvement metrics at nearly every level — from high-level strategic priorities down to the daily unit metrics used on DMS boards.
Evidence-based, appropriate care
The Quality Department also leads efforts focused on clinical quality, including:
- Ensuring clinicians have the latest in evidence-based care through clinical guidelines,
- Helping employees maintain board certification in their medical specialty,
- Acting as the coordinating center for more than 18 statewide collaboratives,
- Providing quality improvement and patient safety training at all levels of medical education.
In partnership with the U-M Institute for Healthcare Policy & Innovation (IHPI), Quality founded the Michigan Program on Value Enhancement (MPrOVE). This joint venture brings together researchers from IHPI and clinicians across the health system to identify, implement and evaluate specific projects focused on appropriateness of patient care. In short, their work seeks to ensure patients receive the right care at the right time without receiving any unnecessary care.
As the department looks to the future, plans are in the works to launch a new website aimed at providing faculty and staff with easier access to comprehensive data and reporting tools. The site also will be a way for people to learn more about the department and its professional offerings, and be a quick way to find resources or support.
“I am excited to see where this department goes,” Chervenak said. “We have an incredible team with a lot of great ideas about how we can continue to provide the highest quality and safest care for our patients. As a department, we are looking forward to working with our operational partners to co-create the future of quality and safety at Michigan Medicine.”