College of
Human
Medicine

Culture of Safety

MSU Safer Campus Action Steps - April 13, 2018

MSU is committed to achieving the highest standards in assuring patient care and safety, preventing relationship violence and sexual misconduct, and supporting and responding to reports of such incidents. The university is working with internal and external experts to improve policies, procedures, programs, and operations. Below is a summary of this important work.

Protecting Patients and Improving Patient Care

Michigan State holds the medical profession in high regard, but its trust must be backed by supporting policies, procedures, and verification. MSU is implementing improved patient safety, privacy protocols, and quality of care recommendations from an external review of all MSU clinics. Third-party quality and safety assurance reviews are anticipated to start this summer as we continue our commitment to achieving the highest patient care and safety standards.

  • Although initially developed over a year ago, the MSU HealthTeam chaperone policy was revised in February to ensure a uniform patient workflow and documentation requirements. Changes have been made to the electronic health record to document the presence of a chaperone for sensitive exams, training for providers and staff was conducted, and the system went live March 21, 2018.
    • An audit will be conducted in early June and the results will be provided to providers and staff and reported to the MSU HealthTeam board. Audits will be conducted quarterly, or as needed, therafter
    • In conjunction with the chaperone policy, a “consent to treat” form has been adopted for the patient at the time of registration. The form, when signed by the patient, gives patient consent to the provider for treatment, but also informs the patient of her or his right to a chaperone and makes it clear minors must have a chaperone present.
  • The MSU HealthTeam board approved a practice location policy which identifies approved HealthTeam practice locations. Locations can also be approved by the department chair and dean of the appropriate college, if the location is identified within the provider’s scope of practice.

  • The MSU HealthTeam patient satisfaction survey system is being reviewed for replacement in order to obtain better and more timely feedback from our patients on ways to improve our delivery system. The MSU HealthTeam is also developing uniform clinic signage for wayfinding and to inform patients of their rights, and is exploring placement of TV monitors in clinic waiting areas for patient educational purposes.
  • Interim President John Engler announced a reorganization of the university’s health colleges, clinical practices, and student wellness programs to increase safety and quality of care across all MSU’s health care offerings. Two leadership positions were created to ensure proper oversight of the health system.
    • Norman J. Beauchamp Jr., dean of the College of Human Medicine, was appointed to the newly created position of associate provost and assistant vice president for health affairs. In this role, he works to increase safety and quality practices across all of MSU’s health care services.
    • Anthony M. Avellino will assume the roles of assistant provost and chief wellness officer and MSU HealthTeam chief medical officer. Avellino will assist with strategic development of initiatives and programs, assure compliance while ensuring best practices and exemplary care, and oversee core sports medicine and health care providers, guiding the ongoing reorganization of student health and wellness.
    • Andrea Amalfitano, director of MSU’s Clinical and Translational Sciences Institute, was confirmed by the MSU Board of Trustees as interim dean of the College of Osteopathic Medicine. 
  • MSU is enhancing student-athlete medical care based on a comprehensive review by external sports medicine physicians.
    • Two athletic trainers will be added to the 13 employed currently, and all now will report to medical supervisors rather than strictly through the athletic department.
    • Chaperone and “consent to treat” policies were standardized with those of MSU HealthTeam clinics, as was on-site signage raising awareness of those policies.
    • A “360” method of peer evaluation will be applied for sports medicine and training staff.
    • Athletic trainers’ manual is being revised and will be completed this summer. 

Prevention of Sexual Misconduct and Sexual Assault

  • MSU’s Title IX policies are compliant with all applicable legal requirements. MSU hired an independent third party to conduct a review of MSU’s Title IX policies and procedures. In addition to finding MSU’s Title IX policies compliant with all applicable legal requirements, the review found MSU to be at the forefront of a number of practices. The reviewers also made recommendations for improvement, which MSU is implementing.
    • A second phase of review, released in preliminary form in March 2018, looks at awareness and outreach, prevention and education programs, and crisis and advocacy support services. To be released in final form before the end of the semester, the preliminary draft identifies several areas for improvement in campus community awareness of sexual assault and prevention resources, policies, and procedures. To that end the report recommends more concentrated and credible communications to support cultural changes, promote MSU’s values, and disseminate relevant information to the campus community. Better alignment of training, awareness, and prevention programs, increasing mental health support services, and clarifying responsibilities and accountability for Title IX were among other recommendations.
    • MSU’s Office of Institutional Equity held a series of Campus Climate Forums March 25 and 26 to solicit feedback from students and employees to that report.
  • Community suggestions and other input focused on prevention are being solicited and received by the interim president’s Relationship Violence and Sexual Misconduct Expert Advisory Workgroup through its online contact channel and through consultation with diverse campus and community groups. The workgroup is using the feedback to develop recommendations for improving MSU’s programs and practices and supporting culture change regarding relationship violence and sexual misconduct.

