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In this issue:
Keystone Project Improves Safety in Michigan Hospital
ICUs
MHA Keystone Project Improves Patient Safety in Hospital ICUs
Michigan hospital intensive care units (ICUs) are safer today following a two-year project to reduce medical errors and improve patient safety directed by the state’s hospital association and The Johns Hopkins University Quality & Safety Research Group. Results of the project were announced Oct. 13 by leaders of the Michigan Health & Hospital Association (MHA) Keystone Center for Patient Safety & Quality and patient safety experts from Johns Hopkins. Keystone: ICU is believed to be the largest patient safety collaborative of its kind anywhere in the world, with more than 120 Michigan ICUs and 70 Michigan hospitals participating. The results were shared at a conference in Dearborn for Michigan business leaders, state lawmakers and hospital leaders. Using a predictive model and data collected from project participants between March 2004 and June 2005, the total savings in the 15-month span were:
“As a result of Keystone: ICU, medical errors are being avoided, and lives and health care costs are being saved,” said MHA President Spencer Johnson. “Improving health care safety at the bedside benefits all patients and the governments, employers and workers that pay for health care services. Michigan hospitals are proud to be at the forefront of patient safety and health care quality improvement initiatives.” No Surprise: 2007 State Budget Looks Grim, Too
Michigan’s stalled economy, combined with state tax cuts of recent years, will force the legislature and governor to cut about $750 million from the 2007 state budget, economists and fiscal experts are predicting. Because the state continues to lose manufacturing jobs and revenues to tax cuts, the 2007 budget will not be able to cover skyrocketing Medicaid costs, higher public safety costs and higher education costs. Since 1998, the state’s Medicaid budget has been cut by roughly $630 million, even as the Medicaid caseload has skyrocketed to a record 1.5 million people. Tens of thousands of the new Medicaid beneficiaries are former manufacturing industry workers who have lost good jobs that included health care benefits. “Where the legislature and governor will cut is anyone’s guess, but they should not look to balance the budget on the backs of our most vulnerable residents,” said Michigan Health & Hospital Association President Spencer Johnson. “Cutting Medicaid directly affects children, the disabled and the elderly. Every major cut to Medicaid also shifts higher costs to Michigan employers and their workers and eliminates health care jobs that pay good wages and support local communities.” Legislation Requires Published Comparison of Medicaid, Medicare Rates
It’s well known that the federal Medicare program and the state Medicaid program pay vastly different rates to hospitals and physicians for the same medical procedures, with Medicare rates almost always higher. Now state Rep. Kevin Green (R-Wyoming) wants the state to issue an annual report documenting the differences between the Medicare and Medicaid payments. Public hearings on Green’s House Bill 5040 are expected to be held in the coming weeks and months before the House Family & Children’s Services Committee. The Partnership for Michigan’s Health, a coalition that includes the Michigan Health & Hospital Association, the Michigan Osteopathic Association, and the Michigan State Medical Society, supports the legislation. In a letter to members of the House Family & Children’s Services Committee, the Partnership wrote:
Sign-up for New Medicare Part D Prescription Drug Benefit Starts Nov. 15
Millions of senior and disabled citizens across the nation and Michigan will begin signing up for the new Medicare prescription drug benefit on Nov. 15. Michigan hospitals, Area Agencies on Aging, senior centers, long-term-care facilities, churches and other venues are hosting sign-up events between Nov. 15 and May 15, 2006, the final day beneficiaries can enroll in one of the new Part D plans without paying a financial penalty. Meantime, a new report projects the number of seniors paying more than $4,000 a year in out-of-pocket costs for prescription drugs could decline to just 160,000 in 2006 under the Medicare drug benefit. Currently, more than 1.5 million seniors lack catastrophic coverage and pay more than $4,000 for prescription drugs annually, according to the report by PricewaterhouseCoopers. Medicare beneficiaries with supplemental coverage, such as a Medigap plan, could see their average out-of-pocket costs decline under the new drug benefit to less than $900 from $1,300, the report estimates. Based on U.S. Census and Medicare program data, the report was prepared for Medicare Today, a partnership of more than 350 organizations working to explain the new Medicare benefit through grassroots efforts. The report projects 98 percent of Medicare beneficiaries could have catastrophic coverage under the benefit, up from 52 percent currently. Michigan senior citizens with questions about the new Medicare prescription drug benefit are encouraged to contact the Michigan Medicare/Medicaid Assistance Program (MMAP), a nonprofit organization that offers objective information about the new benefit. MMAP has more than 700 trained counselors who will answer questions by telephone or make home visits to beneficiaries who request them. MMAP will not try to sell any specific plan. Seniors are urged to contact MMAP at (800) 803-7174 or at www.mymmap.org.
