The quality committee for hospital medicine serves two main functions for Hospital Medicine:
- To perform quality assurance via peer review of referred and flagged internal medicine cases cared for at University of Michigan Hospital. This includes reviewing all deaths that occur on the services.
- To help direct, inform, and implement quality improvement initiatives for the inpatient general medicine services.
- Aaron Berg, MD
- Derek Dimcheff, MD
- Scott Flanders, MD
- Hae-Won Kim, MD
- Sweta Kochhar, MBBS
- Vikas Parekh, MD
- Jeffrey Rohde, MD
- Janet Schlaff, MD
- Jeffrey Smith, MD
- Jennifer Vredeveld, MD
- Denege Ward, MD
- David Wesorick, MD
Examples of Quality Improvement Projects
Data indicates that approximately 60% of patients admitted to the Medicine Faculty Hospitalist (MFH) service are actively receiving antibiotics. Studies indicate that upwards of 50% of antibiotics given to inpatients could be considered inappropriate. In coordination with the Centers for Disease Control (CDC) and Institute for Healthcare Improvement (IHI), Michigan Medicine is involved in a national initiative to improve hospitalists’ documentation of their antibiotic use which may improve clinician awareness and appropriateness of use. Appropriate documentation is particularly important at times of transitions. The goal of this project is to improve the percentage of patients on antibiotics who have indication, expected duration, and day-of-therapy/start date clearly documented. This was supported by performing antibiotic time outs with clinical pharmacists on Monday, Wednesday, and Friday.
Medication Reconciliation at Time of Admission
Medication errors are common and can have serious consequences. Obtaining an accurate list of a patient’s current medications is extremely important and yet all too often the list is merely cut and pasted into the H&P with no corroboration. The goal of this project is to increase the percentage of patients admitted to the hospitalist service with complete medication doses, schedules, and clear documentation of the source used to corroborate the patient’s home medication list or documentation of inability to do so on the admission H&P.
Hospitalist Hand Hygiene
Practicing hand hygiene is a simple yet effective way for hospitalists to help prevent hospital acquired infections. The goal of this project is to increase the hand hygiene compliance rates of clinicians on the hospital medicine services. This has been done with the support of infection preventionists and includes presenting performance data to the group and one-on-one discussions with high and low performing clinicians.