2022 SHS Vinod Sahney Awardee - Katie Grzyb

November 30, 2022
Katie Grzyb, MHSA, BSE
Katie Grzyb, MHSA, BSE

Katie Grzyb, MHSA, BSE, a continuous improvement specialist on the Department of Internal Medicine Clinical Experience and Quality team, was selected as a recipient of the inaugural 2022 Society for Health Systems (SHS) Vinod Sahney Award. The Vinod Sahney Award recognizes process improvement professionals who use systems engineering concepts to improve care by partnering with clinicians, administration, and patients to improve efficiency and effectiveness of care.

Katie will be recognized at the 2022 Healthcare Systems Process Improvement Conference taking place in Louisville, Kentucky in February 2023, where she’ll present her winning submission “Reducing Readmissions for Cirrhosis Patient Population and Listening to the Needs of Patients and Families”.

Katie, who received her BSE degree in Industrial Engineering from University of Michigan-Dearborn and her MHSA degree from Madonna University, was also recently promoted to the title of Continuous Improvement Specialist Lead.

“This promotion represents a great recognition of Katie's experience, skills, leadership, and valuable contributions to the department and health system.” - Tammy Ellies, Manager, Clinical Experience and Quality

Katie discusses the quality improvement project she submitted, what she's currently working on, and how she became interested in industrial engineering.

What led to the initiation of this project?

Leadership identified cirrhosis patients as a high readmissions population and a target for quality improvement efforts in 2018. Dr. Elliot Tapper, in the Division of Gastroenterology and Hepatology, was leading work around this and our team was connected with him to start thinking through how to address the topic. Tammy Ellies and I started in a consulting role alongside Dr. Tapper, getting him connected with different resources to start investigating the problems. Eventually, the work was prioritized at both the institutional and departmental level and I was assigned to formally work on this with Dr. Tapper as a clinical quality improvement project.

Why was this project important and what was the goal?

Readmissions for patients with cirrhosis are common, costly, and associated with adverse events including death and disability. Each readmission increases the risk of death by 8% according to a Michigan Medicine study (Volk et al., 2012). In addition, readmissions are associated with broad financial penalties by payors.

The goal was to reduce 30-day cirrhosis readmissions through the identification and management of preventable factors and to improve upon the patient experience.

Tell us more about the project.

It was a multidisciplinary quality improvement project that spanned from 2018 - 2022, involving representation from multiple groups and stakeholders across Michigan Medicine. Utilizing A3 problem solving and Lean methodologies, the team worked to understand the current situation and identify the root causes of the readmissions for the cirrhosis patient population. Talking to all the stakeholders involved from admission to readmission helped to define concerns and barriers impacting readmission. After extensive analysis, the team developed and implemented a set of interventions, including inpatient guidelines, best practice advisories, care team notifications, and educational materials.

What were the results/outcomes?

All interventions had a positive impact on provider and staff satisfaction, along with patient/family satisfaction. Quantifiably, the greatest improvement came from the team’s best practice advisory (BPA) for rifaximin. The implementation of this BPA was associated with reduced readmissions and no increase in mortality.

We developed a sustainment plan to support our improvement efforts, including the relaunch of a full-service urgent care program in February 2022 within the transplant ambulatory care unit at Michigan Medicine.

Findings from this longitudinal project have been published in The American Journal of Gastroenterology and the American Association for the Study of Liver Diseases Hepatology Communications:

"Katie is central to the success of this program. Her mastery of QI processes allowed her to see several steps into the future and empowered the methodical, brick-by-brick development of a program that was poised for success from the outset. She was the heart and soul of the group, keeping us motivated and on task. I learned so much about QI and group leadership from Katie." - Elliot Tapper, MD, Director of the U-M Cirrhosis Program and Associate Professor in the Department of Internal Medicine

What projects are you working on now?

Currently, I’m leading or collaborating on the following projects:

  • Partnering with the 2022-2023 Department of Internal Medicine Quality Improvement Award Winner, Dr. Vanessa Scowden, on “Bridging the Care Gap for Unexpected Findings”
  • Partnering with Dr. Rodica Busui on improving screening and diagnoses of heart failure in individuals with diabetes at Michigan Medicine
  • U-M Medical Group (UMMG) Practice Optimization Initiative (POI): Designing and implementing decision trees with multiple divisions within Internal Medicine to increase scheduling efficiencies
  • UMMG Specialty Quality Focus Measures: “Liver Cancer Screening for Cirrhosis Patients in Hepatology” and “Lung Cancer Screening for HIV Patient Population in Infectious Disease”

In addition to my project work, I’m the Department of Internal Medicine (DOIM) Continuous Improvement Lead for the Graduate Medical Education Patient Safety and Quality Improvement Program, DOIM DEI and Well-Being IMPOWER Administrative Council Member, and Michigan Medicine Quality Department Quality Month (requires U-M level-2 password) Committee Member and Poster Submission Co-Lead.

How did you become interested in industrial engineering?

When I started undergrad at University of Michigan-Dearborn, I was an ‘undecided’ major. I spent the first year of college taking my basic requirement courses and investigating my interests for future career directions. I knew I had skills in math, problem solving, and communication, and so I started to explore engineering opportunities.

As my dad was an engineer at Ford, I already knew that pathway was not for me (I saw a very high-stress environment and a lack of a connection to helping people). My best friend’s mom was a nurse manager in Internal Medicine and told me about an individual named Tammy Ellies in the department who she “thought was some kind of engineer”! She helped me connect to Tammy, and we met to discuss the opportunities that existed in industrial engineering, ranging from automotive, airlines, production, and health care! I was so energized by her excitement for the opportunities that were out there, and particularly her work in the Department of Internal Medicine.

After meeting with Tammy, I pursued industrial engineering and years later, reconnected with her to work on my senior design project for graduation requirements. That work lead to an internship in the DOIM in 2012 and I was then hired after I graduated in May of 2013. Little did I know, this department’s wonderful leadership and staff would influence my career path from an early point in my life and be so supportive that I have never left.

What do you enjoy most about your job?

It is very hard to pick the one thing about my job that I enjoy most! But, if I had to pick, it would undoubtedly be the opportunities I get each and every day to assist faculty and staff in practicing scientific problem solving. We are all prone to ‘jumping to solutions’ for the problems/issues we run into on a daily basis. It is the best part of my job to help people break down those problems and really investigate them to understand the gap to close and the root causes of why something is happening from that front-line perspective.

It’s an honor and a privilege to work alongside the amazing faculty and staff at Michigan Medicine who are making a difference in so many patients’ lives each and every day. If I can help to improve their processes, I feel like I am supporting them in a way to do their daily work better and allow them to focus on the very important work of health care.