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 #58: Optimizing Stroke Care & Breaking Barriers: Achieving Rapid Door to Thrombolytic Times in a Freestanding ED
Jacob Maine, Satheesh Gunaga, Darby M. Russell, Edyta Andersen, Ashley L. Krol, Toni Silas, Kristina Cross, Lin Andreoli, Timothy Manning, Laure Tartal, Holly Stos, Christina Sarkody, Ryan Spencer, Elizabeth Plemmons, and Fadi Delly
Primary Aim: To establish a freestanding acute stroke ready certified Emergency Department at Henry Ford Health Center-Brownstown, serving as a proof-of-concept pilot for Henry Ford Health. Early Stroke Identification and Treatment Aims: Implement a redefined process to ensure that patients suffering from acute ischemic stroke in our community receive prompt, consistent, safe, and high-quality revascularization of at-risk brain tissue. Implementation Aims: Implement a robust monitoring and evaluation system to... Read More
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Project #59: Framework for building a departmental quality and safety program
Namita Jayaprakash, Brittany A. Betham, Rebecca A. Lenz, Michelle Slezak, Seth Krupp, Jennifer Peltzer-Jones, Justin Bright, and John Deledda
Introduction: The Department of Emergency Medicine (DEM) quality assurance and peer review program was established in 2015 and has been successful in formalizing the quality assurance. A gap existed in the translation of identification of gaps to translation to quality improvement and process improvement projects. Quality management systems document processes, procedures, responsibilities for achieving quality policies and objectives. They’re designed with a purpose to enhance the quality of care... Read More
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Project #60: Early identification of impairments after neck dissection surgery to support timely referral to outpatient physical therapy
Jessica Gibson and Adele Myszenski
Background: Neck dissection surgery (ND) for head and neck cancer (HNC) can cause shoulder weakness, loss of range of motion (ROM), and pain resulting in decreased quality of life (QOL); Implement functional and physical outcome measures to quantify deficits; Identify need for outpatient physical therapy (PT) referral through outcome measures while inpatient.
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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 #62: Collaboration is Key: Embedded Clinical Pharmacists in Primary Care Clinics Collaborate to Help Patients with Diabetes and Cardiovascular Risk
Emily Thomas, Christine Jiang, Patricia Lee, Octavia Solomon, Sarah Kolander, Terry Gottschall, Alison Lobkovich, Namitha Nair, Maksym Nykin, Kylie Schmitt, Priscilla Howard, Marwa Hammoud, and Ericka B. Ridgeway
Aim: Embedded clinical pharmacists within primary care clinics optimize pharmacologic care for patients with high-risk disease states including Type 2 Diabetes Mellitus (T2DM) and established cardiovascular disease. Glucagon-like peptide 1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) are two classes of evidence-based therapies for these indications. However, medication access is a common barrier for these medications due to high cost, drug shortages, and need for insurance... Read More
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Project #63: Supporting New Nurses Transition to Practice
Betty Bear, Jodie M. Cole, Tara Govan, Astacia Hahn, Mary Kravutske, Lauren Lowell, Michael Mannina, Kim M. Meeker, Hannah N. Rice, Debra Temrowski, Brenda VanWallaghen, Leni Ward, and Bernadette M. White
Problem Statement: Henry Ford Wyandotte Hospital (HFWH) 2022 annualized 1st year Nurse Resident (NR) turnover data was the highest amongst all Henry Ford Health hospitals. The results illuminated the need for priority focus and intervention. An overwhelming amount of literature indicates that lack of an effective transition to practice program for graduate nurses in a hospital setting can lead to issues such as: Inadequate Skill Development; Increased Stress and... Read More
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Project #64: Home Health Visit Utilization
James Foucher, Kathy Bulgarelli, Beth Newman, Kim Robinson, Lisa Tischbein, Rose Anne M. Coffey, Amanda Tarlton, Kay Renny, and Lisa G. Davani
An opportunity exists to improve our episode management in Home Health Care, specifically for visit utilization and care coordination during the episode of care. The current process leads to improper utilization of resources, which leads to poor financial outcomes for HFHHC, and/or poor clinical outcomes for patients, as well as poor satisfaction on patient surveys (HHCAHPS). Improvement should result in better financial outcomes for HFHHC and improved patient clinical... Read More
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Project #65: Senior Care Navigator Program: Using Care Navigation to Improve Patient-Reported Outcomes Amongst Older Adult Patients
Veronica Bilicki, Laura L. Susick, Lonni Schultz, Sara Santarossa, Shetoya Rice, Philesha Gough, Nubia Brewster, and Rob Behrendt
Problem Statement: Older adults struggle to navigate health and social care systems, resulting in poorer patient health and satisfaction. Improvement (Goal) Statement: Design and implement a patient navigation program to help older adult patients and their caregivers navigate the health and social care systems resulting in improved patient health and satisfaction.
