Shoutout: Safety Huddle results in solutions!

Every Monday through Friday at 10 a.m. we conduct a Safety Huddle at Henry Ford Hospital. One of the first things we do at the meeting is to give shoutouts, a collective praise given to team members who have gone over and beyond the usual.

This is my shoutout to the Safety Huddle.

The Safety Huddle is conducted to get problems reported and identified for correction.

Henry Ford Hospital conducts a daily Safety Huddle to report problems and identify solutions, and to share information.

The Safety Huddle is conducted to get problems reported and identified for correction. Some components are recurrent, such as looking at sentinel events, healthcare associated infections, patient satisfaction rounds, borders in the emergency department, beds available or anticipated, or femoral lines that are presently in patients. Others are episodic. An event, equipment breakdown, parking problem, you name it. Each part of the house is methodically asked to report issues or levels of activity, like occupancy in the newborn nursery or numbers of ventilators being used.

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The Yuck Factor

All of us in health care know the importance of cleaning and washing our hands when we care for others. This simple act can prevent injury to patients and save lives.

I am going to give you another reason to wash your hands.

Take a good look at the bacterial cultures of the hands of two of our employees. Hand2You can see those areas that represent growth of bacteria. Bacteria that can be transmitted to others, including our patients, our co-workers, our friends, our spouses, our children and ourselves.

This phenomenon qualifies by a very precise scientific term, YUCK. Continue reading

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IDEAL: Advancing Surgical Innovation

Advances in health care happen in a variety of ways.

Sometimes they occur as a matter of necessity – the desperate attempt to save a life.

Sometimes they occur as a matter of luck – the “eureka” moment of discovery.

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Robotic kidney surgery at Henry Ford Hospital.

Most of the time they occur as a result of thoughtful innovation, development and assessment, and then tested for reliability and safety.

When you take a prescription or an over-the-counter drug, you probably don’t give very much thought as to how that particular medication came to be; you know what it does, potential side-effects and why you’re taking it.

But there’s a strong process in place for developing new drugs and making them available to the masses, to ensure quality, safety and effectiveness:

  • The drug manufacturer tests it and submits evidence through a “new drug application” to the FDA’s Center for Drug Evaluation and Research (CDER).
  • A team of CDER physicians, statisticians, chemists, pharmacologists, and other scientists then review the data provided in the application and propose labeling, should it be approved for use.
  • After that a clinical research process continues to test the validity of the studies and role of the medication in the treatment process.

Clear. Effective. Tested.

Ever wonder how the tracheostomy came to be a surgical method of treating an obstruction in the trachea?

The technique was clearly an innovation at the time. But it was not required to go through a randomized controlled trial or other strictures required of new prescription drugs and medical procedures.

You can take a drug “off label” for other uses – there’s a clear method for researching alternative uses and effectiveness as such.

Shouldn’t we have something similar in place for new surgical techniques? For surgical and procedural cases, the “off label” uses are not as clearly understood or often as rigorously scrutinized.

Once the “off label” procedure is proven to work, how do we ensure that it is safely performed by other surgeons and proceduralists? Continue reading

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The Annual Quality Expo

This week marked Henry Ford Health System’s 21st Annual Quality Expo.

The Quality Expo, hosted at Henry Ford Hospital, offers an opportunity for all of Henry Ford Health System to showcase the innovations and improvements made by our employees, departments and hospitals in the areas of health care quality, patient safety and care delivery.

Leo, a therapy dog at Henry Ford Wyandotte Hospital, is one of the most remarkable therapists that I have ever encountered. Leo and HFWH’s Pet Therapy Program were featured at the Quality Expo.

Henry Ford is the only health care provider in southeast Michigan to host such an event.

The Quality Expo’s features 70 projects, all of which are aimed at reducing medical errors and improving patient safety, quality and satisfaction.

As always at this event, I was truly impressed, as I walked through the poster presentations and spoke with colleagues, by the tremendous work being done by our health care teams to continuously enhance quality and safety throughout the system.

I did stop to see one of our employees, Leo, a therapy dog at Henry Ford Wyandotte Hospital.

Leo is one of the most remarkable therapists that I have ever encountered.  He is calm, friendly, and extraordinarily soothing, and part of a great program of pet therapy throughout our System.  Within minutes of being with him, all of my concerns and anxieties were gone.

(Of course, my own dog, Co Co, previously feature in Doc In the D, continues to be the one I confide in the most.  Co Co’s colleague, Mr. Mo, aka Uncle Mo, provides coverage as needed. Sometimes both are needed to “treat” me.)  Continue reading

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Driving Innovation (and an Electric Car) in Detroit

When I last met up with Frank Venegas, we were at the Detroit Institute of Arts talking about Frida Kahlo and her ties to Frank’s family, as well as Henry Ford Hospital.

Henry Ford Hospital also has something else in common with Frank and his company, Ideal Group:  a focus on innovation in Detroit.

One of Ideal Group’s customers, General Motors, is responsible for creating one of the bigger innovations to recently come out of Detroit – the Chevy Volt, a plug-in, range-extended electric vehicle with an on-board gasoline generator.

Not only did Frank show support for GM’s innovation by buying two Chevy Volts, he’s also been documenting his driving experience on his blog, “Frank’s V in the D.”