No New Regulations Needed: Michigan Hospitals Boost Patient Safety
When a major employer has an obvious problem that is harming people and driving costs higher, media scrutiny and increased government regulation often result to push corrective measures. In some instances, the responsible industry will step up to the plate and solve the problem itself, with no additional motivation other than to do what is right. In November 1999, a landmark Institute of Medicine study concluded that at least 44,000 people die in hospitals nationwide each year as a result of medical errors. The report, which generated major concern among America’s hospitals and with media nationwide, called on Congress to enact new laws and challenged health care providers to design safer delivery systems. Reducing medical errors by 50 percent, the study said, would save lives and reduce costs by billions of dollars. While the government pondered ways to turn the report into new regulations, Michigan hospitals took action. We concluded that if, as the report suggested, most medical errors “do not result from individual recklessness,” but instead are caused by “faulty systems, processes and mistakes,” then surely we have the power to fix them. In early 2003, the Michigan Health & Hospital Association (MHA) established the Keystone Center for Patient Safety & Quality. A few months later, a two-year, $1 million federal grant enabled MHA Keystone to partner with national patient safety experts from The Johns Hopkins University and Michigan intensive care units (ICUs) in a pioneering effort to make ICUs safer. Why ICUs? More than five million people are treated each year in U.S. hospital ICUs. Care delivered in ICUs costs about $180 billion a year, representing nearly 30 percent of total annual acute-care spending. ICU patients are also at risk for certain types of preventable infections that can drive up costs, increase lengths of stay and lead to death. Keystone: ICU became what we believe to be the largest patient safety collaborative of its kind anywhere in the world, with more than 120 Michigan ICUs and 70 Michigan hospitals participating. Hospitals in three other states also joined the project.
Working with hospital ICU teams, Keystone project leaders did exactly what the report recommended: they improved the delivery of medical treatments in ICUs through simple interventions that have significantly reduced infections and pneumonia. Central intravenous (IV) lines are a major source of infections in ICUs that harm patients and increase lengths of stay, which drive up costs. Prior to MHA Keystone, Michigan’s rate of central line infections ranked average in the nation. Now, Michigan’s performance ranks among the nation’s best. Hospitals participating in Keystone: ICU have reduced central IV line infections by nearly 50 percent. Of the 127 participating ICUs, 68 have reported zero bloodstream infections or ventilator-associated pneumonias for six months or more. This achievement was once thought impossible, even according to the U.S. Centers for Disease Control and Prevention. Overall ventilator-associated pneumonia rates in the project also continue to decrease. Each prevented infection reduces costs, reduces the time a patient must stay in the ICU, and often saves a life. In fact, using a predictive model and data collected from project participants between March 2004 and June 2005, the total savings in the 15-month span were:
The success and expansion of the MHA Keystone Center are important because every patient in every hospital deserves to get the best care possible in the safest environment. Future projects will focus on improving treatment delivered in other health care settings. While the nature of health care is to constantly seek improvement, we’re proud to say that Michigan is now the best in the business. Our doctors, nurses and administrators stepped up to the plate with no new laws, but instead, with a new determination, spirit of collaboration and renewed mission to deliver evidence-based care. Today, if you need treatment in a hospital ICU, Michigan is the place to be. |
