Meet Serge Gajic, MD, MHQS
By Amanda Loudin
From right to left: PPMC’s Serge Gajic, MD, MHQS, associate medical director of Respiratory Care Services; Huey Pigford, RRT, associate director of Respiratory Care Services; and Arshad A. Wani, MD, director of the Medical ICU and medical director of Respiratory Care Services.
During his fellowship in Pulmonary and Critical Care Medicine at Penn Medicine, Srdjan “Serge” Gajic, MD, MHQS, treated a COVID patient in the Philadelphia VA intensive care unit (ICU) who had been on a ventilator for three weeks. Every morning, the patient, who had a tracheostomy tube in his neck and couldn’t talk, tried unsuccessfully to communicate with Gajic through gestures. This is a common problem for critical care doctors and nurses, and Gajic wondered how he could help.
Gajic, who joined Penn Presbyterian Medical Center (PPMC) in July as a Pulmonary and Critical Care physician and the associate medical director of Respiratory Care Services, recalled a lecture in which the presenter had mentioned a novel technique that allows patients with certain tracheostomy tubes to speak while on a ventilator. After forming a workgroup with speech-language pathologists, gathering data, and consulting with other institutions, Gajic’s team developed protocols for the new tracheostomy tubes and rolled them out for patients first at PPMC in the fall of 2021, followed by the Hospital of the University of Pennsylvania and Pennsylvania Hospital. Their intervention has resulted in many patients being able to speak while on a ventilator, including a terminally ill patient who was able to speak with loved ones and record his voice for his children before passing.
That project – the outcomes of which Gajic and colleagues plan to submit for publication this fall – is an example of how he has applied, and continues to draw on, lessons from the new Masters of Healthcare Quality and Safety program at The Penn Center for Healthcare Improvement and Patient Safety (Penn CHIPS) in his approach to patient care.
A Commitment to Quality Improvement
Gajic was drawn to the field of health care quality improvement (QI) because he noticed the “rapid and tangible impact that QI work can have for patients,” he said.
The QI field uses evidence-based principles to provide more standardized and evidence-based care, drawing on methods developed by other safety-oriented industries, such as auto manufacturing and air travel.
Gajic completed the master’s program concurrently with his fellowship. It’s one of several training programs offered by Penn CHIPS for physicians, nurses, advanced practice providers, pharmacists, administrators, and other health care professionals. The master’s program, rolled out in 2020, serves to prepare students to take on careers in healthcare administration, or as in Gajic’s case, combine their clinical and academic careers with a focus on healthcare quality and safety leadership.
In addition to helping patients speak while on ventilators, while in the master’s program Gajic led a project in HUP’s Medical ICU to safely remove breathing tubes earlier for critically ill patients, as well as a multi-hospital evaluation of a new pulse oximetry device – used to measure oxygen in the blood – with the goal of addressing increased rates of falsely high measurements in patients with darker skin tones.
“Serge demonstrates a sincere commitment to a career leading healthcare systems improvement,” said CHIPS Director Jennifer Myers, MD. “He’s not only a promising young physician in the ICU, but he’s already led systemic improvements in the ICU patient population.”
Now, as associate medical director of Respiratory Care Services at Presby, Gajic works most closely with Arshad A. Wani, MD, director of the Medical ICU and medical director of Respiratory Care Services, and Huey Pigford, RRT, a respiratory therapist and associate director of Respiratory Care Services. The three meet regularly to work on quality initiatives, address safety events, develop guidelines, and ensure regulatory compliance.
"Serge exemplifies dedication to quality and safety in multiple ways, always exploring opportunities and rethinking innovative means of improving not just patient safety, but also satisfaction and sense of accomplishment among colleagues,” Wani said. “He will not stop thinking or focusing on a potential problem if he sees or anticipates one. Our work environment is safe when we have his thoughtful attendance."