Beaumont Health Recognized as a ‘Pioneer in Quality’ by the Joint Commission

Beaumont Health has been recognized by The Joint Commission as a 2019 Pioneers in Quality Solution Contributor in electronic clinical quality measures (eCQMs). Beaumont is just one of 12 hospitals and health systems to be named in The Joint Commission’s Pioneers in Quality: Proven Practices Collection 2019 for submitting a Proven Practice.

Beaumont’s Proven Practice helps inform Pioneers in Quality program activities and identify trends that help hospitals overcome eCQM and health IT barriers and challenges.

Carol Poterek from Beaumont’s quality team and Brian Meitzner and Shannon Sass, from the health system’s IT team, submitted Beaumont’s practice for addressing eCQM Data Validation: “Letting the data drive the improvement.”

Bringing eight hospitals together to become Beaumont Health after the 2014 merger involved uniting providers, support and administrative staff to ensure patients receive consistent, quality care.

“We needed to standardize our electronic medical record system. We also needed to streamline our eCQM data validation process. This led to the development of our Core Measure Abstractor Report. The report helps us drill down into cases that do not meet quality measures and helps us identify trends to drive our process improvement efforts. We are pleased The Joint Commission recognized our staff’s commitment to continuous quality improvement,” Beaumont Health senior vice president, chief quality and safety officer Dr. Sam Flanders said.

“We commend Beaumont for its recognition as a 2019 Pioneers in Quality Solution Contributor for its contributions and commitment to eCQM data and practices toward quality improvement,” says David W. Baker, MD, MPH, FACP, executive vice president, Division of Healthcare Quality Evaluation, The Joint Commission. “We believe gathering and analyzing performance data is crucial to continuously improving quality of care and outcomes for all patients.”

Until recently, most hospitals collected information to measure health care quality by manually pulling data from patient records. Today, through eCQMs — which rely on structured, encoded data present in the electronic health record — hospitals can electronically collect and transmit data on the quality of care that patients receive. The electronic data can be analyzed to measure and improve care, processes, performance and outcomes.

This year’s list of recognized Pioneers in Quality organizations consists of 18 Expert Contributors, five of which are featured in the 2019 Proven Practices Collection and 13 that participated in measure development and testing activities. Another 12 organizations were named Solution Contributors and helped inform Pioneers in Quality program activities and determined trends to include within the Collection.

For more information, visit The Joint Commission website.

Eagle Eye Jaime Puchalski, CRNA, Corrects Medication Dosage Error

Jaime Puchalski, CRNA at Beaumont, Grosse Pointe believes nurses have the ultimate responsibility to advocate for patients to keep them safe. Working at Beaumont since 1999, Jaime has been assisting patients in the operating room for the past eight years.

As a Certified Registered Nurse Anesthetist, Jaime is an advanced practice nurse who specializes in anesthesia training. “CRNA’s have a heavy responsibility in the operative setting,” she said. “They’re tasked to safely administer more than 49 million anesthetics to patients each year in the U.S. in a variety of settings and collaborate with the entire health care team to keep patients safe during the operative period.”

CRNAs work in every setting where anesthesia is administered, such as the Operating Room, Endoscopy, Interventional Radiology, Obstetrics, MRI and CT Scan. On average, a CRNA can take care of three to four patients in an 8-hour shift.

One day during her shift, Jaime was about to start a Remifentanil infusion on a patient undergoing back surgery. Remifentanil is an ultra-short acting narcotic pain medication that is stronger than morphine by 100-200 times. “When programming the pump, I realized the pump was programmed to run this medication at 1,000 times the correct dose,” she said.

After discovering the error, she immediately notified the pharmacist and an investigation was conducted. An update was found, and it was sent to all Alaris pumps with the incorrect dosing units. “I had no hesitation to speak up,” Jaime said. “If this medication was given, it could have resulted in a very poor outcome for the patient.”

Jaime encourages others to speak up.

“I truly believe in teamwork and communication as being a priority for a culture of safety within the health care system,” she said. “This culture of safety is what patients deserve and expect from all of us in health care.”

Farmington Hills OR Wall Paintings Build Teamwork

After surgical tech Kenneth Baier shared the idea of having staff paint their hands onto the main Surgical Services hallway, clinical nurse manager Karen Dulka had the idea sanctioned as a teambuilding exercise.

“It brought staff members together from all areas of Surgical Services, including surgeons and anesthesiologists,” Karen said.

The hallways, which are part of a second phase of construction, have been transformed into a fun art gallery that includes signed handprints from employees. The real eye-catchers, however, are the creative caricatures of cartoon characters, smiley faces, icons and feel-good images that have infused a cheery vibe into an otherwise sterile hallway that leads to the nine new operating rooms.

“When patients are rolled through on their way to the OR, they notice the bright and fun walls and it seems to lift their spirits,” Karen said.

The wall paintings in the newly constructed hallway that connects the new East Pavilion’s third floor to the existing part of the building have become a place of pride for employees, physicians and patients.

