Integrity: Doing the right thing
Michigan Medicine’s core value of integrity reads: “I will adhere to the highest ethical standards, demonstrating courage, truth, and transparency in my words and actions.”
While it may feel a bit overwhelming to hold ourselves to high standards, it’s often the little things we see and do every day that encourage us to do the right thing. We see it in the teammate who can be counted on for extra support, the leader who sets a good example, the person who has the courage to speak up and the one who is respectful and listens.
Here are a few examples of how our coworkers are bringing integrity to life at Michigan Medicine:
Another good catch
The fast-paced operating room environment at University Hospital must run under a strict routine to keep things orderly, but sometimes routine become so automatic that things get missed. Fortunately, the sharp eyes and attention to detail mindset of staff nurse Jaclyn Bourdon averted what could have been a serious contamination issue.
“I saw some black debris on a sterile saline bottle and needed another set of eyes to confirm this wasn’t normal,” she said. “I have always incorporated ‘see something, say something’ into my practice. Amy [Neubecker] was the next person I went to after I saw the debris, and she confirmed that this was not normal and suggested we escalate it from there.”
Neubecker, an otolaryngology surgical services lead, alerted the charge nurse, Katie Bornhoft, who quickly assigned perioperative techs to examine all bottles of sterile water and saline in the OR core storage, while Neubecker went from OR to OR to alert surgical staff.
Bottles of sterile saline are used in every surgical case, with an average of 70-100 surgical cases a day. The debris could have contaminated sterile fields, which increases the risk of surgical site infections across all the UH ORs.
The quick response from the team and leadership support prevented any potential patient harm and represents many high reliability safety skills, including “Speak up for Safety,” “Know Why and Comply” and “Attention to Detail.”
A smile in her voice
After 16 years as an inpatient unit clerk, you would think Deicy Barroso would be settled in at one unit, but although she is most often seen in C&W 8 East, she is cross-trained to serve seven other adult units within C&W, UH and UH South.
That’s because she can be counted on to flex to a new schedule at a moment’s notice, especially in high-stress situations, when nursing clerical services become understaffed, a more common occurrence since the pandemic.
“Deicy has been moved to different units without advance notice several times and she always accepts the challenge without hesitation,” said clerical senior supervisor Marilyn Cullen. “She’s even been asked to work two units for half of her shift and she has accepted the challenge with a smile in her voice.”
Barroso, who provides support and customer service to patients, visitors and staff, believes it’s her job to provide everyone with a positive experience at Michigan Medicine.
“Some people feel at their lowest when hospitalized,” she said. “Encouragement goes a long way to recovery and well-being. The people that come to the hospital are looking for answers to make themselves healthy again. I treat our patients with respect, consideration, empathy and encouragement to assist in having them go home happy.”
If not me, who?
It was a standard retinal checkup with a patient who visited Northville’s Ophthalmology Clinic on a regular basis. But when ophthalmic technician Alison Burke realized the patient couldn’t remember the date, she became worried that this woman might not be able to give proper consent. She had to speak up.
“We’d cared for this patient before and knew she had dementia, but this time she was obviously having a bad day,” Burke said. “I didn’t want her to have a shot, get upset and not clearly understand why she was having it. If this was my grandmother, I would want to make sure she was completely comfortable with what was happening.”
“We often read things to patients who have visual impairments and help people with simple items on a form,” said assistant administrative manager Katie Francisco. “It’s easy to overlook something like a wrong date and move on. That’s why it was important for Alison to question it and look at what was really going on.”
Once Burke raised the issue with Francisco, they contacted the patient’s daughter and discovered there was a power of attorney which needed to be on file at the clinic. Once faxed and verified, the patient was able to receive the necessary treatment.
According to Northville’s Ambulatory Care Director Cara Shepard, Burke had used the High Reliability skills of “Humble Inquiry,” “Validate and Verify,” “Know Why and Comply,” and “Speak up for Safety” when she supported this patient.
“I work under the idea, ‘If not me, who? If not now, when?’” Burke said. “I believe in saving a patient’s energy. It’s often hard for them to come in for treatment, and it might be easier to shuffle someone through a process quickly. However, if something isn’t right, or if a patient becomes frightened or confused, it will take twice as long to do it over again correctly.”
It’s a people business
A nurse at Mott recently reached out and recognized unit custodian Ken Collins, saying, “Ken never has a day that he doesn’t offer help outside the scope of his job. He is always willing to lend a hand and help families and staff.”
Collins doesn’t see it that way: “I’ve never really seen my job description, but I feel it’s a people business. We clean, but it’s really just about taking care of people.”
For the past seven years, Collins has worked in Environmental Services, and whether he was assigned to the NICU, Mott or his current location, the Med Inn Sleep Lab, he believes it’s important to make a difference for those he meets along the way.
“It’s part of the deal,” he said. “When you work in a place where people are sick, some of them terminally-ill, you do what you can to help them feel normal. I may walk past a room and hear a patient ask for a blanket or a glass of water, and the nurse is busy charting, and I will get it. It’s the little things that can make their day better. It might be as simple as saying good morning or ask how they are doing. That might be all takes to help people, so why not?”
Finding answers in the questions
We often think that a call center representative has all the answers, but Lynette Duguay, representative for rheumatology, is full of questions — and all the right ones, according to Karen Click, R.N.
“Lynette is always cheerful and is always asking fantastic questions,” Click said. “Her questions help her more fully understand what is going on with patients so that she can direct their calls and assist patients in the most appropriate and helpful way. Our call center agents frequently deal with folks who are in pain and not necessarily at their best. She never seems to let crankiness, for example, affect her competence or her attitude. She is respectful and her genuine caring comes through on the phone.”
Duguay sees her role as part of a support system.
“Sometimes patients feel very overwhelmed with all that is going on, especially if they are seeing multiple doctors or have just received their diagnosis,” she said. “I try to be the person that will listen to them or help them navigate through what they are going through, even if it’s just trying to coordinate appointments for them. I always try to treat patients how I would want to be treated or how I would want my family members treated.
“I have learned over the past three years that even if someone is unfriendly, as long as I am nice to them, I can usually change their attitude. I try with every call to put a smile on my face and remember that my attitude will have an effect on the person on the other end of the phone.”
Building confidence to improve care
A team of professionals working within the Cardiac Intensive Care Unit (CICU) grew concerned that internal medicine residents doing rotations on the unit may lack knowledge to provide the unique therapies required for complex patients.
To build their confidence and integrity, a multidisciplinary team, led by house officer Ahmad Abdul-Aziz, M.D., Michael Thomas, M.D., and Sarah Adie, Pharm.D., BCCP, developed a CICU handbook to improve knowledge and confidence in several CICU procedures, such hemodynamics, mechanical ventilation and targeted temperature management.
A follow up survey showed significant improvements in confident levels in residents after using the guide as a resource.
For example, only 6% of residents reported they were confident in sedation knowledge in a pre-survey compared to 90% in the post-survey, while 5% reported being confident in hemodynamics before using the guide compared to 92% afterwards. In general, there were improvements in all eight procedures represented in the guide. The guide is now emailed out to all residents and interns on their first day of rotation and is also shared with medical students.