Healthcare workers across the state gathered April 13 in Southeast Michigan to discuss best practices for patient handling to ensure the safety of both the patient and the caregiver.
The MHA Keystone Center partnered with EarlyMobility.com to bring live safe patient handling demonstrations and interactive mobility equipment activities to more than 60 occupational therapists, quality and risk managers, nurses, physical therapists and physicians. Participants discussed the importance of safe, early and continuous mobility and how properly utilizing mobility equipment ultimately is in the best interest of patients and caregivers. Presenters also highlighted the cost and time savings that come from prioritizing revised best practices for patient handling and mobility.
The Michigan report details information on episode payments, mode of delivery, patient characteristics and rates of hemorrhage, hypertension and severe maternal morbidity for 90-day claims-based episodes of care for vaginal and cesarean delivery at MVC participating birthing hospitals from January 2019 to December 2021. It found 7.5% of patients had a diagnosis of hemorrhage, 4.2% had a diagnosis of hypertension and 1.8% had a diagnosis of severe maternal morbidity (SMM) during their index birth hospitalization. A notable finding was the difference in rates of these complications by race. Patients who were identified as Asian or Pacific Islander had higher rates of hemorrhage than other race categories, while patients who were identified as Black had higher rates of hypertension and SMM than the overall population.
Through support from Blue Cross Blue Shield of Michigan, this report helps to better understand disparities in care while guiding the MHA Keystone Center’s efforts to increase equitable care and decrease preventable several maternal morbidity and mortality.
Registration is now open for the MHA Keystone Center Safe Patient Handling Conference. The all-day event will take place April 13 at the Ann Arbor Marriott Ypsilanti at Eagle Crest.
In partnership with the MHA Keystone Center, EarlyMobility.com and Blue Cross Blue Shield of Michigan, the free event will provide participants with a better understanding of how caregiver and patient safety are connected. Attendees will also learn how safe, early and continuous mobility can help achieve better patient outcomes inless time with fewer staff.
Participants will view live simulations demonstrating best practices for patient handling and discuss how to avoid care activities that cause caregiver injury and compromise quality of care.
Risk and safety officers, physicians, nurses, physical and occupational therapists and worker’s compensation staff are encouraged to register.
Nursing, physical therapy, risk management and quality credits have been secured for the event. Continuing education credits for occupational therapy are being pursued.
About the speakers:
Margaret Arnold is one of the world’s foremost experts on early mobility and is CEO of EarlyMobility.com. Margaret has over 25 years of experience as a PT, specializing in back injury treatment and prevention, industrial rehabilitation, ergonomics and safe patient mobility. You can often catch Margaret both domestically and internationally speaking at conferences related to PT, early mobility and safe patient handling. She is the editorial advisor on early mobility for the International Journal of Safe Patient Handling and has a seat on the board of directors for the American Safe Patient Handling Association. She has published extensively on both topics and is a pioneer in integrating early mobility programs with safe patient handling programs.
Janice Homola is President Emeritus of the Michigan Health Care Safety Association (MHCSA). As a certified safe patient handling associate (CSPHA), Janice specializes in safe patient movement and mobility by conducting gap analyses, collaborating to determine improvements, providing coaching and education and by improving organizations’ cultures of safety.
Janice was co-developer and presenter for five years for MIOSHA funded, statewide seminars, On the Backs of Healthcare Workers, to spotlight the depth and breadth of patient movement challenges and provide innovative solutions. She participated with MIOSHA in ergonomic standard development and provided safe patient movement education to MIOSHA’s Consultation Education and Training division.
EarlyMobility.com is an AOTA Approved Provider of professional development. This live event is an introductory level course. The assignment of AOTA CEUs does not imply endorsement of specific course content, products of clinical procedures by AOTA.
“I have gained this by philosophy; I do without being ordered what some are constrained to do by their fear of the law.” ― Aristotle
In last month’s CEO Report, we focused on the new political environment in Lansing, with a host of first-time lawmakers taking office, Democrats assuming majority control of both chambers of the legislature and a host of new leaders in key roles. The playing field has changed in a palpable way.
As healthcare leaders, the list of emerging challenges may seem endless today, ranging from unprecedented labor shortages, inflation, cybersecurity and much more. But as the new legislative session ramps up, we also can’t turn a blind eye toward issues from years past which have the potential to rear their ugly head once again. Medical liability is at the top of that list and merits our close attention.
One of the MHA’s signature achievements over the past thirty years was the passage of sweeping medical liability reforms in the early 1990s. Our leadership and collaboration with our friends in organized medicine and other partners helped to directly address a situation that had become untenable for Michigan: runaway verdicts in medical liability cases were threatening the financial viability of hospital-based service lines (and even entire hospitals). Doctors, particularly those in high-risk specialties, were leaving the state in droves and our recruitment efforts faced an extraordinarily high hurdle.
