Apr 9 2014

Improving safety for patients on warfarin therapy

Orthopaedic Surgery/Anticoagulation Service partnership helps meet National Patient Safety Goals for high-risk medication

A partnership between the Department of Orthopaedic Surgery and the Anticoagulation Service improves patient safety for orthopaedic patients who are on high-risk/high-alert Warfarin therapy.

Brian Kurtz, PharmD, and Shelley Howells, LPN, from Anticoagulation Services, discuss a patient referral.

Post-operative Orthopaedic Surgery joint reconstruction patients typically receive anti-clotting medications such as Warfarin (Coumadin) to prevent deep vein thrombosis (DVT)—blood clots in the calf or thigh. This is a life-saving but high-risk/high-alert medication because staff must closely monitor the therapeutic levels in the blood.

In fact, the Joint Commission has made reducing the likelihood of patient harm associated with anti-clotting medications a National Patient Safety Goal.

Back in 2012, U-M faculty, staff — and most importantly patients — were dissatisfied with the level of management this high-risk population received. So, in January 2013, a multidisciplinary team formed to tackle the issue – as one of the inaugural “Lean – Train the Trainer” Projects under the Michigan Quality Initiative.

Using several lean tools, the team identified tasks within their control that they could change to improve the process to identify and monitor patients—and to get them started in the service.

“After several meetings, we aligned clerical work with clerical staff and significantly reduced the involvement of the clinic/phone triage nurses and Joint Service mid-level providers associated with managing these patients,” says Dorothy Nalepa, administrative manager of the Taubman Center Orthopaedic Surgery Clinic. Read the rest of this entry »

Mar 19 2014

Operating room whiteboards help fight infection

Sometimes the best solutions are right before our eyes

Since the 1960s it has been known that certain procedures — such as hysterectomies and colorectal operations — run a high risk for infections, and that if surgeons use prophylactic antibiotics during these surgeries, infection can be avoided.

Now, the Health System hospitals operating rooms are using electronic whiteboards to inform OR medical staff of each patient’s antibiotic needs.

“We had already put up these giant screens in the ORs to show the patient’s name and procedure, and it occurred to us that we could put the screens to even greater use by adding the specific antibiotic individual patients should receive based on the procedure they are having,” says Mark Pearlman, M.D., professor of obstetrics and gynecology, and head of the OB/Gyn portion of the project. Read the rest of this entry »

Mar 5 2014

Safety Huddles: Sports tactic makes U-M hospitals safer, more efficient

University of Michigan hospitals are using a classic team tactic—huddles—to make things safer and more efficient for patients and staff.

These huddles are safety huddles—daily morning meetings that prep staff on necessary information, including patient admissions and discharges, problems with equipment, medication changes, support services, supplies and more. They run Monday through Friday, from 8:45 a.m. to 9 a.m.—a brisk 15 minutes—right after bed briefing.

Chris Dickinson, M.D., professor of pediatrics and the co-architect of patient safety huddles, leads a morning huddle to help staff make the hospital safer and more efficient for patients and staff.

Although the safety huddles have never been mandatory, “everybody wants to come,” says Scott Marquette, intermediate project manager at U-M C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital. A typical meeting includes charge nurses, ambulatory care bed managers, laundry managers, support staff, biomed, Office of Clinical Safety and MCIT (Medical Center Information Technology)—in short, everyone with information to give to others and/or a need to know. Marquette sends information gleaned from the huddle to 190 managers and staff across Children’s and Women’s via email. Staff who want to be added to the email list should email Marquette.

“Like all hospitals, we have safety concerns,” says Chris Dickinson, M.D., professor of pediatrics and the architect, with Marquette, of the safety huddles. “To get people thinking about safety, you really have to change your culture. The safety huddles get people thinking about safety all the time. We talk about all sorts of error prevention strategies.” Read the rest of this entry »

Sep 20 2013

Gifts of Art names winners of annual UMHS Employee Art Exhibition

U-M Health System employees have a plethora of expertise and skills that help our patients and keep our institution operating efficiently. Now the artistic talents of our faculty and staff are on display through Oct. 7 in the Taubman South Lobby Gallery, level 1 in UH.

From traditional paintings to collages and photography, UMHS projects are featured as part of the 26th Employee Art Exhibition hosted by Gifts of Art. Winners of the exhibition were named at the Artists’ Reception & Awards Ceremony on Sept. 10.

Ten Best in Category awards and a Best in Show award were determined by guest juror Gunalan Nadarajan, dean of the Penny W. Stamps School of Art & Design. A Peoples’ Choice award was given by popular vote from patients, visitors and staff.

The host for the event was Julia Donovan Darlow, regent of the University of Michigan. Winners were selected from 112 pieces submitted by 71 artists and 22 family members of UMHS employees.

“Contributing employees view the Employee Art Exhibition as an opportunity to share a part of themselves, their creative side that they usually can’t share in their jobs,” says Gifts of Art Visual Arts Coordinator Kathi Talley.

