CEO Report — Our Commitment to Safety and Quality

MHA Rounds Report - Brian Peters, MHA CEO

If you can’t describe what you are doing as a process, you don’t know what you’re doing.” — W. Edwards Deming

MHA Rounds Report - Brian Peters, MHA CEOThe 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

As always, I welcome your thoughts.

MHA Values Work of Michigan Legislature on FY 2022 State Budget

MHA CEO Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association. 

MHA CEO Brian PetersOn behalf of Michigan hospitals and health systems, we value the work of the Michigan Legislature to pass a budget that protect MHA priorities that include fully funding the Healthy Michigan plan, the rural access pool, the obstetrical stabilization fund, and maintaining rate increases for Medicaid and critical access hospitals. We also commend the legislature for expanding postpartum coverage to a full year for mothers on Healthy Michigan. However, more work remains, particularly to address the behavioral health crisis in Michigan. We look forward to working with the legislature through the supplemental appropriations process to secure transformational behavioral health solutions. 

Michigan Birthing Hospitals Discuss Obstetric Hemorrhage and Severe Hypertension

The MHA Keystone Center and the Michigan Department of Health and Human Services (MDHHS) launched five interactive maternal health safety sessions from June through September 2020. The safety sessions were held virtually for birthing hospitals across various regions statewide.

The maternal health safety sessions convened participants to discuss prevailing barriers, opportunities and successes of recognizing and treating obstetric (OB) hemorrhage and severe hypertension in pregnancy. The sessions emphasized addressing severe hypertension, which is known to be a “silent killer” of pregnant women. The safety sessions’ goal was for participants to work toward full implementation of the Michigan Alliance for Innovation on Maternal Health (MI AIM) safety bundles to reduce maternal mortality and morbidity.

The offerings reached across the state, with 86 OB physicians, nurses, healthcare providers and quality improvement professionals from 61 Michigan birthing hospitals participating in the safety sessions.

In addition, two maternal health educational webinars were conducted during the summer of 2020, providing healthcare professionals an additional opportunity to hear from leading maternal health experts to expand their knowledge of maternal hypertension and the MI AIM safety bundles.

The key topics discussed during the safety sessions were communication between providers and patients, sustainable education for physicians, and overcoming barriers to data submission. 

In 2021, the MHA Keystone Center and the MDHHS will host four additional maternal health safety sessions that build on information learned during the 2020 sessions. These sessions may focus on the following:

  • Emergency department education.
  • Data abstraction.
  • Patient education.
  • Connecting MI AIM facilities to discuss data collection tips and overcome barriers by learning from one another.

Members with questions may contact the MHA Keystone Center.

Next Maternal Health Webinar and Safety Sessions Geared Toward Northern Michigan

Improving the health of mothers and infants is a priority for the MHA Keystone Center and the state of Michigan, as Gov. Gretchen Whitmer shared in her State of the State address earlier this year.

To strengthen ongoing efforts to reduce harm and improve quality for mothers and infants, the MHA Keystone Center partnered with the Michigan Department of Health and Human Services (MDHHS) to provide educational webinars and collaborative safety sessions for birthing hospitals across the state of Michigan.

The next webinar is scheduled from noon to 1 p.m. July 17 and is geared toward birthing hospitals in Northern Michigan and the Upper Peninsula. June Murphy, DO, a maternal-fetal medicine specialist at Munson Medical Center in Traverse City, will provide insight on maternal hypertension.

The educational webinar complements the MHA Keystone Center and MDHHS Maternal Health Safety Sessions, which are virtual, interactive discussions. Attendees of the webinar in prosperity regions 2 and 3 (Northern Michigan) are encouraged to register for a July 22 follow-up Maternal Health Safety Session.  Attendees in prosperity region 1 (Upper Peninsula) are encouraged to register for an Aug. 12 follow-up Maternal Health Safety Session.

During the safety sessions, participants will discuss implementing the Michigan Alliance for Innovation on Maternal Health (MI AIM) safety bundles, which equip hospitals with influential protocols, necessary equipment, employee education and drills to prevent and adequately treat severe maternal events. This peer-learning format allows participants to discuss barriers and successes of identifying and treating obstetric hemorrhage and severe hypertension.

Registration is also available for the Maternal Health Safety Sessions to be held in September in other prosperity regions, where similar content will be covered. Members with questions may contact the MHA Keystone Center.

