Quality

MHA Keystone

The MHA Keystone Center acknowledges and appreciates the generous financial support of Blue Cross Blue Shield of Michigan.

Mission Supporting healthcare providers to achieve excellence in the outcomes desired by the people they serve.

Values Excellence. Innovation. Compassion. Teamwork.

Vision Achieving the highest quality healthcare outcomes that meet individual values.

MHA Keystone Report

improving together

Download a PDF of the report to learn about everything the MHA Keystone Center is doing to promote high quality healthcare in Michigan.

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2017-2018 MHA Keystone Center Quality Initiatives

MHA Keystone Center Celebrates First Anniversary of Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN) Contract

In September 2016, the MHA Keystone Center, Illinois Health and Hospital Association, and Wisconsin Hospital Association signed a two-year contract with optional third year as part of the Centers for Medicare & Medicaid Services HIIN.

The partnership united three state hospital associations and 316-member hospitals across Michigan, Illinois and Wisconsin with a common goal: to reduce hospital-acquired conditions by 20 percent in numerous areas of harm and achieve a 12 percent reduction in all-cause readmissions.

Great Lakes Partners for Patients

Michigan HIIN Outcomes

20%

Reduction in Five Areas of Harm:

  • Central line-associated Bloodstream Infection (CLABSI) in both ICUs and hospital-wide.
  • Catheter-associated Urinary Tract Infections (CAUTI) in the ICU and hospital-wide.
  • Surgical-site Infections (SSIs) following hysterectomies.
  • Possible ventilator-associated pneumonia.
  • Adverse drug events related to anticoagulants.

From September 2016 to June 2018

10%

Reduction in Five Areas of Harm

Michigan Hospitals Have Achieved in the Past 22 Months:

  • SSIs following total knee replacements.
  • Clostridium difficile (C. diff).
  • Adverse drug events related to glycemic control.
  • Venous thromboembolism (deep vein thrombosis and pulmonary embolism).
  • Total infection-related ventilator-associated complication plus.

Results

  • Estimated cost savings: $80.6 million
  • Instances of harm avoided: 6,392
  • Lives saved: 214

GLPP HIIN Membership

316 hospitals total, with 112 Michigan Hospitals

Areas of Focus

Sepsis is the body’s extreme response to an infection. Without timely treatment, sepsis can rapidly cause tissue damage, organ failure and death. Sepsis is the number one cause for hospital readmissions and a leading cause of mortality in Michigan. The MHA Keystone Center has focused on identification and treatment of sepsis and ways to prevent sepsis readmissions.

MHA Keystone Center Tackles Sepsis Through Specialized Member Training

The MHA Keystone Center aimed to tackle sepsis by offering sepsis simulations to its members. The simulations provide participants with a chance to work in real-life scenarios of identifying and treating patients who are septic. The simulations were hosted across the state, allowing participants to attend at least one simulation. Throughout the year, 154 attendees from nearly 50 facilities participated in seven simulations on sepsis best practices.

Tracers Teach Ways to Improve Sepsis Rates

During a tracer, sepsis care experts visit hospitals to understand the delivery of care for sepsis patients and provide recommendations for improvement. The subject-matter experts perform a tracer methodology that follows a patient through the care process, from the emergency department to the ICU to a patient care unit to discharge. Staff are encouraged to share thoughts on current sepsis practices and what could be improved throughout the process. After the tracer concludes, a leadership meeting is held to discuss the findings. Later, written recommendations are provided to the facility to guide them in improvement efforts. In the 2017-2018 program year, sepsis tracers were performed at three facilities, involving more than 35 physicians and nurses.

Sepsis Readmissions Regional Learning Session Highlights Readmission Prevention Strategies

Nearly 90 clinicians from more than 20 hospitals across Michigan, Illinois and Wisconsin participated in a session to review strategies for readmission prevention and evidence-based practices at discharge and post-discharge. The session was led by two nationally known sepsis experts: Pat Posa, RN, BSN, MSA, quality excellence leader, St. Joseph Mercy Ann Arbor, and Hallie C. Prescott, MD, MSc, assistant professor, University of Michigan, Ann Arbor, and health system and research scientist, Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System.

Podcast Raises Awareness About Sepsis

The MHA’s MiCare Champion Cast featured an episode in December on sepsis and raised awareness about Michigan hospitals’ efforts to combat the serious condition. The episode featured interviews with Pat Posa, RN, BSN, MSA, quality excellence leader, St. Joseph Mercy Ann Arbor; Corine Ross, patient safety and quality coordinator, MHA Keystone Center, Okemos; and Rebecca Thomas of Harrison Township, who was hospitalized with sepsis in 2017.

The MHA Keystone Center regularly works with its members to implement fall prevention best practices. Over the past year, the MHA Keystone Center conducted 11 site visits to observe daily safety briefings and current procedures and practices and to make key recommendations to reduce the number of falls and prevent patient injury.

The opioid epidemic is one of the most pressing issues in America. Over the past year, the MHA Keystone Center has participated in national opioid task forces and produced educational materials to help organizations address the overuse, misuse and disposal of opioid products and prescription medications.

Advocating for appropriate opioid stewardship will remain a priority for the MHA Keystone Center in the year ahead.

