The Quality Expo is an opportunity for improvement projects created by employees to be shared as part of the Henry Ford Health culture of continuous process improvement.
For more information, visit https://onehenry.hfhs.org/departments/qualityandsafety/Pages/Quality-Expo.aspx
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Project #10: Less Chaff, More Wheat: Clinical Decision Support Governance
David Allard, Donna S. Summers, Brian M. Church, Lori Doyle, Michael Eichenhorn, Pam Ferguson, Matt George, Christopher Gortat, Mary Griffin, Salim Hamadeh, John Joseph, Tanya Larocque, Ronnel G. Miranda, Rajika L. Munasinghe, Lance K. Podsiad, Martin Ratusznik, Ilan Rubinfeld, Jonathan Sykes, Glenn Tokarski, Rachel Tshiamala, Cynthia Valerio, Adrienne Vaught, and Linda Vergilio-Panek
Aim: Use governance structures to establish guidelines for effective use, oversight, approval and post-implementation assessment of clinical decision support tools Improve the sophistication of team in designing and implementing effective decision support. Use five rights of decision support (the right information, to the right person, in the right format, through the right channel, at the right time in the workflow) as guiding framework for design and review. Minimize impact... Read More
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Project #24: Reducing Blood Culture Contamination Rates in the Emergency Department
Kelly Ashcraft and Marlene Derbyshire-Green
Sepsis and Septic Shock is one of the leading causes of death in the United States. Blood cultures are an important diagnostic tool for identifying pathogens responsible for infection. Blood culture contamination is a significant problem which can result in unnecessary antibiotic exposure, extended length of stay, and increased hospital expense. Recent studies associate 1 false positive blood culture with $4,162 avoidable cost and 3.7 extended hospital days1. A... Read More
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Project #50: Utilization of PIC Score to reduce ICU utilization in patients with chest injury
Shanen Beck, Sara Glowzinski, Marianne Franco, and Maria Schneider
Aim: To achieve 10% reduction in ICU utilization for chest injured patients at West Bloomfield Hospital, while maintaining 0% adverse event rate attributable to placement in a lower acuity setting within 12 months of implementation.
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Project #69: Improving the Documentation and Utilization of Alteplase as a Declotting Agent for Specific Central Lines at Henry Ford Hospital
Kiera Kaiser, Sharron Alejandria, Cindy Quinn, Robin Williams, Swati Verma, and Teresa M. Eiben
Aim: To improve the documentation and utilization of Alteplase as a declotting agent for patient with specific central lines: Peripherally Inserted Central Catheters (PICCs), Central Venous Catheters (CVCs), and Hemodialysis Catheters (HD).
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Project #53:Clinical Decision Unit (CDU)
Anna Leszczynski, Elizabeth F. Ashley, Kristina M. Cross, Wendy Butterfield, Ghazwan Atto, Ghassan Atto, Toni Silas, Elizabeth Plemmons, and Ryan Spencer
Aim: Focused action plan to decrease observation patients’ length of stay (LOS) supporting increased hospital bed capacity. The goal is for decision to discharge as observation or admission occurring under 23 hours of placement. This reduction in LOS will result in expanded site capacity, decreasing holding hours for all admitted and observation patients bed placement. Observation LOS at other observation units at Wyandotte Hospital from October 2022-November 2023 average... Read More
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Project #18: Improving Early Detection of Clostridioides difficile Infections Through Electronic Reports
Hannah M. Musgrove, Abigail Ruby, Princetta Morales, Yolanda Thompson, Eman Chami, Arielle H. Gupta, Geehan Suleyman, Gwen Gnam, and Edward Pollak
Clostridioides difficile (C. difficile) is a serious infection, causing life-threatening diarrhea. Patients with C. difficile will have liquid, loose, mucous-like, or non-formed stools. The financial burden of C. difficile infection (CDI) is substantial, increasing costs up to an additional $32,000 during hospitalization.1 These patients can have complications leading to surgical intervention, longer length of stay, and are at risk for recurrent infection, which further adds to healthcare cost.2 Each... Read More
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Project #19: Using Interprofessional Collaboration to Reduce Reported Rates of Central Line-Associated Bloodstream Infection in an Intensive Care Setting
Hannah M. Musgrove, Abigail Ruby, Yolanda Thompson, Eman Chami, Gwen Gnam, Edward Pollak, Geehan Suleyman, and Arielle H. Gupta
Central line-associated bloodstream infections (CLABSIs) are preventable healthcare-associated infections (HAIs) associated with increased morbidity, mortality, and prolonged hospital stay. Additionally, CLABSIs are the most expensive HAIs with an estimated cost of $46,000 per case.