Since the passage of our reforms, which brought reason and predictability to the system, medical liability has been relatively stable for nearly three decades, even as the caps on noneconomic damages continued to grow with inflation. And over the years, the MHA has been extremely vigilant, advocating to preserve these reforms both in the legislative arena and in the courts, where we have filed countless amicus curiae briefs on behalf of our members and the healthcare field. However, a recent decision by the Michigan Supreme Court is bringing these concerns back to the forefront of our minds.
The case of Estate of Langell v McLaren Port Huron, heard by the Michigan Supreme Court in 2022, ultimately affirmed a Court of Appeals decision that a plaintiff’s estate can recover all earning potential that a decedent would have been able to earn and provide if a person who died due to medical malpractice had lived. This is now the law, even if that person was not responsible for the support of anyone else. The Court of Appeals cited the precedent established in Denney v Kent Road Commission. Since that decision, what a decedent’s estate can recover is referred to as “Denney damages.” Cases that once settled for $250,000 are now expected to be resolved for $700,000.
With “Denney damages,” the liability for healthcare organizations increase as earnings can be counted for any victim of medical malpractice, even those who have yet to establish any known talents, educational attainments or trainings typically used to calculate such earnings.
It is important to note that while we engage on this topic in the public policy arena, our ultimate priority is the safety and wellbeing of patients. Our hospitals and providers take the life of each patient in their care extremely seriously and there is nothing a hospital wants to avoid more than a medical error. To that end, we have “put our money where our mouth is” by establishing the MHA Keystone Center, which has become a true leader in this space, both in Michigan and nationally. The Keystone Center, which also operates a federally certified Patient Safety Organization, collects and analyzes data on medical errors and “near-misses,” serving as a North Star in our collective efforts to improve patient safety and quality. Our successes have been well-documented in peer-reviewed medical journals. Blue Cross Blue Shield of Michigan has provided significant funding to the MHA Keystone Center over the years, and so has the federal government through a series of contracts, as they have seen and valued the tangible improvements we have made and will continue to make.
Back to the issue at hand: our hospitals and providers are committed to doing right by patients, through the provision of the highest quality care possible. And for nearly three decades, Michigan’s medical liability laws have proven our system can fairly handle cases of medical malpractice that compensate patients and families fairly while maintaining hospital liability at sustainable levels that do not threaten the viability of an organization due to a single error. The system works and it is our intention to keep it that way.
The MHA Keystone Center recently released its 2021-2022 Annual Report, which showcases the center’s commitment to working alongside members to improve safety and quality in healthcare. Through support from Blue Cross Blue Shield of Michigan, this report highlights the profound impact collaboration and partnership amongst the Michigan healthcare community can have on Michigan’s communities.
Report highlights include:
An introduction to the MHA Keystone Center’s Health Equity Task Force, which was assembled to provide guidance to members in their efforts to redesign and implement interventions that address disparities in care.
An overview of the well-being program (WELL-B) launched in partnership with Duke Center for Healthcare Safety and Quality to address workplace burnout in healthcare.
A birds-eye view of the collaboration taking place to address increasing opioid use disorder cases.
The MHA and fellow healthcare leaders joined a virtual panel discussion on clinical genomics Sept. 22 hosted by the White House Office of Science and Technology Policy and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The purpose of the webinar was to raise awareness about the clinical utility and lifesaving potential of clinical genome sequencing, as well as highlight coverage models for state Medicaid programs and private payors to help enable equitable access.
According to the National Department of Health and Human Services (HHS) and the National Institutes of Health, recent technological advances have made it possible for clinicians to quickly sequence the genomes of critically ill newborns and children to rapidly make a diagnosis. This powerful technology can transform lives by identifying potentially lifesaving and life-changing medical treatment. However, despite the enormous promise of genome sequencing to improve health outcomes, not all patients who might benefit from this technology can access it.
Laura Appel, executive vice president of Government Relations & Public Policy at the MHA, joined the conversation to speak on our state’s model for advancing coverage of genomic sequencing. Other panelists from Michigan healthcare institutions, included:
Brian Keisling, director of bureau of Medicaid policy at the Michigan Department of Health & Human Services.
Caleb Bupp, M.D., FACMG, division chief of medical genetics & genomics at Beaumont Health Spectrum Health and Helen DeVos Children’s Hospital.
Lynne Carter, M.D., MPH, medical director at Blue Cross Blue Shield of Michigan.
Wendy R. Uhlmann, M.S., LCGC, genetic counselor and clinical professor at the Departments of Internal Medicine (Division of Genetic Medicine) and Human Genetics at the University of Michigan.
During the discussion, the group touched on Project Baby Deer, an initiative that provides rapid whole genome sequencing testing for critically ill infants up to one year of age. The program can enhance clinical management of young patients by initiating life-saving treatments, avoiding unnecessary tests and procedures, shortening hospital stays and helping families with treatment decision-making.
