Each October, Michigan Medicine celebrates the efforts that faculty and staff make in order to improve the quality and safety of patient care across the institution. With its commitment to collaboration and innovation, the Department of Pathology is always well represented at the annual Quality Month event. This year was no exception.
The October 18th event featured a poster session, break-out sessions, and talks. It began with the panel Engaging Patients in Quality Improvement, moderated by Dr. Steven J. Bernstein and featuring the departments of cardiology and pathology. Patient members, Michele Mitchell, and Dennis Serras, of the Department of Pathology’s Patient and Families Advisory Council (PFAC), shared their stories, along with Vice Chair of Clinical Affairs and Quality, Dr. Jeffrey Myers. “Participating in the Quality Panel was so rewarding!” Mitchell said. “I so enjoyed sharing specifics as to how the Pathology PFAC has used the patient voice to impact real work.”
The event’s posters highlighted teams and projects that have used the Plan-Do-Check-Act (PDCA) cycle throughout the year. The PDCA cycle is a four-step model for carrying out positive change. It consists of recognizing an area for improvement, planning an experiment to test a change, reviewing the results and identifying what was learned, and then taking action based on the study. The PDCA cycle is intended to be never-ending, for continuous improvement.
The Quality Month projects must demonstrate:
Members of The Department of Pathology worked on projects featured in nine of the event’s eighty-four posters. Additionally, a poster from the Department of Social Work by Lisbeth Harcourt, LMSW and Erin Loomer, an MSW student intern, featured The Traumatic Death Outreach Program which benefits patient families of U-M’s Washtenaw County Medical Examiner’s Office which is part of the division of anatomic pathology.
The Quality Month Poster Review Team selects exemplar finalists and an exemplar winner. The poster, Reducing Inappropriate Laboratory Ordering for Heparin-Induced Thrombocytopenia (HIT), a multi-disciplinary project including pathology’s special coagulation technologists and Drs. Scott Owens, Lee Schroeder, and Steven Pipe, and staff members Jeff Lott, Usha Kota, Linda Johnson, and Lindsay Szczepanski, was one of four exemplar finalists.
Heparin is commonly prescribed for hospitalized patients but it can cause a potential for HIT. Using PF4 ELISA (protein four antibody enzyme-linked immunosorbent assay) and serotonin release assays (SRA) testing can help predict a patient’s likelihood of developing HIT. However, hematologists and hospitalists had concerns over the appropriateness of testing and wanted to measure compliance to standards to reduce inappropriate use. It was found that only 44% of the tests ordered were clinically useful. A change was made to hold SRA orders until PF4 ELISA are back and only order SRA testing if required. The project resulted in a 75.6% reduction in the use of (SRA) testing across the hospital system.
The event’s exemplar winner was for the poster Optimizing Clinic Efficiency by Developing a Novel Bandage Wrapping Device. This project reduced the time spent rolling bandages enough to save five full weeks of staff time at just one MedSport clinic.
Pathology posters included:
Efficient Staffing of Satellite Labs (Recognized for impressive outcomes.)
Strategic Development of Two Fully Automated Arkray Aution Hybrid AU-4050 Urinalysis Analyzers (Recognized for impressive outcomes.)
Giving Innovance a Chance (Recognized for great use of technology.)
High Sensitivity Troponin T: Implementing a New Test in the Chemistry Lab (Recognized for great use of technology to improve care, efficiency, and money.)
Tandem Dye Antibody Breakdown Detection in new 10 Color Flow Cytometry Panels (Recognized for a great background section that clearly articulated the importance of solving this problem.)
Emergency Department Implementation of a High-Sensitivity Troponin T Assay within a Chest Pain Evaluation Pathway (Recognized for great problem statement and great use of a multi-disciplinary team.)
Reducing Inappropriate Laboratory Ordering for Heparin-Induced Thrombocytopenia (HIT) (Recognized as Exemplar Finalist.)
Impacting Antimicrobial Stewardship: With a Timely, Reliable POC Flu Test (Recognized for robust PDCA cycle with impressive outcomes.)
Identifying Patients at Risk for Hereditary Cancers (Recognized for great use of a multidisciplinary team with impressive use of technology.)
Our teams in the Department of Pathology are continuously looking at process improvements that will positively enhance the patient experience, optimize quality and safety, develop employees, lead to value creation, and improve financial performance and diversity and inclusion. We look forward to celebrating this year’s improvements at next year’s Quality Month event.