U-M patient safety leader receives national honor

Darrell A. Campbell, Jr., M.D., wins Eisenberg Award for efforts to improve surgical safety in U.S., and make U-M “the safest medical center in America”

ANN ARBOR, MI – For nearly a decade, transplant surgeon Darrell A. Campbell, Jr., has worked to make surgery a safer experience for patients around the country, through massive cooperative efforts that now involve hundreds of surgical teams at nearly 200 hospitals.

At the same time, he has spearheaded a broad patient-safety and quality-improvement campaign at one of the country’s major medical centers: the University of Michigan Hospitals and Health Centers, where he is chief of staff and senior associate director.

Now, he has been recognized on a national level for this body of work, as one of only two recipients of the 2007 Eisenberg Patient Safety and Quality Awards for Individual Achievement.

The award, which he will receive on Sept. 27 in Washington, D.C., is given by the National Quality Forum, a broad public-private organization that includes members from all health care sectors, and The Joint Commission, the nation’s leading health care accreditation and quality organization. The award is named for a national patient-safety and health care quality pioneer who died in 2002.

It’s not the first such recognition for Campbell, who holds the Henry King Ransom professorship in Surgery at the U-M Medical School and has been chief of staff since late 2001. In 2005, he was recognized by the Michigan Hospital Association with a statewide patient safety award.

“I’m honored to be recognized as an individual, but really this recognition belongs to all of the committed physicians, nurses, staff and trainees who I’ve worked with to build and sustain all of these programs, and to those who have provided financial support and leadership approval,” says Campbell. “It is truly gratifying to see how far we have come, but we all must continue to find new ways to prevent and learn from medical errors and near-misses, to avert infections and injuries, to implement full-disclosure policies, and to deliver the right care to the right person at the right time.”

In 1999, Campbell led the development of — and U-M’s participation in — a groundbreaking American College of Surgeons pilot program that collected and analyzed surgery data to give surgeons the information they need to improve care and reduce complications. The project grew out of an initiative in the Veterans Affairs hospital system, but the pooling and sharing of such data in civilian health care was seen as daring at the time. U-M was one of three hospitals in the pilot program.

That project has since grown to become a national effort called the National Surgery Quality Improvement Project, or NSQIP, that now includes 172 hospitals nationwide.

Campbell chairs the NSQIP’s advisory committee, and last year led a Best Practices Initiative to help participating hospital take steps to share ways to prevent infections related to the surgical site.

Last year, he helped lead the effort to bring more Michigan hospitals into the NSQIP, through an effort known as the Michigan Surgical Quality Collaborative or MSQC. With funding from Blue Cross Blue Shield of Michigan, which has also agreed to reimburse hospitals at a higher rate if they participate in MSQC, the project now involves 34 of Michigan’s largest hospitals. In addition to participating in the NSQIP, which gives them an infrastructure for measuring quality and looking for ways to improve, the Michigan hospitals participate in regular meetings to share information and best practices.

In addition to these surgery-specific initiatives, Campbell has led an effort to make U-M the “safest medical center in America” through a broad range of initiatives that make safety the top priority in all aspects of patient care.

One initiative for which U-M has received widespread attention is the “full disclosure” policy for medical errors, patient injuries and legal claims filed on behalf of patients. This approach includes thorough review of incidents, full disclosure of findings to patients and their attorneys, and a process for applying the lessons learned from each instance to patient care. It has resulted in a substantial decrease in the U-M’s medical malpractice exposure and legal costs, while also creating a culture shift that directly links patients’ experiences with improvements in future clinical care.

Other initiatives implemented throughout UMHHC under his leadership include:

An online Patient Safety Reporting Form, through which anyone involved in patient care at U-M can quickly and easily report an error, a near-miss, or a dangerous situation. The form triggers a swift response to the immediate problem, but also sets in motion a review process that allows clinical staff to learn from the incident in a blame-free way, and to make changes that will prevent it from happening again. The forms also provide data for analysis.
Regular Patient Safety Rounds where Campbell and members of his core patient safety team visit inpatient units in the hospitals and talk frankly with clinical staff about opportunities to reduce the risk of errors or accidents, and improvements that staff have been making in their area that might be applicable to other areas of the hospital. Such rounds have led to new U-M-wide procedures, and this year Campbell and Maureen Thompson, MSN, RN, published a guide for other hospitals to implement the practice.
Several new UMHHC policies including “Speak Up for Safety” which empowers employees to point out a potentially risky patient care situation, regardless of their job or training; the “Wrong Side/Wrong Site” surgery policy that requires the entire operating room team to call a verbal “time out” before starting each procedure so they can verify key information; and strict patient identification standards to ensure patients receive the right care.
A Rapid Response Team of physicians and nurses who can be summoned anywhere in the medical center to help patients who are showing signs of imminent health problems such as breathing or heartbeat irregularities. UMHHC also has a cardiac resuscitation team that can help patients experiencing a heart attack or cardiac arrest, but the rapid response team focuses on intervening before a crisis strikes.
The Clinical Simulation Center, where life-like computerized mannequins and other equipment allow doctors, nurses, paramedics, technicians and students to practice procedures in a risk-free environment. Up and running since 2004, the center was recently awarded accreditation as a Level 1 Comprehensive Education Institute by the American College of Surgeons. This is the highest level of accreditation and is only awarded to those institutions that offer state-of-the-art surgical education
Mandatory annual patient safety training for all employees, even non-patient care staff.
For information on patient safety and quality initiatives at U-M, visit www.med.umich.edu/quality.

Written by Kara Gavin