Sylvester and UMH Team Wins Top Sterling Award for Major Patient Safety Advance

A team of physicians and staff at Sylvester Comprehensive Cancer Center and University of Miami Hospital who joined to significantly improve patient safety by reducing response time to one of the few true oncologic emergencies won the 2017 State Team Showcase Competition at the 25th Annual Florida Sterling Conference.

From left, David M. Lang, D.O., Lauren Gjolaj, M.B.A., B.S.N., Randi Alfonzo, administrative director, Myka Whitman, B.S.N., RN, and Gustavo Fernandez, M.D., M.B.A.

The annual Sterling Conference Team Showcase provides a public forum for participating teams to demonstrate the principles and techniques of improving organizational performance. In addition to the overall showcase award, the UMH team was honored at the June 2nd event for greatest customer impact for raising awareness of neutropenic fever among emergency room staff and cancer patients undergoing chemotherapy.

Neutropenic fever results when chemotherapy kills white blood cells known as neutrophils, which fight infection. “It’s a dire emergency for patients,” said Lauren Gjolaj, M.B.A., B.S.N., executive director of oncology services at UMH and leader of the project team. “When people lose neutrophils they can be at very high risk for infection, sepsis and organ failure.”

The problem is, not all cancer patients and non-oncology medical staff know that. “In the emergency room, when a patient comes in and says they have a fever, that’s a pretty low priority if you don’t understand the pathophysiology of it,” Gjolaj said. By getting the right people focused on the problem, the UMH team significantly shortened the time from the patient’s arrival at the ER to administration of antibiotics.

“I am very proud of our team accomplishment,” said Gustavo Fernandez, M.D., M.B.A., assistant professor of medicine in the Division of Hematology-Oncology and now chief medical officer of The Lennar Foundation Medical Center. “Working as a team we were able to identify a patient population that presented to our UMH ER and provide them rapidly needed treatment.

“For these patients, who were at risk of dying from an infection, we have decreased the time to receive antibiotics from more than 90 minutes to near 30 minutes.”

The team created a neutropenic fever alert card for patients, added a question on the ER sign-in sheet, and created a neutropenic fever alert in the hospital. When a cancer patient presents with a fever, anyone is authorized to issue an alert, which deploys a team to the emergency room.

“This was a great project with members from risk management, patient safety, oncology, the emergency room, nursing, lab, and pharmacy,” Gjolaj said. “It really took a village to come together to make it happen.”

Michael Gittelman, CEO of UMH, couldn’t be prouder of that village. “This award shows that our teams are truly driven to be the best they can be,” he said. “Everyone works together to keep expanding and enhancing our processes to provide the most advanced, compassionate care to improve and often save our patients’ lives.”

When the data from the neutropenic project was assembled, Gjolaj said, “we knew we had to share it with other people, not only so the team could get recognition, but so we could share best practices and potentially save other patients’ lives in other places.”

David M. Lang, D.O., service chief and medical director of emergency medicine, and Myka Whitman, BSN, RN, interim chief risk officer, were the other leaders of the team who presented the UMH success story – which they called “Miami Fever!” – at the Sterling conference. They also told the story through a funny, relatable skit they performed in front of about 600 people.

“I’m very proud of the emergency department staff for far exceeding and maintaining our goal of time from patient arrival to antibiotic administration,” Lang said.

“Winning the overall showcase and the biggest customer impact award really spoke to our passion about care for our cancer patients,” Gjolaj said. “It’s a wonderful opportunity to celebrate our great team and the miraculous things that happen here.”

Tags: emergency room, neutropenic fever, Sterling Conference Team Showcase, Sylvester Comprehensive Cancer Center, University of Miami Hospital