Brenda Miller, B.F.A., parent coordinator in the Brandon Newborn Intensive Care Unit, won Best in Category for Collage and Mixed Media.  Millers’ piece is entitled “Salamander”.

“The inspiration for my piece is two-fold,” says Miller. “A nurse in our Newborn Intensive Care wrote a story about a family that was in the unit, with characters from nature. Our conversations resulted in illustrations of these creatures. In addition, the focus of my work has been conservation, sustainability and protecting the most vulnerable.”

Miller’s daughter, Emily Slomovits, won Peoples’ Choice for her work ‘Les Miserábles’.  The mosaic is based on the original book cover art done by Victor Hugo.

Emily Slomovits stands by her work ‘Les Miserábles’ which won Peoples’ Choice in the Employee Art Exhibition.

“For our senior art project at my school, we had to make a mosaic,” says Slomovits, who is a musician and loves musical theater.  “‘Les Miserábles’ is one of my favorite musicals. The picture is so iconic, and I thought it would lend itself well to the medium.”

Chris Hardy, a supervisor in Health Information Management, won Best in Show for his black and white photograph “At a Distance You’re Strong, Until the Wind Comes”.

“In this piece, I found an old abandoned farm house off some rural road,” says Hardy. “Seeing it alone, isolated and centered right in the middle of a large overgrown field, reminded me of strength and loneliness. This simple wooden covered house, with its one window barely hanging on, conveyed the contrast of being so desperately alone in such a vast space, but still having that desire to stand strong through the isolation and despair.” Read the rest of this entry »

May 20 2013

Beloved doctor, medical educator killed in crash

A “physician’s physician” known for his devotion to high-quality patient care and training future physicians was killed Saturday following an automobile crash on Interstate 94.

Steven E. Gradwohl, M.D., who had been on the Medical School faculty since 1994, was a clinical assistant professor of internal medicine and practiced general internal medicine at the Briarwood Medical Group. An investigation of the crash is underway.

“Steve was not only a very caring and outstanding clinician, he was also a dear friend to many of us in the department and across the university,” says Internal Medicine Chair John Carethers, M.D.

Laurence McMahon, M.D., chief of the General Medicine division, notes, “With a ready smile, full of energy and always willing to help, he will truly be missed. His devotion to his patients and friends was only exceeded by that to his family.” Gradwohl is survived by his wife Lisa Mann, N.P., and their two daughters, Alexandra and Kelsey.

A graduate of Carleton College and the University of Chicago’s Pritzker School of Medicine, Gradwohl had been named by his peers as one of the Best Doctors in America several times. He was an Army veteran, having served on active duty while in medical residency at the Letterman Army Medical Center in San Francisco, and in medical leadership posts at Fort Lee in Virginia and the Presidio in San Francisco. He came to Michigan in 1994, attracted by the opportunity to take part in medical education in an outpatient setting.

“He was an outstanding teacher of his colleagues, our resident physicians, and medical students,” says Thomas O’Connor, M.D., medical director of the Briarwood Medical Group. “Steve was an outstanding physician devoted to his patients from the day he first joined us.”

Says James O. Woolliscroft, M.D., dean of the Medical School, “Steve was a wonderful colleague, friend and one of our finest physicians. From his dedicated, empathic and compassionate care for his patients, to his ready availability and willingness to assist colleagues, to his commitment to the education of the next generation of physicians, everyone who came to know Steve was better for it. We will all miss his warmth, humor and intellect. May his family find comfort in knowing how much he was respected and admired by his friends and colleagues at U-M.”

Gradwohl won the Medical School’s Outstanding Clinician Award in 2012, and was cited for excellence in teaching outpatient medicine, and for serving as the internist to many patients with complex medical conditions. He volunteered regularly at the health clinic run by U-M physicians at the Ann Arbor Shelter Association’s homeless shelter, and served on a University-wide committee on employee health and wellness.

“To lose any of our dedicated clinicians in such a way is a tragedy, but our loss is compounded by the fact that Steve played such a key role in our academic medical center,” says Ora Hirsch Pescovitz, M.D., CEO of the U-M Health System. “Our hearts and thoughts go out to his family.”

Gradwohl was a member of the Executive Committee on Clinical Affairs, a team of top clinicians from across the U-M Faculty Group Practice who advise top leadership on many clinical topics and credentialing of physicians. An advocate and teacher of evidence-based medicine, he led the development of, and co-authored, a key guideline for the treatment of urinary tract infections and a self-study online course for physicians and other health care providers anywhere.

During his military service, Gradwohl earned the U.S. Army Surgeon General’s Physician Recognition Award, two Meritorious Service medals and two Army Commendation medals. He was chosen as an inaugural member of the Clinical Excellence Society, an honor bestowed on few of U-M’s hundreds of internal medicine physicians.

A memorial will be held Thursday, May 23 from 6-9 p.m. in the ballroom on the second floor of the Michigan Union. All are welcome.