Improving professionalism and accountability for physicians

• “When I raised my concern to Dr. AA, Dr. AA rolled his eyes.”
• “I told Dr. BB our policy didn’t allow us to do that. Dr. BB said ‘Well can you put me on the phone with someone who knows what they’re doing?’”
• “The patient was in on isolation precautions for C.diff. I reached for the cart to hand Dr. CC and the student gowns and gloves. Dr. CC replied, ‘It doesn’t matter. I took care of him this morning before we knew he had C. diff. It’s too late for me.’”

These are actual concerns documented by coworkers at Michigan Medicine. They range from impolite behavior to serious safety risks — for both patients and colleagues.

Repeated issues like these create an unpleasant and potentially dangerous work environment for the entire care team and patients. 

To bring more awareness to these concerns and to help physicians, Michigan Medicine recently kicked off a new program focused on improving the professionalism and accountability for clinical faculty.

Working together, the Office of Clinical Affairs and the Office of Patient Experience have partnered with Vanderbilt University’s Center for Patient and Professional Advocacy (CPPA) to implement the evidence-based Patient Advocacy Reporting System (PARS) and Coworker Observation Reporting System (CORS). This program uses informal and confidential volunteer peer mentors to inform faculty about concerns from patients and coworkers.

Supporting ongoing initiatives 

PARS and CORS aligns with many of the initiatives currently active at Michigan Medicine, including the journey to High Reliability; the establishment of a Wellness Office for all Michigan Medicine employees; Diversity, Equity & Inclusion initiatives; Sexual Misconduct policy updates; and the LCME accreditation process.

“Promoting professionalism is critical to supporting our efforts to improve our culture of safety and aligns with our High Reliability journey,” said Jeff Desmond, M.D., chief medical officer. “We have always had processes to help faculty succeed, but PARS and CORS will be additional tools that leverage trained peers to help promote professionalism among clinical faculty.”

According to the CPPA, this approach has been successful across all specialties and at more than 180 institutions, many of which are academic medical centers. 

How it works

Faculty, staff, patients and families report concerns or issues through the Risk Pro RL patient safety reporting system. All Michigan Medicine patient and coworker risk, safety and complaint data is compiled daily and securely sent to Vanderbilt, where the data is processed via proprietary algorithms to identify physicians with professionalism concerns.

The program then generates reports, which are sent back to Michigan Medicine with summarized findings. Michigan Medicine faculty peer mentors and select leaders review the reports and follow a standard set of guided steps to dispatch informal confidential peer mentors to meet with identified physicians in the report.

Those physicians will receive feedback from trained peer mentors and be monitored for future concerns for a period of three years. If no additional occurrences occur within that time frame, the faculty member will be released from the program. 

“Institutions which have successfully administered the program have seen improvements in professionalism, patient safety and employee engagement,” said Keith Gran, chief patient experience officer at Michigan Medicine. “When we address issues early, the experience for our patients and families also improves.”

How you can help

To succeed, this program requires full support from all faculty, staff, patients and families at Michigan Medicine. Any time you observe behavior by clinical faculty that poses a risk to patients and colleagues, you have three ways to report it:

• Click here to complete a report in the Risk Pro RL patient safety reporting system
• Call the Compliance Hotline: 866-990-0111. The hotline is a professional call intake and triage center, operated by a third party vendor (outside of U-M) and staffed with interview specialists who are available 24/7/365. If you wish, you can request to file your report anonymously and your anonymity will be protected.
• Contact the Office of Clinical Affairs: 734-647-2239.

While it is best to address issues directly with those involved, if that is not possible or if you are not comfortable with that, please use the options above.

Thank you making the effort to improve professionalism, safety and accountability at Michigan Medicine!