  • All students and employees are required to complete an online training program. Both the student and employee programs focus on:
    • Providing information to identify sex discrimination and sexual harassment, including relationship violence and sexual misconduct;
    • Raising awareness of the impact of these issues on the campus community and encouraging community members to engage in efforts to end these types of violence;
    • Advising members of the MSU community about their rights and reporting responsibilities under the Relationship Violence and Sexual Misconduct Policy;
    • Communicating behavioral expectations for all members of the MSU community as outlined in the policy;
    • Connecting community members with support and resources that are available when issues or assaults occur;
    • And training employees on their roles in administering the policy.
  • MSU’s Sexual Assault and Relationship Violence Prevention Program is using a grant from the governor’s office to tailor sexual assault awareness training for fraternity and sorority affiliated students and risk managers. The training encourages leadership, intervention and continued dialogue related to sexual assault and relationship violence prevention.

  • An updated leadership development training session for MSU supervisors and administrators focused on preventing harassment and discrimination rolled out in March, 2018. New protocols for information sharing between campus units are part of the session content.
  • MSU is training employees how to recognize and report child abuse. The university introduced enhanced training in March, 2017, for individuals managing youth programs, including information about mandatory reporting requirements and recognizing signs of child abuse. This training is being expanded to a full-day workshop in March, 2018.

  • MSU established the Youth Programs Policy in 2013. The policy has evolved over time with multiple revisions that are detailed online.
    • In May, 2017, MSU strengthened protections for youth participating in campus programs. The university’s youth program policy has been updated to mandate that all individuals who have unsupervised access to minors are required to undergo criminal background checks within the past 12 months. This extends to any external organization using MSU facilities. Additionally, new requirements have been put in place regarding annual trainings, reporting protocols, and transportation of minors. 
  • MSU is making continuing efforts to train youth program directors and coordinators. Trainings focused on identifying and reporting child abuse and expanded to an annual workshop for Youth Protection Workshop in 2017. 
  • MSU hired a Youth Program Director to help manage and oversee all youth programs. David Chupak joined MSU in November, 2017, to oversee youth programs including any class, camp, program, or other learning activity held on and off-campus that includes participation by minors.
    • A Youth Programs Advisory Board was established in January, 2018, from multiple campus units to consult on youth program policies and procedures.
    • Training was expanded for youth program coordinators and directors, including presentations from subject experts covering topics such as policy compliance, identifying maltreatment, reporting requirements, gender equity, police response, and supporting mental health.
    • Other program personnel trainings in the planning stage include interviewing practices to prevent child maltreatment, implicit bias awareness, surviving active shooter situations, and addressing cyber-bullying.
    • Director Chupak is working with General Counsel and his advisory board on youth program policy revisions covering topics including one-on-one adult/youth exposure and electronic communications. New requirements will include application of industry guidelines for supervisor-to-youth ratios.
    • Handbook templates containing uniform program requirements also will be developed, including the topics of central policies, communication processes, and conduct rules for program participants.
    • Program registration deadlines will be set and a software will be implemented for online registration to allow more efficient program tracking.
    • The director will begin conducting program compliance audits this summer.
    • Director Chupak provides ongoing consultations to youth program directors. Program directors have displayed an eagerness to comply with university-wide policy requirements and a commitment to providing safe experiences for minors.
  • The campus-wide “It’s On Us” campaign held a Spring Week of Action April 2-6, 2018. MSU faculty, academic staff, and support staff were encouraged to participate in a series of awareness activities to lead of national Sexual Assault Awareness Month.

Responding to Sexual Misconduct and Sexual Assault

In addition to the two, strong, survivor-support programs we have had on campus for many years—the MSU Sexual Assault Program and MSU Safe Place—we have dedicated significant new resources to strengthen our efforts to combat sexual and relationship violence. We have made significant strides. Nonetheless, sexual assault and relationship violence are still problems on our campus and in society at large. It is clear that more needs to be done so that when prevention fails, we are able to act decisively to assist victims.