Problem Statement: The surgical intensive care unit (SICU) at Henry Ford Hospital experience high rates of CLABSI in 2019 and 2020. Improvement Statement: By end 2022, the goal was to reduce the CLABSI rate per... Read More
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Project #30: Reduction in use of CXR for Children with Asthma, Bronchiolitis, and Croup
Elizabeth Plemmons, Trisha Ribitch, Zoe Kaps, and Asma Engelbrecht
Problem Statement: Respiratory illnesses particularly asthma, bronchiolitis and croup are among the top diagnoses for which children visit the emergency department. Chest x-rays are frequently used by emergency providers in children presenting with these conditions, yet they rarely reveal information that contribute to changes in management and can lead to excess cost, radiation exposure, & overtreatment with antibiotics.
Improvement (Goal) Statement: Reduce the use of chest x-rays in children... Read More
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Project #75: Serious Safety Event STAT Huddle Improving Employee and Patient Safety
A. Renee Richards, Jane Ziemba, Megan E. Prochazka, Brooke M. Buckley, Kim M. Meeker, Thomas McKeown, and Rand O'Leary
Safest Care and Best Outcome Opportunity: Reduce delays in awareness and declaration of serious safety events to:
Expedite immediate actions to ensure patient and employee safety.
Understanding what is preventable at the time of harm occurrence.
Addressing immediate needs of patient, family, and caregivers.
Chartering Root Cause Analysis team to focus on process opportunities may have led to contributed to the serious safety event.
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Project #42: Improving Documentation for Trauma Patients in the Emergency Department
Michelle Ring, Lisa Simpson, and Vanessa L. Wargosie
Problem Statement: Staff turnover and lack of standardized processes led to missing documentation and inefficient management of trauma patients. The RNs in the ED at HFWH need education, support, consistency, and prompt feedback to ensure high quality trauma care that meets American College of Surgeons (ACS) national benchmarking standards. In previous years, overall trauma documentation for vital signs and GCS were below the national trauma standard of 90% and... Read More
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Project #46: Enhancing the Sepsis Narrator Tool to Improve Patient Care and Outcomes
Suzanne Schlacht, Heatha Bailey, Darinda L. Blaskie, Ronnel G. Miranda, Tanya Larocque, Cynthia Valerio, Jean Kokochak, and Namita Jayaprakash
Background: The SEP 1 bundle is evidence based best practice guidelines for the management of patients with severe sepsis and septic shock. Compliance with SEP 1 bundled care is monitored by CMS and publicly reported. When all required SEP 1 bundle elements are delivered within timing specifications of 3- and 6-hours, patient outcomes demonstrate lower mortality, fewer complications, and a reduction in length of stay.
Problem statement: At Henry... Read More
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Project #61: Vasopressin is #1: Optimization of Vasopressin Use with a Multidisciplinary Health System Approach
Zach Smith, Patrick Long, Kristin M. Griebe, Nicole Morearty, Jessica Buchanan, Vince Procopio, Amanda Roberts, Gay Alcenius, Kimberly Corpus, Diana Kostoff, Charles T. Makowski, Carolyn Fascetti, Rachel Eklund, Jennifer Swiderek, Daniel R. Ouellette, Michael Peters, and Jayson Zebari
Introduction: Each year the pharmacy enterprise reviews the top 25 inpatient medication expenditures to assess for optimization in medication use. In 2022 vasopressin, a vasopressor agent used in critically ill patients, was the #1 inpatient medication expenditure with a total cost of $2.7 million USD. A multi-pronged approach was developed to optimize the use of vasopressin in critically ill patients in a cost-efficient manner, that would not impact patient... Read More
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Project #68: A Collaborative Approach to Enhance the Radiology Scheduling and Access Experience
Karen A. Sparks, Charity A. Williams, Ben Halliwill, Nicole Buckingham, and Josie Herrick
The Northwest Territory has grown exponentially in last the 5 years with the opening of 3 major medical centers(Bloomfield Twp, Royal Oak and Plymouth). As a result, there has been an influx in need for scheduling and access for our patients. The previous departmental and technical set up (phone system)was unable to accommodate such increases which resulted in higher queue totals and patient dissatisfaction. Utilizing a collaborative approach our... Read More
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Project #72: Empathic Inquiry: An Approach to Assessing Social Needs among Patients
Renee A. Zack, Dana Parke, Andrew S. Bossick, and Denise White-Perkins
Improve screening rates and results for social determinant of health (SDOH) needs, specifically food insecurity (FI), among patients across all HFH primary care clinics Design and implement a training with the goal of improving screening rates by giving staff the communication skills required to appropriately assess patients’ needs Provide staff with tools to enhance the patient care experience by using empathy when assessing patients’ social needs Equip staff with... Read More