MHA Keystone Center Opioid Stewardship Tools & Resources

  • Michigan Opioid Legislation Hospital Compliance Checklist: The checklist was created to help guide MHA-member hospitals through the requirements of a package of bills signed into law December 2017 in response to the opioid epidemic.
  • Medication Disposal Tool: The MHA Keystone Center, Michigan Department of Environmental Quality and Michigan Pharmacists Association created the standardized tool to outline how to properly and safely dispose of expired, unused or unwanted prescription medication.
  • Opioid Knowledge Self-Assessment: The MHA Keystone Center administered a self- assessment for any member who wished to use the tool with practitioners who prescribe, dispense, and/or administer opioid products.
  • Be Rx Safe: The MHA Keystone Center teamed up with Blue Cross Blue Shield of Michigan, the Michigan Osteopathic Association, the Michigan State Medical Society and the Michigan Opioid Prescribing Engagement Network to create the Be Rx Safe campaign – an effort to raise awareness about the dangers of prescription drug abuse and overuse and to encourage prescribers and patients to do their part in addressing the opioid crisis.

Health equity refers to differences in access, treatment and outcomes across different populations. The MHA Keystone Center continues to pursue several opportunities to educate its members on why health disparities are vitally important and what can be done to reduce inequities in healthcare. Some examples from 2017-2018 are shown below.

  • Advancing Health Equity: The three-part webinar series taught 573 participants from 142 Michigan, Illinois and Wisconsin hospitals how to use data to identify and address health disparities and improve the quality and safety of care.
  • The Bridge Model: A person-centered, social work-led, interdisciplinary model of transitional care was launched as a pilot to address hospital readmissions among the state’s most disparate populations. Bridge emphasizes collaboration among hospitals, community-based providers and the Aging Network to ensure a seamless continuum of health and community care across settings.

Opioids kill tens of thousands of U.S. residents per year, and the death toll is expected to continue to climb. Providers, federal regulators and healthcare organizations have confronted the opioid crisis with various prevention, treatment, pain management and support solution options.

Manistique-based Schoolcraft Memorial Hospital (SMH) set out to address this complex, multidimensional issue through an integrated approach. It formed a Substance Abuse and Treatment Services Program to improve health outcomes of patients of all ages by increasing access to high-quality, integrated mental health and substance use disorder medical services.

schoolcraft memorial
SMH staff members who are involved in the Substance Abuse and Treatment Services Program include Janet Pratt, PMHNP- BC; Kim Shiner, LPN, SMH rural health clinic director; Sara Giles, marketing director; Bob Crumb, CEO (not pictured); Mark Hebert, RN, BSN, chief quality and patient safety officer; and Jenna Bradshaw, patient navigator.

SMH believes that childhood trauma can adversely affect life trajectory and, consequently, lead to mental health and substance use issues. Therefore, the program is both patient- centered and trauma-informed. It aims to tackle opioids with a unique triad approach, including childhood trauma, mental health issues and substance abuse. Staff education and community collaboration are integral parts of the program.

SMH hired a family psychiatric nurse practitioner in 2017 to assist with the mental health needs of the community. It also recently recruited a pediatrician to be available one day per month to provide specialty services to children. The hospital plans to integrate substance use disorder services into its care system and to hire a trauma-informed mental health therapist to help patients address issues.

SMH also hired a patient navigator who serves as an internal and external liaison to coordinate care, services and community resources. This helps patients, young and old, navigate complex systems to assure their mental health, substance use disorder, and/or medical care needs are addressed.

Many community organizations collaborate with SMH to improve healthcare. The Substance Abuse and Treatment Services Program was launched with support from the Michigan Center for Rural Health, Blue Cross Blue Shield Foundation of Michigan and Superior Health Foundation. Other partners include the Department of Health and Human Services – Trauma Initiative, Schoolcraft County Mental Health Court and Substance Abuse Court, Manistique Area Schools, Great Start Initiative, and the Schoolcraft County Sheriff’s office. SMH has also helped Great Lakes Recovery Centers fill a long-vacant position for a substance use disorder counselor.

Addressing the cycle of trauma and abuse during childhood can have a positive impact on future generations. Recovery is lifelong and requires support. SMH is confident that great strides toward mental and physical health can be realized for children and adults when a collaborative approach is applied.

Connecting with Members

MHA Keystone Center Connects with Members Through Monthly Check-In Calls

MHA Keystone Center staff started to connect with member hospitals this year through monthly check-in calls. These calls are valuable, as hospitals can discuss the struggles they’re facing, areas for improvement, data needs, educational opportunities and any successes the facility is experiencing and willing to share with its peers.

The MHA Keystone Center staff also find the calls helpful, as they allow them to keep a finger on the pulse of the hospital community. Lastly, the calls are a way for MHA Keystone Center staff and member hospitals to maintain contact and hear from one another about needs on both sides.

Webinar Statistics for the 2017-2018 Program Year

  • 1,834 Participants
  • 228 Hospitals Represented

Workshops

Members Learn Best Practices in Critical Care
More than 200 MHA Keystone Center members participated in the MHA Keystone Center Fall 2017 Workshop: Critical Care to learn how to implement best practices in critical care surrounding sepsis, readmissions, pressure ulcers, patient falls and antimicrobial stewardship.

Spring Workshop Offers Unique Member Experience
The MHA Keystone Center Spring 2018 Workshop: Preventing Harm Across the Board featured two breakout sessions that allowed participants to learn best practices from their peers in four specific areas – pressure ulcers, adverse drug events, patient falls and venous thromboembolism – and how to implement processes in their own facilities to reduce harm.

workshops