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.

Mar 6 2013

100-year-old UMHS patient on exercise: “You’re never too old to start”

A gym for the 65-and-over crowd: Senior participants break a sweat at UMHS’s Functional Fitness class; one of program’s first-ever participants turns 100

In between chats with friends and quips with her fitness trainer, Margaret Rookes spent a recent morning walking on the treadmill, stepping on a NuStep and leg pressing 100 pounds.

When it comes to maintaining her three-times-a-week, 75-minute workout routine, Margaret makes no excuses – not even the fact that she just turned 100 years old.

Watch Margaret in action on Channel 4 Detroit!

“I wouldn’t be in this condition if I didn’t come here,” says Margaret, sporting white sneakers while switching between strength and cardiovascular machines and stretching exercises. “It’s kept me moving. It’s kept me young.”

At age 89, Margaret was one of the first three participants to enroll in the Functional Fitness for Older Adults class that started at the University of Michigan Health System more than a decade ago. The class, which is offered by the Department of Physical Medicine and Rehabilitation for people age 65 and over, has since grown to more than 60 gym-goers.

For Margaret, the class offers a social outlet and place to connect with peers while improving her strength, balance, endurance and mobility – components that typically decline with age and can pose major health risks for older adults.

“I wouldn’t be in this condition if I didn’t come here. It’s kept me young,” says Margaret Rookes, 100. Margaret has been coming to UMHS’s Functional Fitness for Older Adults class since she was 89.

She says the class kept her so fit that at age 95, she was able to take a trip back to Bermuda – her home of five years in the 1930’s where she waitressed after college and met her late husband. Along with her daughter and son-in-law, she was able to visit all of her favorite landmarks and even walk up and down the 39-flight of stairs that took her from her beach cottage to the ocean.

“There’s no getting around it – I’m old,” says Margaret, sitting near a photo from her recent birthday celebration that pictures her with a bottle of sparkling cider under the caption “still partying at 100.” “Coming here is good for my body and mind. It gives me a reason to get out of bed every day. My doctor told me ‘whatever you’re doing, keep doing it.’” Read the rest of this entry »

Feb 11 2013

UMHS Quality & Safety website: Support Services Program of the Year

What do our patients think of the care we provide, and the environment we provide it in?

How well do we keep our patients from getting infections or complications related to their care?

How often do we make sure that patients with diabetes, asthma and heart disease get tests and medications that can keep their condition in check?

What’s the survival rate for patients who have transplants or complex operations at UMHS?

How often do our clinicians wash their hands?

The answers to these questions – and many more – can be found on a website that’s open to everyone, anywhere in the world.

It’s all there in the charts, graphs, easy-to-understand explanations and more on www.uofmhealth.org/quality, the UMHS Quality & Safety site.

Putting this huge amount of data on a public website makes UMHS one of the most “transparent” health systems in the country. It’s part of our commitment to patient safety and high-quality care.

That website has just been named Support Services Program of the Year for 2012, and the award was given to the team that built and maintains the site with no additional financial support. They call themselves “Team Transparency”, and they include members of the Performance Assessment & Clinical Effectiveness (PACE) division of the Office of Clinical Affairs, and of the Public Relations & Marketing Communications department. PACE includes members of the former Clinical Information and Decision Support Services (CIDSS) and Customer Performance Metrics & Improvement units.

Working with no additional funding, the team designed the UMHS Quality & Safety site from the ground up to offer comprehensive, easy-to-understand, easy-to-navigate and fully transparent data and information about UMHS clinical performance.  It’s fully integrated into UofMHealth.org, the Health System’s patient-focused web presence.

Read the rest of this entry »

Feb 11 2013

Bringing Hope to UMHS: Clinical Program of the Year

Being without health insurance is like walking a tightrope without a safety net below you. All it takes is one tiny slip to send you into a health crisis.

But for uninsured people in Washtenaw and western Wayne counties, a charity called the Hope Clinic helps keep uninsured patients from falling too far.

For decades, U-M doctors, nurses, staff, medical students and residents have volunteered at Hope’s location in Ypsilanti, helping weave a safety net that has served thousands of people.

