SOM event puts focus on Quality and Patient Safety

Click on the image to watch the 2021 Quality Patient Safety Day event.

More than 50 students, residents and fellows participated in the 8th annual Vijay Babu Rayudu Quality and Patient Safety Day with poster and oral presentations on May 21 at the School of Medicine.

The event provides an opportunity to present research and learn from experts in the field of patient safety.

Mallika Joshi, MS 3, and Kayla Reifel, MS3, captured the top student honors for their abstracts, while Megan Hamner, M.D., and Cree Kachelski, M.D., received the top awards for residents and fellows. The four were selected to give oral presentations of their research.

Joshi presented on “Improving the Sleep Quality of UMKC Medical Students: A Quality Improvement Project.” Reifel presented a project titled “Improving Breast Cancer Related Lymphedema Detection – Creating a Standard Practice for Preoperative Arm Measurements.”

In the resident/fellows category, Hamner, a second-year pediatric infectious disease fellow, gave an oral prestation on her winning abstract, “Improving Skin and Soft Tissue Infection Antibiotic Duration Concordance with National Guidelines in Pediatric Urgent Care Clinics.” Kachelski, a second-year pediatric emergency medicine fellow, presented “Improving time to antibiotics in open fractures in the Children’s Mercy Emergency Department.”

Three students, Parth Patel, MS3, Lakshmi Pryiya, MS5, and Aarya Ramprasad, MS3, and three residents/fellows, Bemjamin Hoag, M.D., Raed Qarajeh, M.D., and Ray Segebrecht, M.D., received honorable mention  for their poster presentations.

A complete list of student and resident/fellows oral and poster presentations and videos of the oral presentations are available on the School of Medicine research web site.

Jennifer S. Myers, M.D., professor of clinical medicine and the director of Quality and Safety Education for the Department of Medicine at the Perelman School of Medicine at the University of Pennsylvania, gave a keynote address. She is the Director of Penn’s Center for Healthcare Improvement and Patient Safety (CHIPS) fellowship program and oversees all aspects of quality and safety education for the Department of Medicine.

Myers talked about the history of the quality improvement and patient safety movement and its influence on medical education. She also discussed health and health care equity as a cornerstone of quality health care.

She said the health care delivery system has several goals for providing quality care in that it be safe, timely, effective, efficient, equitable and patient centered. However, she said that “equity has been the forgotten name of health care quality until very recently.”

“I do think academic medicine is evolving to embrace clinical quality and safety, but I think we still have work to do,” Myers said. “Achieving health equity and health care equity are integral to this work.”

UMKC’s Nicholas Yeisley appointed to AAMC steering committee on quality care

Nicholas Yeisley, a fourth-year student at the School of Medicine, has been selected to serve as student liaison to the Association of American Medical Colleges (AAMC) Integrating Quality steering committee.

The group serves an advisory role for the AAMC to provide recommendations and feedback regarding high-value initiatives relating to quality of patient care. It focuses on activities to promote a culture of quality care, and patient safety strategies and resources.

Yeisley has been a member of the national organization’s Office of Student Representatives (OSR). He was selected to serve a one-year term as the sole student liaison to the Integrating Quality committee beginning this summer.

He has also had leadership opportunities through the American Medical Association’s Medical Student Section, including his current role as chairperson of the regional executive board.

“I am personally interested in quality improvement and translational research and thought being on the steering committee would be a great way to learn,” Yeisley said. “A personal goal is to share insights on quality improvement and translational research with the rest of the OSR and our medical students at UMKC so that we all can learn more about medical careers enriched in quality improvement.”

During the past three years, Yeisley has worked with Stefanie Ellison, M.D., professor of emergency medicine and associate dean for learning initiatives, on a Community Home Health Initiative. The project is to develop a survey that will help determine if important social history questions are being missed in standard emergency room visits. The inquiries would focus on topics such as home environment, finances, literacy and disabilities. Yeisley has also helped coordinate an annual opioid overdose training program for fellow trainees.

He said he plans to take the next year off from medical school to complete an accelerated MPH program at Johns Hopkins University.

“I want to continue gaining skills toward quality improvement and translational research in the context of public and community health,” he said.

 

 

Patient safety expert discusses effort to reduce medical errors

Michael Handler, M.D. '84
Michael Handler, M.D. ’84

The Institute of Medicine’s 1999 report, To Err is Human: Building a Safer Health System, stated that up to 98,000 Americans die each year in hospitals because of preventable mistakes — or as Michael Handler, M.D. ’84, put it, “the equivalent of a jumbo jet crash every one to two days.”

Handler, a hospital leader and expert in patient safety, gave the keynote address at the second annual Vijay Babu Rayudu Quality & Patient Safety Day program at the UMKC School of Medicine on May 15.

An obstetrician-gynecologist by training, Handler is the medical director and chief medical officer of SSM St. Joseph Hospital West in Lake Saint Louis, Missouri. He is also the medical director of the Center for Patient Safety, a not-for-profit organization established by the Missouri Hospital Association, the Missouri State Medical Association and the health-care consulting firm Primaris.

“As I think about patient safety, I think about three expectations the patient has,” said Handler, who sees the Institute of Medicine report as the genesis of the patient safety movement. “The patient has expectations of ‘don’t hurt me, be nice to me and cure me,’ and probably in that order.”

According to Handler, it is imperative for health-care organizations to develop a culture of safety, which acknowledges the high-risk nature of the work, avoids blame and promotes collaboration across disciplines. Strong leadership is also necessary, he said.

“One thing I want to remind you is, all physicians are leaders,” Handler said. “It doesn’t matter if you have a title or if you’re a director or if you’re a chairperson or whatever. Every single physician is a leader. Everybody is looking at you. It’s like you’re onstage all the time. You always have to pay attention to that in everything that you do.”

Handler believes health-care organizations have changed their approach to patient safety. The focus used to be on the individual. Today, organizations focus on systems, such as the way doctors and nurses transfer patient responsibility during shift changes. “The way to reduce errors is to learn about the causes of errors and use this knowledge to redesign the systems,” he said.

Handler also stressed that working toward a blame-free culture is not a shirking of accountability. He drew a distinction between mistakes that should be met with coaching and more rare instances of “willful neglect.” A blame-free culture encourages health workers to document unsafe conditions and near misses, which are great learning opportunities, said Handler.

“You want people to report. You want the culture to be such that people are not afraid of retribution.”

With an eye on the horizon, Handler said diagnostic errors will become an area of focus in coming years. In fact, an Institute of Medicine committee is evaluating the existing knowledge about diagnostic error and its role in the quality of care, he said.

Peter Almenoff, M.D., the Vijay Babu Rayudu Endowed Chair of Patient Safety, introduced Handler and welcomed the members of Rayudu’s family who were in attendance. Rayudu was a medical student at UMKC at the time of his death in 2007.

Following Handler’s talk, students made oral presentations on antibiotic utilization, the role of interpreters in emergency rooms and other topics. Residents and fellows presented posters in the School of Medicine lobby. A list of presenters is available at https://med.umkc.edu/docs/events/RayuduPatientSafety2015.pdf.