Everyone plays a part in keeping our environment safe
Nothing is more important than maintaining a blanket of safety and security for our patients and staff. Daily efforts by all Michigan Medicine faculty, staff and learners work to preserve this level of safety, and many coworkers have shared examples of their peers going above and beyond and Speaking up for Safety through the Recognition site.
These “Make a Difference” awards exemplify the Safety and Quality initiative within our BASE strategic priorities — and often represent key High Reliability (HRO) skills.
Acting fast to keep patients safe
Keeping patients safe means working swiftly to resolve any safety issues that may arise, no matter what role you have.
Recently, clinical information analyst senior Stephanie Lewis praised senior IT professional Basanthi Krishnan for her help in navigating the safe treatment of a patient.
“Basanthi jumped in on a possible patient safety issue and we had a plan of correction in less than 15 minutes,” said Lewis. “Basanthi is the embodiment of a team player, always there to lend a helping hand.”
“Stephanie is a very dedicated supportive individual and always strives to give her best,” replied Krishnan. “She has extensive experience and knowledge about the United Network for Organ Sharing forms, and always willing to help us with questions. It’s a pleasure to work with her and her Clinical Information Analyst team.”
Anesthesia tech Nicholas Ingram made note of the great work done by IC planner associate Tyler Livingston, who displayed quick thinking as he took charge of a patient safety situation.
“Thank you, Tyler, for taking the time to facilitate an anesthesia recall during a busy day,” said Ingram. “Tyler was able to get approval of a sub and lead the way and we want to recognize him for his diligent work to ensure unsafe recalled supplies do not reach our patient!”
A questioning attitude can lead to the safest outcomes
In a fast-paced setting, it is key for staff and faculty to be thorough and meticulous in their work.
Clinical pharmacist generalist Logan Bixman recognized her coworker, Dana Moton-Cox, for spending extra time to ensure the safe treatment of a patient.
“On her second day of infusion training, Dana came across a ready-to-treat patient with an order for a drug supplied through an access program,” noted Bixman. “This drug isn’t seen often and its treatment required an incredibly long time researching the chart. When the dose and infusion instructions didn’t sit right with her, Dana worked tirelessly to get ahold of the provider. Her questioning attitude led to the safest treatment option for the patient.”
In the Transplant Center, Stephanie Lewis provided another recognition — this time for the hard work performed by fellow clinical information analyst Michele Kenney.
“Michele’s constant attention to detail has allowed us to catch multiple things that could have turned into patient safety issues,” said Lewis, adding that “Michele’s ability to ask when unsure allows us to provide top notch service to our patients and our colleagues.”
Promoting a culture of safety
Not only do care teams work hard to ensure patient safety, but many operate behind the scenes to create educational materials and build networks to enhance HRO skills and exemplify our BASE Safety and Quality strategic priority.
Educational nurse coordinator and adjunct clinical instructor Deborah Totzkay recently highlighted the work of fellow educational nurse coordinator Paula Marentay.
“Committed to enhancing patient safety, Paula dedicates literally hours of effort to developing policy content and educational materials that reduce the potential for unintentionally retained surgical items,” said Totzkay. “Most recently, Paula created and shared a presentation that adds clarity to our surgical count practice changes, thereby empowering perioperative staff to enrich our culture of safety.”
“Paula is passionate about her commitment to patient and staff safety,” added Totzkay. “The scale of this work is crucial to gaining behavior change.”
Safety and high reliable skills are often best taught by example. Safety coaches and safety stories help share how staff can best use these skills on the job. Deborah Kollar, B.S., M.H.A., R.T.(R)(MR), administrative manager for the Department of Radiology at C.S. Mott Children’s Hospital, was recognized for her role as a safety coach and for coming forward during a training session to share a safety story.
“The HRO team believes it is important for our newly onboarded coaches to hear from their fellow coaches,” said Kathrynn Thompson, high reliability lead for quality. “By role modeling the expected HRO behaviors, skills and tools — and encouraging those around her to do the same — Debbie is influencing positive culture change.”
“I find the safety coach rewarding,” Kollar said. “I feel very blessed and enjoy seeing my staff tell the stories that they encounter using the high reliability skills and tools. I can tell that it makes them feel good to be a part of this.”
The safety story below is a great example of how one of her team members spoke up for safety and used the ARCC (Ask, Request, Concern, Chain of Command) tool to provide safe patient care:
“In C&W, a 6-month-old baby arrived at 2 a.m. due to possibly swallowing a foreign object. X-ray images didn’t show any signs and, following standard protocol, a swallow study was ordered. The mom told the x-ray tech that she thought she saw some white spots on the roof of the baby’s mouth. When the peds surgery and the radiology residents arrived, the tech asked if one of them could look inside the baby’s mouth to validate and verify that there was nothing there. She requested a change in protocol. The surgeon checked and pulled out a piece of plastic the size of a quarter. If the tech hadn’t voiced her safety concern, the plastic could have lodged in the baby’s throat, causing an airway blockage. Chain of command was not needed, as the physicians heard the x-ray tech’s concern and performed the cross-check requested. Putting ARCC into action prevented a serious incident from occurring.”