Accepting the Program of the Year award for clinical services on behalf of the dozens of UMHS faculty, staff and trainees who have volunteered for the Hope@UMHS program are, from left, Perry Schechtman, Ophthalmology, Heather Pontasch, Dermatology, Julie Brown, Hope Clinic, Trisha Goodridge, Plastic Surgery, Robbi Kupfer, Otolaryngology, Katherine Simpson, Hope Clinic, Seyi Aliu, Plastic Surgery, and Paul Salow, Otolaryngology/Anesthesiology.

Now, Hope has come to UMHS in the form of a specialty clinics held at the Taubman Center and Kellogg Eye Center – a major step made possible through the tireless efforts of faculty, staff and trainees in several specialty departments.

This effort, called Hope@UMHS, has earned the UMHS 2012 Program of the Year recognition – as well as the gratitude of the hundreds of patients who have already been seen there.

The Saturday-morning specialty clinics – - staffed by an all-volunteer team – - help uninsured patients get free access to advanced care that can’t be offered at Hope’s own locations. Read the rest of this entry »

Jan 14 2013

Domino’s Farms Surgery Pre-Op Clinic adopts Michigan Quality System’s lean in daily work system

(From left) William Palazzolo, clinic director; Jennifer Tomford, clinic manager; and Linda Schaffier, medical assistant, discuss process improvement ideas during a leadership walk in front of the visual metric board.

Would you jump at the chance to improve employee satisfaction in your area if you could? Even if you weren’t sure you totally believed in the methods at hand?

Eighteen months ago, Bill Palazzolo, M.S.., P.A.-C, clinical director at Domino’s Farms Surgery Pre-Op Clinic, rolled out Michigan Quality System’s (MQS) lean in daily work system in his area and was pleasantly surprised.

“If you had told me years ago that lean worked, I wouldn’t have believed you,” he says. “But now I get it. I’m a believer.”

Knowing that patient satisfaction and employee satisfaction are linked, Palazzolo was looking to improve communication and satisfaction among his team, with the goal of improving the patient experience.

The clinic, which has been in existence for over 4 years, provides perioperative risk assessments and pre-operative risk optimization for scheduled surgical patients for the majority of surgical departments. Its patients are primarily adults—12,000 patients a year and growing—from ophthalmology to cancer to orthopaedic surgery, who have complex medical problems or potentially difficult airways.

Clinic staff sees 50 to 70 patients a day with appointments that last about an hour each.

The clinic has a full-time staff of 10 PAs, two registered nurses and five medical assistants. Rotating anesthesia staff as well as PAs and nurse practitioners from other surgical services also provide pre-operative care in the clinic space.

Since the clinic began its lean journey:

  • Employee engagement (a willingness to recommend your area to other employees) has seen a jump from 53.3 percent in March 2009 to 82.3 percent in March 2012.
  • Employee satisfaction, measured by the Lean Culture Survey, has seen an overall improvement of 20 percent. The two largest improvements—working in a fear-free environment and seeing waste and problems as opportunities—have risen 36 percent and 31 percent, respectively.
  • Time from patient check-in to check-out decreased 17 minutes—from 97 minutes to 80 minutes.
  • Employees submitted 170 everyday lean ideas —from assigning patients to employee workflow.
  • In their most recent survey, 90.9 percent of patients were pleased with the care they received, and 95.8 percent would schedule another appointment with the clinic.

Palazzolo attributes these successes to a number of lean-in-daily work activities, including 10-minute daily huddles in which the entire staff meets at the clinic’s metric board to discuss what they can do better or differently. Each employee takes the lead for a full week. “So we all own it,” he says.

“With our patients’ needs, what we do can be very complex. Lean helps us achieve highly coordinated patient-centered care.”

Associate Dean for Clinical Affairs and Professor of Internal Medicine Jack Billi, M.D., agrees. “The Pre-Op Clinic at Domino’s Farm’s is a ‘model line’ for the Michigan Quality System’s lean in daily work system,” Billi says.

“Bill and his staff integrate robust teamwork, visual management and structured problem-solving into how they do their work every day. Their employee engagement and patient satisfaction results prove out the lean maxim that ‘Good process produces good results.’”