Frank’s even been handing the key fob (no keys needed for the Volt) to business colleagues in Detroit, giving them the chance to test-drive this game-changing product.

I recently had the opportunity to get behind the wheel of Frank’s Volt. (And, yes, it does comfortably seat someone taller than 6 ft.)

I thought that one of the best ways to really test the car’s electric charge and gas mileage – and continue the conversation about innovation – was to drive to a few Henry Ford sites in and around Detroit, where innovation is changing how we care for our patients.

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Ride in My Shoes: Shadowing a Henry Ford Police Officer

Not long ago, I spent some time walking in the shoes of Richard Ford, an electrician at Henry Ford Hospital who handles everything from keeping the music playing in the hallways to maintaining our overhead paging and fire systems.

This time around, I spent some time “riding” in the shoes of John Snitgen, a dedicated police officer who has worked at Henry Ford Hospital for more than 10 years.

John and our entire security team are responsible for keeping our hospital campus safe, and I learned more about some of the complexities our police officers face.

And they’re doing a great job: Thanks to our police officers, the crime rates on our campus are similar to or lower than reported crime rates in many suburban cities, such as downtown Birmingham.

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Care Rounds

As you may have read this week in a Detroit News article, my leadership team and I have recently incorporated care rounding with patients at Henry Ford Hospital into our weekly activities.

You might ask, “What’s new about a physician and an administrative team rounding on patients in a hospital?”

My response? “Quite a bit.”

At Henry Ford Hospital, care rounds concentrate specifically on the general care and services a patient receives.

Although not fully divorced from clinical issues, these rounds bring out issues related to environment, food, communication, ease of use, and general comfort. Quite simply, it is the service aspect of our profession and business.

At the hospital, all of us go about our activities with a specific purpose. As a physician caring for patients, my concentration and intention is primarily on the diagnosis and treatment of the patient. Patients’ needs are generally first viewed from the perspective of their clinical care.

Much is discovered when the lens is focused intently.

I was struck by the application of purposeful activities when studying LEAN-inspired management methods, where so called “waste rounds” had managers stepping out of their usual role (which includes waste reduction in processes) to concentrate fully on eliminating unnecessary steps or use of supplies.

On care rounds, after asking if I can come into the room and talk, I introduce myself and acknowledge the patient formally before asking one simple question: “How has your care been at the hospital?”

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Day 3: The Complete Top 10 Health Care Issues in 2011 List

Here are the final three items on my list of the top things I expect to see in health care over the next year. 

I will stop at 10.

Which are on your mind? (Please post your comments, or your top 10 list below.)

 Top 10 List, Day 3:

1. Fight Over Health Care Reform
2. Transparency. Moving Toward Reporting Performance & Outcomes in Health Care
3. Organized Physician Practices (Can You Say Accountable Care Organizations?)
4. Health Care Amenities
5. Recruitment, Retention and Engagement
6. Declining Revenues
7. Reduction in Cost per Unit Service

8. Looking for Solutions Outside of Our Industry
. Health care has been slow to adopt business practice changes that other industries have used to be internationally competitive. 

Industrial re-engineering, relentless process improvement and management transformation will increasingly be used in hospitals beyond the usual inventory and production functions.

Benchmarking of performance will become more focused on best in class, not best in industry. (Think of the service expectations set by an excellent hotel versus a traditional hospital).

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Day 1: Top 10 Health Care Issues in 2011

Frequently I am asked to name some of the top things I expect to see in health care over the next year. 

I thought it might be a good starting point for me to start the list and see what you think. 

I have to say that my list will be biased related to the immediate issues that The Henry Ford Hospital faces, and I view the list as broadly related to health care. 

I’m going to begin posting my Top 10 for 2011 list today, and continue adding other items to the list throughout the rest of the week.

Join in if you wish to add, delete or create a more specific list of your own, such as the top discoveries or the top trends that you see.

Top 10 List: Day 1

1.     Fight Over Health Care Reform. The politics and positioning may be as interesting to watch as the Super Bowl, but the stakes for all are much higher. Increasing challenges will come from all arenas, including judicial challenges, leading to a possible Supreme Court ruling on the constitutionality of health reform.

The dominant issue looming is the continued high costs of health care and the national deficit concern. The outcome of health care reform will more likely be predicated on finances and health care expense, competing priorities with other social programs, and state budgets and entitlements.

Best advice on how to individually deal with health care reform: Commit to staying as healthy as possible. If you are a health care worker, commit to being a solution to the high cost of health care.

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Taking a Page from Airlines’ Safety Playbook

I am writing this post 37,000 feet over Nebraska, returning home from a conference in California on Sunday. 

Before you comment about the jet-setting life of a hospital CEO, let me point out that I left two days ago, sat in meetings for ten hours each day, and I cannot watch or listen to the Super Bowl in this plane.

But the time made me reflect on something my friend Dr. Bob Wachter said in the meeting.  Bob has written a great deal about health care safety, both in a book as well as on his blog, Wachter’s World.

At this weekend’s meeting, he briefly talked about the comparative safety of the U.S. airlines industry versus health care. 

This has been the topic of many papers, books and conferences. It is not a new idea, but it is a bit more immediate when you are sitting in the exit row of a 757. 

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