“When they have an extra few minutes, they grab painting supplies and they start painting their favorite scenes,” Karen said.

The project that started out with simple handprints has turned into a display of artistic talent that has provided a team-building opportunity. It has been a great deal of fun for staff and made the day a little brighter for patients.

“Employees who don’t normally have the opportunity to interact during their work day are able to do so while painting their favorite images on the walls,” Karen said.

Kat Thiede is the OR charge lead nurse who brought in painting supplies for employees, “I was so proud to look around and watch our entire OR team take part in the painting of our temporary walls,” Kat said.

The walls will soon be painted by the construction team, which means the artwork will soon disappear.

The idea of painting onto canvases that can be hung throughout the hospital has been discussed as a way for preserving future artwork beyond the construction phase.

“Maybe we can extend this idea into an employee-driven project that would continue to grow the camaraderie and pride that has resulted from this simple, fun idea,” Karen said.

Leah Speights – Testimonial

When Leah Speights was 35 years old, she had one of the most devastating days of her life. It just so happens it was also one of the most joyous.

Leah was a frequent migraine sufferer since her teens. In February, she was hit with a headache like she’d never had in her life, causing her to vomit. She felt weak, so she ate a bowl of cereal but vomited again.

“I decided to take a shower. When I got out, I felt like I was going to collapse,” recalled Leah. She called her sister, Belendia Williams, to come sit with her. She went to the staircase to go down and unlock the door for her but collapsed at the top. After a little while, she was able to get up and go down the stairs.

“I barely made it back upstairs and into my bed because I felt ready to collapse again,” she said.

When Belendia arrived, she found Leah unresponsive. She called an ambulance, and they were rushed to Beaumont, Wayne.

In the Emergency Center, Leah was in and out of consciousness and experiencing a lot of pain. The medical team ran tests, and bloodwork showed she was pregnant ― news that made her smile for a mere second.

Then her symptoms worsened.

“Leah’s hands clenched up, her mouth twisted a bit, and it felt like she was looking through me, staring off into space,” recalled Belendia.

At first, the medical team suspected seizures and treated her with medication. While that calmed the clenching, it didn’t touch the pain, which was so bad Leah began ripping out her hair by the handful.

She was admitted to the ICU and given an MRI/MRV. Dr. Suheb Hasan, a neurologist, was called onto the case.

“He told us Leah had multiple clots on the back of her brain, with one leaking, and that she was deteriorating by the minute. He said he wasn’t sure if she would ever go back to normal after this,” said Belendia.

Dr. Hasan consulted with Dr. Sandra Narayanan, a stroke and interventional neurologist and director of the Neuroendovascular Program at Beaumont, Dearborn, Taylor, Trenton and Wayne. Together, they diagnosed Leah with extensive superficial and deep cerebral venous sinus thrombosis, which are long blood clots in the main veins draining blood from the brain.

“Although she was experiencing the symptoms, the blood was still finding channels to get out of the brain, so she was still awake and talking to us,” Dr. Narayanan said.

The expectant mother needed neurointerventional surgery to remove the clots. “I’d never seen anyone with this much clotting in the veins of the brain before,” said Dr. Narayanan.

Leah was transferred to Beaumont, Dearborn for a mechanical thrombectomy.

“We were in full prayer mode,” said Belendia. “There were a lot of tears and panicking, but we tried to remain calm and have faith that she’d pull through. We were just in shock because, prior to this, she was healthy.”

Because Leah was pregnant, doctors used local anesthesia for the procedure to minimize potential risk to the fetus. “Inside her skull, we were able to inject blood thinners to lace the clot and then pass suction catheters to break up and suction large portions of it out,” said Dr. Narayanan.

The surgery was a success, but the relief was short-lived.

Three days later, while recovering on 7 South, Leah began experiencing strange symptoms. Her right arm was numb, and she couldn’t speak.

Clots were forming again in the corners of Leah’s veins, leading to a buildup of pressure in her brain. She needed another surgery, and this time, Dr. Narayanan used a newer technique after consulting with colleagues over Leah’s unusual case.

“I went through her jugular vein and used medication to loosen a clot, inflated the balloon on the tip of the catheter and pulled it backward with the balloon inflated,” Dr. Narayanan explained. This enabled the balloon to scrape the walls of the vein, dislodging the clot.

The second procedure was a success.

While at Beaumont, Dearborn, Leah had her first ultrasound, which confirmed she was 7 weeks pregnant.

“That’s when I knew I was going to be a mom. It was an amazing feeling,” she said. “When I heard her heartbeat for the first time with my mom there with me, they told me her heart was strong. I can’t describe that feeling. I knew I had no choice but to be strong for both of us.”

Today, Leah revels in the joy of living with her daughter, Dakota. Born without any health issues, Leah considers her whole family lucky.

“She’s a happy, independent and smart baby. I’m really blessed,” Leah said. “I’d like to say thank you to the team of doctors, my fiancé, family and friends for all they’ve done.”