Leadership Corner: GLPP HIIN Concludes After Three and a Half Years of Quality Improvement Work

Michelle Norcross

The Leadership Corner features monthly updates from the MHA leadership team. The updates will provide new insights to patient safety and quality as well as information obtained from healthcare workshops and conferences across the country.

Michelle Norcross, MSA, senior director of safety and quality, MHA Keystone CenterMichelle Norcross, MSA, senior director of safety and quality, MHA Keystone Center, discusses the success of the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN) over the past three years.

In September 2016, 316 hospitals across Michigan, Illinois and Wisconsin committed to driving a 20% reduction in 13 preventable harms and a 12% reduction in readmissions under the GLPP HIIN. Three and a half years later, the GLPP HIIN is able to share the many successes hospitals achieved during this time.

As a network, the GLPP HIIN saw a total cost savings of $292,903,501, saved 3,350 lives and avoided 25,204 incidents of harm within hospitalized patients over the last 42 months. Further, the GLPP HIIN made improvements in 12 out of 14 areas of harm.

Displayed below are the highest performing measures within each area of preventable harm. A positive number indicates improvement; a negative number indicates an increased rate of harm.

GLPP HIIN Improvement Data


ADE – Anticoagulants


Pressure Injury: AHRQ PSI-03


ADE – Hypoglycemics


Sepsis and Septic Shock Mortality


ADE – Opioids


SSI – Abdominal Hysterectomy NHSN SIR




VTE – PFE or DVT Rate: AHRQ PSI-12


CLABSI Rate – ICU and other units




C. Difficile Rate


Readmissions – Same Facility


Falls with Injury: NQF 0202



The GLPP HIIN made significant gains across the tri-state network in the implementation of meaningful Person and Family Engagement (PFE) strategies. Many HIINs across the nation have been able to correlate strong PFE practices with reduced harm. The GLPP HIIN will be reviewing its data to determine whether it can make similar correlations over the coming months.

PFE Activity

% of Hospitals Implementing Activity

PFE 1:  Implementation of a planning checklist for patients known to be coming to hospital


PFE 2:  Conduct shift change huddles and bedside reporting with patients and families


PFE 3:  Designation of an accountable leader in the hospital who is responsible for PFE


PFE 4:  Hospitals having an active Patient and Family Advisory Council or other committees where patients are represented


PFE 5:  One or more patient representatives serving on hospital Board of Directors


The GLPP HIIN collectively demonstrated considerable improvement in all-cause harm. The GLPP HIIN Reliability Measure quantifies all-cause harm by aggregating the total number of harm events across 16 different measures divided by patient days to depict the impact of HIIN work on reducing overall patient harm. To date, the GLPP HIIN has seen a consistent decrease in the Reliability Measure over the last seven consecutive quarters, spanning almost two years. The state-level performance of the HIIN Reliability Measure is depicted below.

Click for a PDF version of the HIIN Reliability Measure Chart

It is essential to highlight the meaningful work of our critical access hospitals (CAHs), which represented 35.8% of our network. Participating CAHs were able to drive improvement in 74.2% of their applicable measures. Additionally, they drove over 51% improvement in surgical site infections for knee arthroplasties and hysterectomies, over 62% improvement in methicillin-resistant Staphylococcus aureus (MRSA) and over 73% in central line-associated bloodstream infection rate across all units. 

The success of the GLPP HIIN wouldn’t be possible without the active participation, dedication and commitment of each participating hospital.  We want to thank you for your continued focus on entering timely data, which allowed us to demonstrate progress and further develop meaningful activities. It has been a pleasure working with each organization and being a small part of their quality improvement journey in working toward zero harm.

Looking to the future, the GLPP HIIN (Illinois Health and Hospital Association, Michigan Health & Hospital Association and Wisconsin Hospital Association) and the Minnesota Hospital Association have partnered with the Lake Superior Quality Improvement Network (MetaStar, MPRO and Stratis Health) and the Midwest Kidney Network to form Superior Health Quality Alliance (Superior Health). Superior Health was named a Network Quality Improvement and Innovation Contractor in early 2019 and is actively pursuing available proposals for improvement work through the Centers for Medicare & Medicaid Services. 

In the meantime, the GLPP HIIN has developed and maintained a strong relationship with the Minnesota HIIN following the collaborative development of the Reliability Culture Implementation Guide and, together, they remain focused on the spread of successful work to drive improvement further. The four state hospital associations are now developing a series of monthly webinars that will run from April through September 2020 to maintain engagement of all HIIN hospitals. We hope you will join us for these webinars as you are able. Registration for this series is now open – please click the links below to sign up now. All webinars will occur from 2 p.m. to 3 p.m. ET.

Again, we thank you for your continued participation and commitment to reducing patient harm. The success demonstrated above is just a small piece of the outstanding work achieved through the dedication of every participating organization. Thank you for your continued commitment to making care for hospitalized patients safer each day.

This article was featured in the MHA Keystone Center Newsletter. To subscribe, please contact the MHA Keystone Center.