Jeremy Cauwels: ‘Perfection, for just one day’

Clinic quality leader aims to reduce medical errors

Dr. Jeremy Cauwels smiles and uses a stethoscope to examine a hospital patient while she sits in bed.

Dr. Jeremy Cauwels is the senior vice president of clinic quality. Here, he shares information about his background, the role everyone plays in ensuring safety and how his family has enabled his career success.

Early life and education

Cauwels was born in Viborg, South Dakota. His family soon moved to Beresford, South Dakota, for a brief period and then Hawarden, Iowa, where Cauwels grew up.

Cauwels attended the University of Northern Iowa in Cedar Falls as an undergraduate, where he met his wife, and then enrolled in medical school at the University of Iowa, graduating in 2002.

From there, he and his wife moved to Kansas City. There, she practiced law and he completed a three-year internal medicine residency at the University of Kansas Medical Center and then spent one year as a chief resident.

Joining Sanford Health

After completing his residency, Cauwels traveled to Sioux Falls, meeting with physician leaders at both Avera and Sioux Valley.

It was Tom Braithwaite, who was key to establishing the hospitalist program, who encouraged Cauwels to join Sioux Valley. In fact, it was just one conversation with Braithwaite, who lost his battle with cancer a few years ago, that solidified Cauwels’s decision to practice at Sioux Valley.

“Tom was one of the kindest, most patient-centered individuals I’ve ever met in my life. He was my mentor and still is my mentor for what an outstanding clinical practice in medicine with an eye toward what the big picture looks like,” Cauwels says.

Cauwels has since been at Sanford Health for nearly 15 years.

Practicing as a hospitalist, Cauwels was the longtime chair of the Medication Safety Committee. “One of the things I’ve always liked to do in my hospitalist role is get involved in physician governance and medical quality and reducing medical errors,” he says.

Cauwels spent about four-and-a-half years as the medical director of the hospitalist group in Sioux Falls. He was also the sitting chief of staff for the Sioux Falls Medical Center for about two years, which kept him in about 50% practice and 50% governance.

So when the position of senior vice president of clinic quality was created, Cauwels was a natural fit.

Roles and responsibilities

Cauwels began his current position on Jan. 1 of this year. In his new role, he tracks how well physicians follow established protocols. He believes in roughly 95 percent of cases, surgeons and primary care doctors should be able to follow set patterns of treatment.

“Where truly great medicine comes in is when your surgeon or primary care physician recognizes why you don’t fit into the pattern,” he says.

In order to ensure quality, safety and high reliability, Cauwels believes three things must be done. One, we must do everything possible to keep people safe. Two, we have to make sure our processes are good enough that we deliver quality treatment, and we deliver it every time. Three, we have to treat people well, ensuring a positive patient experience.

One piece that will be critical to continual improvements in quality is the steady progress of technology. Cauwels specifically cites the possibility of microphones being built into the walls of patient rooms so they could immediately record and transcribe doctors’ notes. This would help meet the goal of the Health Services Division to reduce the amount of time doctors spend recording patient visits by 25% in the next two years.

“What I enjoy most about my work is knowing that if I do it well, there will be possibly hundreds of people every year that will never come to see us and I will never find out about because they didn’t have a medical error or they didn’t have a bad experience or because they got screened for illness, disease or other process while we were doing quality work,” Cauwels says.

Accomplishments and future goals

When asked what he’s most proud of in his work so far at Sanford Health, Cauwels says, “The fact that I’ve convinced nearly an entire hospital of nurses to call me by my first name.”

This is no minor issue to him.

“I feel like at a certain point in order to get to a place where everybody feels like they can stop the line to do the right thing to make sure that a patient is safe, you have to be at a point where you can call people by their first name and understand that there’s not a power gradient between people,” he says. “They’re all just people working for the same goal.”

On the flip side, Cauwels examines what he would most like to accomplish. In the next year and a half, his team is going to establish what they call a “serious safety event rate.” These are serious events that happen to one of their patients or staff or ones that nearly did. Cauwels will then focus on reducing that rate by 80% and then continue to chase zero.

“My dream is that some day we will take care of every patient in every Sanford Health facility without a single noted or unnoted episode of harm, and we’ll do it perfectly — even if it’s just for one day, because if it’s for one day, we can do it for a second one.”

Family life

Cauwels is married with three children, a 14-year-old and a pair of 11-year-old twins. One selling point of becoming a hospitalist when he initially began was the schedule. It was one week on, one week off, and he could spend that week off with his children.

In looking back, Cauwels attributes his success in his career to his wife, Teresa.

“My wife gave up a very promising law career to go part-time so I could pursue this,” he says. “I will tell you that without her help and guidance during all of this, I wouldn’t have ever gotten here. I owe her a debt that I don’t think I could ever repay for getting to this level of success and this level of enjoyment at my job.”

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Posted In Faces of Sanford Health, Internal Medicine

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