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Project #66: Improvement of Deep Sedation Practices Post Rapid Sequence Intubation with Rocuronium
Gurpreet Kaur, Elizabeth Kunjummen, Adam Ladzinski, Javardo McIntosh, and Javad Najjar-Mojarrab
Rocuronium is a paralytic agent commonly used for rapid sequence intubation(RSI): Onset 60-75seconds, duration 40-60minutes; Deep sedation is recommended post RSI; Propofol is a sedative frequently used in ICU for sedation; Barriers to use of propofol for deep sedation post RSI with Rocuronium; Hemodynamic instability; Ordered as PAD light sedation protocol. Baseline Date: Patients intubated using rocuronium in Pod 1, 2, and 4 between January 1st and March 31st... Read More
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Project #67: Utilizing Human Factors and Ergonomics Approach to Improve Workforce Safety at Henry Ford Hospital
Jessica Salazar, Megan Efremov, and Swati Verma
A physically and psychologically safe staff is essential to providing high-quality care that meets the needs of patients. We have utilized a human factors and ergonomics approach to reduce the high incidence of injuries to our staff related to slips/trips/falls or struck by injuries from equipment throughout the basement. Through the implementation of a variety of initiatives our goal was to reduce struck by and slip, trip, and fall... 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 #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 #70: Use of Virtual Monitoring to Prevent Inpatient Hospital Falls
Diane Wyatt, Jodie Cole, Lily Paciorkowski, Caleb Ashley, and Rebecca Conti
Problem Statement: Limited in-person patient safety assistants (PSA) for fall risk patients contributing to our high fall rates: Fall rates higher than NDNQI target of 2.70 x 2 years; Fall with injury rates below NDNQI target of 0.58 and 0.60, but trending up; Staffing challenges with PSAs and nursing staff; Higher acuity patients; Nursing assistants (NA) removed from patient care to fulfill PSA duties when not available. Improvement Statement:... Read More
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Project #71: Creating a Pressure Injury Prevention (PIP) Rounding Team to Reduce Healthcare Acquired Pressure Injuries (HAPIs)
Diane Wyatt, Andrea Sheldrake, Maria Masongsong, Maria Toscano, Yvette Toscano, Julie Metzger, Tonya M. Layow, Paula Majors, Caleb Ashley, and Brenda VanWallaghen
Problem statement: Patients were lacking application of pressure injury prevention interventions leading to HAPIs: Newer staff who had less experience with wounds and wound prevention; Auditing showed few interventions in place and lack of Q2 hour turns. Improvement Statement: Implement a multidisciplinary PIP rounding team comprised of leaders, certified wound care nurses, HAPI & PIP committee members, skin champions, and new nursing staff monthly to provide education to staff,... 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
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Project #73: Implementation of a Multi-Faceted Approach to Reduce Catheter Associated Urinary Tract Infection (CAUTI)
Jocelyn Maceri
Aim: By December of 2022, Henry Ford Health (HFH) - Detroit inpatients requiring an indwelling urinary catheter will be less likely to develop a Catheter Associated Urinary Tract Infection (CAUTI), by decreasing annual CAUTI occurrence to 3 or less (66% decrease from 2021) utilizing a multifaceted quality improvement approach.
Plan: Urinary Tract Infections (UTIs) are a very common and impact about 150 million people worldwide annually (Werneberg, 2022). Per... 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
Aim: 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 #76: Enhancing Visual Communications for Dialysis Team Members
Tiffany Riley, Allyce Haney Smith, Jake Garbutt, Jennifer Holcomb, Nicholas A. Kromrei, and Laurie Amburn
Communication among dialysis teams can be improved through a digital, visual method of information dissemination. This allows dialysis teams to access quality metrics and expand knowledge to improve safety and implement of standards of practice. The current process includes sharing quality metrics, organizational updates, and safety reminders through email, placing postings in break rooms, and during brief team huddles. These practices can cause inconsistent communication across dialysis facilities: (a)... Read More
