Patient Safety Continues to Drive Clinical Operations Kellogg’s clinical leadership has been focused on increasing safety in our clinics for many years. This commitment to safety enabled Kellogg to quickly adapt to the challenges of COVID-19 and to improve safety for patients and our care teams. “We have great support from leadership to think outside the box in designing new ways of doing things,” says Beth Hansemann, COT, continuous improvement specialist at Kellogg. Building on this long-standing commitment to a “culture of safety,” Kellogg clinics adopted a process of proactive planning for multiple scenarios, implementing steps common across scenarios, rapidly assessing performance and quickly making needed adjustments.
Beth Hansemann, COT, and Jennifer Weizer, M.D., lead Kellogg’s safety team.
Safety Processes and Equipment: Kellogg clinics were the first in Michigan Medicine to implement patient screen-
Ensuring a Safe Environment: In addition to regular
ing, masking for all staff, and the use
cleaning, eye protection, hand sanitation, and physical distanc-
of plexiglass barriers for encounters.
ing, airflow and air quality concerns have been identified as
Rather than waiting for commercial
potential risk factors for the spread of COVID-19, especially
suppliers, Drs. Rebecca Wu and Shahzad
in indoor environments. Working with environmental health at
Mian, together with other faculty and
Michigan Medicine, Kellogg rooms were rechecked to make sure
staff and Dr. Lauro Ojeda of the School
that all air flow had HEPA filtration and that air exchanges met
of Engineering quickly designed, tested, had manufactured, and
or exceeded Joint Commission standards of at least 6 exchanges
installed enhanced slit-lamp shields. The shields were larger than
per hour.
any then commercially available. Subsequent studies showed that shields of this size would block more than 99% of droplets
Applying Data Sciences: Kellogg’s Dr. Joshua Stein, Direc-
between a patient or physician or technician. The success of
tor of Analytics, along with Dr. Mian and clinical leadership,
these slit lamp shields has spurred development of safety shields
created a risk algorithm for glaucoma patients that provided a
for other instruments that previously had no shields of any
personalized estimate of both the risk of vision loss and the risk
kind, such as the special viewing system for clinical examination
of severe COVID-19 outcomes. This “score” facilitated the ap-
of the periphery of the eye (“indirect ophthalmoscope”), led by
propriate rescheduling of patients when clinical care was limited
Dr. Lev Prasov.
to urgent and emergent patients by state regulations. Doctors Caring for Patients with COVID-19: Kellogg’s teams, led by
used this data to better balance the risks of vision loss with risks from COVID-19 infection, while enabling patients to understand their risk profile.
Dr. Roni Shtein, medical director of
18
our main Wall Street clinic, rapidly
Changes Here to Stay: Together with the advances in
established a safe way of seeing our
data sciences, COVID-19 has catalyzed significant changes in
COVID-19 patients with urgent eye
how eye care can be delivered. Kellogg’s “drive through” and
problems while maximizing safety for
“virtual plus” clinics (see page 10) as well as other innovative
everyone else. “We encourage as little
approaches pioneered during the pandemic are here to stay.
contact as possible with minimal face-to-
“We’ve been open to new ways to make things work, and we’ve
face interaction for COVID-19 patients.”
been able to continue our journey to increase safety for patients
Although the number of patients seen in this “Red Clinic” has
and staff.” says Jennifer Weizer, M.D., ophthalmology professor
been small, “We’re prepared,” says Dr. Shtein. The protocol
and Kellogg Safety Committee chair. “We’re confident that we’ve
keeps our non-COVID-19 patients safe so they can come to
learned important lessons for the future if we have another out-
Kellogg for their eye care issues with peace-of-mind.
break and for issues such as the seasonal flu.”