  • The University Policy on Relationship Violence and Sexual Misconduct is clear: Michigan State University is committed to maintaining a learning and working environment for all students, faculty and staff that is fair, humane, and responsible— an environment that supports career and educational advancement on the basis of job and academic performance. Relationship violence, stalking, and sexual misconduct are not tolerated at Michigan State University. 
  • Interim President John Engler convened the MSU Relationship Violence and Sexual Misconduct Expert Advisory Workgroup, composed of campus leaders with deep expertise in the areas of sexual assault and relationship violence. The workgroup is tasked with gathering ideas and input from students, faculty, staff, and alumni and working closely with other organizations, committees, and units on campus. They bring diverse viewpoints to the table as the workgroup advises the president on policies and programs to make MSU a national model of safety and inclusiveness for all. 
  • The workgroup quickly recommended increasing the number of therapists and victim advocates in the MSU Sexual Assault Program, or MSU SAP, to meet increasing demands for services. The workgroup collaborated with the Michigan Department of Health and Human Services to secure grant funding through the Victims of Crime Act (VOCA) to create four full-time positions for MSU SAP, including two therapists and two victim advocates. MSU is also funding an additional full-time crisis counselor.
    • MSU SAP is a primary resource on campus for student sexual assault survivors, and the demand for services has risen sharply in recent years. Last year, MSU SAP served over 650 clients and provided individual therapy to nearly 300 MSU students with a clinical staff of five therapists, one crisis counselor and one victim advocate. The new MSU and VOCA-funded positions will increase MSU SAP’s capacity to meet current and future levels of demand for services.
  • The workgroup also recommended creation of the Office for Civil Rights and Title IX Education and Compliance to oversee the Office of Institutional Equity and the Title IX Prevention, Outreach and Education Office and the Title IX Prevention, Outreach, and Education Office, which is dedicated to the outreach, education, and prevention of sex and gender discrimination, including relationship violence, sexual misconduct, and stalking.
    • Feedback from the MSU community and external reviewers indicated a need to clarify and streamline OIE processes, and to improve communication with both claimants and respondents. As non-investigatory staff, the new service coordinators will serve as primary points of contact for claimants and respondents, ensuring that OIE investigators can focus solely on conducting thorough, neutral investigations
    • The reorganization improves investigatory capabilities and the capacity to deliver prevention, education, and outreach programs. Five positions have been created:
      • Two service coordinators to provide resources for claimants and respondents, and help navigate OIE processes, including interim measures and investigations;
      • A data analyst to identify trends in reporting and provide data support to prevention, outreach and education efforts;
      • An OIE case manager to review incident reports, assign cases to OIE investigators and oversee case flow to improve timeliness of investigations;
      • And an Americans with Disabilities Act (ADA) coordinator—previously combined with the Title IX coordinator role, the ADA coordinator will now be a dedicated, full-time position.
      • An additional OIE investigator will also be hired, bringing the total number of OIE investigators to 10.

    • The new Title IX Prevention, Outreach and Education Office will be dedicated to the broad-based prevention of sex and gender discrimination, including relationship violence, sexual misconduct and stalking. The office will also focus on outreach—in alignment with MSU’s land-grant mission—and education, emphasizing our commitment to cultural change through increased knowledge and awareness. The new office will be staffed by six new positions, including five prevention specialists:
      • Faculty/staff education and community outreach specialist;
      • Sexual Assault and Relationship Violence program and specialized workshop specialist;
      • Bystander network specialist;
      • Graduate and professional student outreach and education specialist;
      • And a male engagement specialist.
      • Before this change, MSU had one full-time employee dedicated to prevention programming. The new office increases staffing and resources for prevention, outreach and education. Specialized positions were created to address gaps in programming based on feedback from the MSU community and recommendations from the Husch Blackwell Phase 2 Preliminary Report.
  • The MSU Police Department and the Office of Institutional Equity have implemented a new protocol to ensure that police notify OIE when investigating relationship violence, stalking, or sexual misconduct complaints.
    • The new reporting protocol will enable full communication and accountability between these two MSU units. The protocol will also ensure all victims receive information about campus resources and options from OIE. Previously, MSU policy required OIE to report incidents to MSU police, without a reciprocal protocol for reporting from MSU police to OIE.
    • Additionally, interlocal agreements bring local police agencies in East Lansing, Meridian, Bath, and Lansing townships and the Michigan State Police into our system so that MSU gains awareness of off-campus misconduct or assaults.
  • MSU has strengthened its policy on mandatory reporting obligations. As part of an annual review of its Relationship Violence and Sexual Misconduct Policy, MSU enhanced the policy to address violations of mandatory reporting obligations. Employees who fail to report sexual assault allegations as required by the policy are subject to discipline, up to and including termination. 
  • MSU has hired Kroll, a leading global independent, third-party investigative services firm, to assist with investigations and reduce the response time for complaints filed under MSU’s Title IX Relationship Violence and Sexual Misconduct Policy. Investigators will be used, as needed, to handle complex complaints and to reduce the time between filing and finding. 
  • Discussions began to better coordinate complaints directed to the Office of Institutional Equity, MSU Police and/or the MSU Hotline, which is supported by the Office of Internal Audit. It is crucial that appropriate MSU leaders are rapidly informed of complaints that may have an adverse effect on patient safety so interventions can take place quickly. 
  • The MSU HealthTeam CEO met with MSU Police to ensure a safer environment for patients and staff. MSU Police are taking over incident reporting at the Eyde clinical buildings from the Meridian Township police department to prevent gaps in complaint reporting. MSU Police are also increasing patrols in our clinics as well as providing staff training.
    • The MSU HealthTeam is obtaining proposals from independent peer review experts to assist with the review of sensitive cases.
    • The MSU HealthTeam also is evaluating replacement systems for its incident reporting system. The current system reports incidents, but we need to have the ability follow up and “close the loop” for reporting purposes.

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