To learn more about clinical genome sequencing, visit the HHS website. Those with questions about Project Baby Deer may contact Laura Appel at the MHA.
Blue Cross Blue Shield of Michigan announced Jan. 19 that four Upper Peninsula community organizations will receive $490,000 in grant funding to help them address gaps in service for individuals and families facing substance use disorder (SUD) and to support the development and growth of recovery communities. Recovery communities offer a variety of services to support people recovering from SUD and their family members.
The MHA is a community partner in the project, along with the Upper Peninsula Health Plan and four members of the Michigan Opioid Partnership: Blue Cross Blue Shield of Michigan, the Blue Cross Blue Shield of Michigan Foundation, the Michigan Health Endowment Fund and the Superior Health Foundation.
The organizations’ two-year grant programming begins in January 2022. Organizations receiving the funding include the Eastern Upper Peninsula Opioid Response Consortium, Great Lakes Recovery Centers Inc., the Western Upper Peninsula Health Department and Superior Housing Solutions.
The MHA Board of Trustees identified behavioral health as a critical priority for the association in its 2021-2022 Strategic Action Plan. The board established goals for behavioral healthcare that include setting guiding principles, overcoming obstacles and seeking new funding. The MHA’s partnership in this grantmaking project is one of several steps toward achieving those goals.
Coverage of the press release includes stories from WJMN-TV and WLUC-TV6. For more information on the grants, contact Ruthanne Sudderth at the MHA. Additional information on the association’s efforts to address behavioral health is available from Laura Appel at the MHA.
If you can’t describe what you are doing as a process, you don’t know what you’re doing.”— W. Edwards Deming
The last week has been an eventful and successful one for the MHA. The Michigan Legislature and Gov. Gretchen Whitmer came to an agreement on the state budget for the new fiscal year, which fully preserves all our hospital and healthcare funding priorities — needed more than ever as our hospitals continue to combat COVID-19 and deal with extraordinary staffing challenges. We were officially honored by Modern Healthcare with the Best Places to Work in Healthcare distinction. And finally, we received great news when Blue Cross Blue Shield of Michigan (BCBSM) announced a $5 million commitment through 2024 to support the MHA Keystone Center’s expanded quality and safety improvement programs. I would like to personally thank BCBSM CEO Dan Loepp for his support of this continued partnership, which is the right thing to do for all Michiganders.
Since its inception in 2003, the MHA Keystone Center has provided leadership and facilitation that has directly resulted in improved patient care and quality outcomes — in other words, we have demonstrably saved lives and saved healthcare dollars. No wonder that the MHA Keystone Center has earned both national and international acclaim.
Our first flagship initiative involved central line associated bloodstream infections (CLABSI). Through that work, Michigan hospitals saw a 22% improvement in CLABSI rates. Initial BCBSM funding also supported work that saw a 31% improvement in catheter-associated urinary tract infections (CAUTI) and a 5.9% improvement in venous thromboembolism.
Following our initial successes, the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN) was created, allowing us to collaborate with our colleagues in Illinois and Wisconsin. Our HIIN efforts from Sept. 2016 to March 2020 produced a total cost savings of nearly $293 million, saved 3,350 lives and avoided 25,204 incidents of harm among hospitalized patients.
The MHA is now one of eight organizations participating in the Superior Health Quality Alliance, a Centers for Medicare & Medicaid Services (CMS)-contracted organization that seeks to improve the quality of health and healthcare through innovation, effectiveness and efficiency in designing and implementing CMS Network of Quality Improvement and Innovation Contractors initiatives that are person-centered and integrated across the continuum of care and services. This important work with federal contracts is yet another way we can improve quality in the acute care setting.
High reliability work has been a focal point for the MHA for several years, which was initiated with our members in 2015. This work ensures exceptional quality of care is consistently delivered for every patient, every time. In 2018, the MHA Keystone Center launched a Reliability Culture Implementation Guide in partnership with our fellow state hospital associations from Illinois, Minnesota and Wisconsin. This guide provides resources available for front-line staff, executive leaders and board members to help identify areas of opportunity.
Over the past year, CEOs representing all our community hospitals have signed the MHA Pledge to Address Racism and Health Inequities, demonstrating our members’ unified commitment to address disparities, dismantle institutional racism and achieve health equity. Recent examples of tangible steps taken to accomplish those goals include the publishing of the Eliminating Disparities to Advance Health Equity and Improve Quality guide and offering a virtual series to address four diversity, equity and inclusion concepts: equitable conversations, equitable messaging, partnership building and diversity pipeline development. The Health Equity guide is geared to assist organizations in addressing health disparities to achieve equitable care by providing key strategies, recommendations for action, implementation levels, and resources to support progress.