MHA Monday Report June 22, 2020

MHA Monday Report logo

Combating the Novel Coronavirus (COVID-19): Week of June 15

Gov. Gretchen Whitmer issued Executive Order (EO) 2020-117 June 18 to extend Michigan’s state of emergency due to COVID-19 through July 16. The MHA continues to keep members apprised of developments during the pandemic …

Legislation to Regulate Electronic Cigarettes Moves to House Committee

The Michigan Senate voted June 17 to support Senate Bills 781-786, a package of bills to amend the regulation of electronic cigarettes. The proposed legislation would establish a regulatory scheme for the sale of electronic cigarettes, provide for …

News Reporters Join Call Announcing “Big Changes Ahead”

The MHA conducted a media call June 15 to announce the launch of its statewide “Big Changes Ahead” public education campaign and website, The campaign is designed to make Michiganders aware of the medical coverage options …

Regional Safety Sessions to Focus on Maternal Hypertension, Implementing Safety Bundles​

Approximately three in five pregnancy-related deaths can be prevented, according to the Centers for Disease Control and Prevention. To address this matter, hospital teams across Michigan are focusing on combating factors contributing to maternal …

Recording Available: Overcoming Challenges for COVID-19 Survivors Webinar​

The June 10 iteration of the bimonthly MHA Workplace Safety Safe Patient Handling and Mobility webinar series focused on overcoming challenges for COVID-19 patient survivors. … Survey Report Describes COVID-19 Impact on Compensation, Benefits, an endorsed business partner of the MHA and a leading software provider of cloud-based compensation data, software and analytics, released new survey data that shows 66% of employers either reduced their workforce or negatively impacted employee pay…

Headline Roundup: COVID-19 Financial Challenges for Hospitals​

Read and listen to coverage about the MHA, including recent interviews with Ruthanne Sudderth, senior vice president, public affairs & communications, on Interlochen Public Radio and WWMT-TV.

The Keckley Report

The Independent Practice of Medicine: Pipe Dream or Realistic Aim for Physicians

“Last weekend, Susan Bailey, M.D., an allergist and immunologist from Fort Worth, Texas, was sworn in as the 175th President of the American Medical Association (AMA) at its virtual House of Delegates meeting. In her acceptance remarks, she vowed to advocate for protection of the independent private practice of medicine and financial support for clinicians. …

“Dr. Bailey’s sentiment is widely shared among clinicians. But is it realistic?”

Paul Keckley. June 15, 2020

News to Know

Important healthcare news for the week of June 22:

  • State licenses for health facilities, agencies and substance use disorder services programs expire July 31, and the 2020-2021 renewal cycle is open through the eLicense portal.

Regional Safety Sessions to Focus on Maternal Hypertension, Implementing Safety Bundles

Approximately three in five pregnancy-related deaths can be prevented, according to the Centers for Disease Control and Prevention. To address this matter, hospital teams across Michigan are focusing on combating factors contributing to maternal mortality, such as hypertension.

The MHA Keystone Center, in conjunction with the Michigan Department of Health and Human Services (MDHHS), is providing virtual Maternal Health Safety Sessions for providers across Michigan and resources for Michigan birthing hospitals as they continue to combat this concern. The webinars are tailored to the State of Michigan Prosperity Regions, with each offering a similar curriculum.

The sessions focus on implementing the Michigan Alliance for Innovation on Maternal Health (MI AIM) safety bundles to reduce maternal hypertension and improve health outcomes for mothers and infants. Safety bundles equip hospitals with influential protocols, necessary equipment, employee education and drills to prevent and adequately treat severe maternal events. This peer-learning format allows participants to discuss barriers and successes of identifying and treating obstetric hemorrhage and severe hypertension.

Elizabeth Langen, MD, from the University of Michigan led an educational webinar June 10 to discuss maternal hypertension and trends in data, as well as how hospitals can implement and use the MI AIM bundles. Participants registering for the Maternal Health Safety Sessions are encouraged to review a recording of this webinar prior to attending their session, as content from the webinar will be referenced. Hospitals will have the opportunity for open discussions to ask questions, provide insight to one another, and provide the MHA and MDHHS teams an understanding of the future education needs of member hospitals. Registration is available online and participation is free of charge.