In-house efforts: House officers make commitment to improving patient safety

March 11, 2019  //  FOUND IN: Our Employees,

Jay Nathan, M.D., and Raymond Yeow, M.D.

Michigan Medicine is joining thousands of health care organizations across the country this week in celebration of National Patient Safety Awareness Week.

Sponsored by the National Patient Safety Foundation, the goal of this week is to celebrate ongoing patient safety efforts and engage health care providers, patients and their families in conversations about safety and its critical role in health care delivery.

As part of these efforts, the organization is highlighting one important group on the frontlines of patient care — house officers.

House officers include physicians who have graduated medical school and are participating in accredited training programs, such as residents and fellows. Michigan Medicine typically has more than 1,250 residents and fellows in training every day.

The House Officer Quality Safety Committee (HOQSC) was established in 2011 with the goal of increasing the direct involvement of house officers in quality and safety initiatives to improve patient outcomes. It is a joint venture between house officers and the Office of Clinical Affairs.

“House officers have a unique perspective on quality and safety improvement efforts that are vital to the organization,” said Maureen Thompson, M.S.N., R.N., director of clinical operations in the Office of Clinical Affairs, who helps lead the group. “The efforts led by HOQSC benefit not only faculty and staff across Michigan Medicine but also our patients.”

Commitment to patient safety

Patient safety is always one area of focus for the committee. A house officer sits on multidisciplinary event reviews led by the Office of Patient Safety, and the group is heavily involved in the initial work implementing Michigan Medicine’s journey to high reliability.

Members of HOQSC will continue to play a central role in helping shape the organization’s patient safety culture as this work continues over the next several years.

The group also focuses efforts on other aspects of patient safety that are important to the organization.

“One initiative the committee is always working on is improving reporting of patient safety events and near misses,” said Jay Nathan, M.D., a house officer in the Department of Neurosurgery and co-chair of the HOQSC. “We have a subcommittee solely dedicated to improving the reporting rate among house officers. Reporting events is the only way to make sure the institution is aware of them and can identify system-level improvements that can be made to keep our patients safe.”

The committee reviews all patient safety events reported by house officers at their monthly meetings and encourages group discussion about ways to improve patient care. This discussion enables members to review every event from the house officer perspective and identify opportunities for improvement that can be shared across departments.

“House officers are on the front-lines of patient care so we see safety events happening in real-time,” said Raymond Yeow, M.D., a house officer in internal medicine and co-chair of the HOQSC. “Providing our members a forum in which to discuss events and learn from one another is an important part of what we do.”

Quality improvement efforts

The committee is also involved in quality improvement efforts across the organization and reports to the Michigan Medicine Clinical Quality Committee.

“As a committee, we work to represent the voice of house officers across the organization on different hospitalwide committees that are relevant to clinical care,” said Nathan. “Currently, we have more than 110 members representing 32 specialties. Every department has at least one member represented.”

Each year, HOQSC undertakes one or two key initiatives that are of particular interest to house officers.

“Selecting initiatives is a very organic process,” said Yeow. “At one of our meetings early in the year, the group discusses and selects a few issues we want to tackle during the year. Members of the group then dive further into the work and report back to the full committee at monthly meetings.”

This year, a key initiative is improving communication between primary care teams and consult teams, and working to standardize how the two groups communicate. The group wanted to examine how consult teams could better communicate their needs to primary care teams so things wouldn’t get lost in the shuffle.

“We surveyed membership about what they thought main issues were between a primary team or consult team,” said Nathan. “For example, many members didn’t know if consult teams would see a patient every day or if they would monitor patients from a distance. So to help reduce the confusion, we created a template within MiChart that allows consult teams to indicate the frequency with which they would see patients and provide updated recommendations or describe the follow-up plan.”

The template has been deployed and is currently being used in consult notes. It is being monitored to see how often it is being used and HOQSC plans to re-survey membership to determine if it is having a positive impact.

“Our group really is a collaborative effort and we wouldn’t exist without the commitment and hard work of our members,” Nathan said. “I really encourage house officers to get involved and help us improve the quality of care we provide to our patients.”

The committee’s next meeting is Wednesday, March 13 from 6:15 – 7:30 p.m. If you are interested in attending or would like more information about the committee, please email Raymond Yeow or Jay Nathan directly.