Thanks to funding from the Michigan Health Endowment Fund, the MHA Keystone Center recently launched its second Age-Friendly Health Systems Action Community free of charge to MHA members. The Action Community builds on existing practices of participating organizations and combines them to reliably implement the evidence-based framework of high-quality care with all older adults in the system. With Michigan’s aging population, this work is exceptionally important and timely.
One way to help instill a safety culture within a healthcare organization is empowering all members of a care team to speak up if they think something may be wrong. Our patient safety organization created the quarterly Speak-up! Award program five years ago to honor healthcare staff who spoke up to prevent harm, which has prevented nearly $12 million in avoidable costs.
We have also done our part to address the tragedy of opioid overdoses, which lead to more deaths in Michigan than automobile accidents. The GLPP HIIN recently created the Midwest Alternatives to Opioids (ALTO) program; participating hospitals collectively have seen an 11.32% decrease in opioid administration and a 13.38% increase in ALTO administration. Because the COVID-19 pandemic has only worsened the opioid epidemic, we are committed to expanding this important work.
The MHA advocacy and policy departments also assisted in the creation of Project Baby Deer, a rapid Whole Genome Sequencing project to improve pediatric intensive care units and outcomes in Michigan. Genetic disorders are a leading cause of morbidity and mortality in infants. Early diagnosis of genetic disease has the potential to change clinical management in many meaningful ways, including initiating lifesaving treatments, avoiding unnecessary tests and procedures, shortening hospital stays and empowering families with real-time diagnoses to help with their understanding and decision-making. In addition to improving outcomes, Project Baby Deer also can prevent avoidable healthcare costs.
As you can see, we have a rich history that we can be incredibly proud of. And without question, BCBSM has been an instrumental partner with us on this journey, providing some $16 million in direct funding support to date. This new BCBSM funding will help to ensure that our critical work in safety and quality continues into the future. Specifically, it will allow the MHA Keystone Center to increase hospital participation in the Michigan Alliance for Innovation on Maternal Health (MI AIM), increasing implementation of pre- and post-partum Obstetric Hemorrhagic Risk Assessment, increasing implementation of Quantitative Blood Loss Assessment, and increasing the percentage of women who receive timely treatment of severe hypertension. It will accelerate our work on the opioid epidemic by maximizing the use of medication-assisted therapy, and it will allow us to expand our efforts to address healthcare workplace injuries — thereby ensuring that hospitals are as safe as possible for our front-line caregivers.
In each example noted above, we have helped to establish a clear process that people can understand, trust and execute.
Lastly, I want to stress that all Michigan hospitals and their team members voluntarily participate in MHA Keystone Center initiatives to advance safety for patients and workers and quality of care. There is no mandate in place to require hospitals to participate in this work, but they each choose to do so because of their missions to care for the sick and vulnerable. The pandemic has shined a bright light on the unselfishness of our healthcare heroes and their participation in these efforts is another terrific example of the lengths they go to improve care for their patients. I want to thank both BCBSM and our member hospitals for believing in this vital work and taking the steps necessary to ensure evidence-based best practices are implemented to the point that they make a difference in patients’ lives. This is mission-driven work that all Michiganders can be proud of
The MHA has been actively fielding and responding to media requests related to the growth in COVID-19 cases and hospitalizations, as well as statewide healthcare workforce shortage. Also included is coverage of Blue Cross Blue Shield of Michigan (BCBSM)’s $5 million commitment through 2024 to expand the MHA Keystone Center’s quality and safety improvement programs.
Below is a collection of headlines from around the state that include statements from the MHA.
Blue Cross Blue Shield of Michigan (BCBSM) will provide $5 million through 2024 to expand the MHA Keystone Center’s quality and safety improvement programs.
The funds will directly benefit the state’s communities by supporting new efforts and hospital-led initiatives related to improving women and children’s health and expanding parameters to create safer environments for both patients and healthcare workers, considering the new challenges brought on by the pandemic. It will also support the work of BCBSM and the MHA Keystone Center to encourage hospitals to offer medication assisted treatment for patients with substance use disorders to help combat the opioid epidemic.
Noting that investments from BCBSM have allowed Michigan’s hospitals to collaborate on issues directly impacting patients and employees, MHA CEO Brian Peters said, “Together, this work has led to lives saved and healthcare errors and costs prevented.”
Peters and BCBSM President & CEO Daniel J. Loepp were guests on WJR’s Paul W. Smith Show Sept. 16 to discuss the insurer’s renewed support of clinically driven work that addresses the cost and quality of common medical procedures and promotes best practices in patient care..
This funding allows the MHA Keystone Center to provide new offerings without instilling additional fees so that members can continue striving to make advancements in healthcare. For more information about the programs and opportunities afforded through the BCBSM funding, contact Molly Dwyer-White at the MHA.