As strides are made to address inequities and disparities in healthcare, governing and regulatory bodies including The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) have created guidelines, benchmarks and policies that evolve over time.
The action plan utilizes quality improvement frameworks and streamlines the requirements into five steps: define, analyze, design, implement and monitor.
The steps include best practices for establishing and maintaining a health equity program in compliance with the new requirements. Adhering to these steps will help organizations align health equity initiatives with existing quality improvement activities and ensure a cohesive and comprehensive approach to providing equitable care.
The intended audience for this resource includes designated health equity leader(s) and the multidisciplinary team(s) responsible for developing and implementing health equity programming.
“Let us not seek the Republican answer or the Democratic answer, but the right answer.” ― John F. Kennedy
Given that the Michigan Legislature has officially adjourned sine die, it is now an appropriate time to reflect on the success of our MHA advocacy throughout 2023. As always, healthcare was in the spotlight as a political and public policy priority. Our team was incredibly busy as we worked to support bills that would advance the health of individuals and communities, and to oppose those bills that would run counter to our mission.
A full recap of these pertinent bills is available, but I want to lift up a few of particular importance. First, for many years, the MHA has advocated for healthcare workers to have similar protections from violence as other first responders. We’re thankful House Bills 4520 and 4521 that increase the penalties for assaulting a healthcare worker or volunteer are soon to be signed by Gov. Whitmer. We know this legislation is just one step towards improving workplace safety and our association will continue to work on more opportunities to protect the healthcare workforce from violence through our advocacy at the state and federal level, the MHA Keystone Center and the MHA Service Corporation.
In addition, the governor signed legislation that will add protections found in the Affordable Care Act to Michigan law. Public Acts 156-163 of 2023 memorialize important protections for Michiganders, such as no-cost essential services, including preventive, mental health and emergency services. A variety of other bills await the return of the legislature in 2024 on issues including auto no-fault insurance, telemedicine, sharps containers, behavioral health policy, maternal and infant health and more.
Of course, seeing no action besides testimony on House Bills 4550-4552 is another testament to the work of our team. These bills would mandate one-size-fits-all nurse staffing ratios for all Michigan hospitals and create significant access issues for patients. As discussed at length in a recent CEO Report, the MHA has communicated with all 148 state legislators to explain the complexity associated with hospital staffing and the tangible solutions that will actually address workforce shortages. We have significantly increased the awareness and understanding of the issue for lawmakers, and the bills not receiving a vote in committee is an example of our effectiveness in that regard.
In addition to all these policy-oriented items, we successfully advocated to protect Medicaid funding for hospitals, including graduate medical education, rural access and OB stabilization, and also secured new funding for recruitment and retention of healthcare workers and for pediatric behavioral health. And of course, we stood tall to prevent any erosion in our Certificate of Need laws, or our medical liability reform protections, both of which continue to play an important role in ensuring access to quality, affordable care for all.
Our work also extends to Washington DC and Capitol Hill. We continue to work closely with the American Hospital Association on federal advocacy that supports Michigan hospitals on issues including Medicare policy, site-neutral payments, the 340B drug pricing program, the healthcare workforce and much more. And just as we have benefitted tremendously from our partnership with Public Affairs Associates (PAA) as our long-time advocacy firm here in Lansing, we are also pleased with our new partnership with Cornerstone Government Affairs, which is helping us with our important work at the federal level.
We cannot accomplish our advocacy goals without the individual commitment from our member hospitals and health systems, large and small. At the end of the day, our unity is our strength; a great example of this is the unified opposition letter – representing 100% of our membership – that we shared with lawmakers last month in opposition to the nurse staffing legislation.
There is a lot of uncertainty in the year ahead. As widely reported, the state House is evenly split between Republicans and Democrats until special elections are held next April. It is also no secret that 2024 is a presidential election year, with all the political dynamics and theatre that will inevitably accompany the entire process. Finally, depending on the outcome of the November election, the lame-duck session that will follow could either be a low-key affair with not much on the agenda…. or a nerve-wracking period fraught with unexpected twist and turns that could directly impact multiple priority issues. Regardless, I am extremely confident the MHA will continue to deliver outstanding results that support our healthcare workers, our patients and communities.
Legislation increasing penalties for violence committed against healthcare workers was approved by the state House of Representatives in a bipartisan vote during the week of Oct. 30. The MHA-supported bills increase fines for assaulting a healthcare …
New report outlines hospital community health efforts in FY 2021 The Michigan Health & Hospital Association released today the Making a Difference in Our Communities report that highlights how hospitals invested more than $784 …
Beyfortus (nirsevimab) is a long-acting monoclonal antibody for the prevention of respiratory syncytial virus lower respiratory tract disease in infants approved by the U.S. Food and Drug Administration in July 2023. The MHA has …
The Michigan Health & Hospital Association Keystone Center a Dragan Spremo at University of Michigan Health C.S. Mott Children’s Hospital with the quarterly MHA Keystone Center Speak-up! Award on Oct 23. The MHA Keystone Center …
Registration is open for the Diversity, Equity and Inclusion in Healthcare certificate program offered Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. ET. The event, hosted by the Michigan Health & Hospital …
The U.S. Department of Health and Human Services (HHS) recently submitted a proposed rule outlining penalties providers would face if they do not appropriately share patient data as outlined in the 21st Century Cures Act. …
The Michigan Department of Health and Human Services (MDHHS) recently published a webpage to track the allocation of $800 million received for opioid settlement investments. MDHHS Chief Medical Executive Dr. Natasha Baghdasarian indicated the website …
Hospitals and health systems face significant adversity, yet Michigan providers continue to provide high quality and accessible healthcare to their communities, in great part because of governing boards, executives and staff leadership. Board and committee …
As we have discussed in these monthly reports in the past, I am incredibly proud that the MHA is committed to the health equity journey, which once again has been identified by the MHA Board of Trustees as …
“As news cycles go, this one was standard fare for healthcare: with the exception of business plan announcements by organizations or as elements of tragedies like Lewiston, Gaza or a pandemic, the business of the health system—how it operates is largely uncovered and often subject to misinformation or disinformation. …
In the next 3 weeks, attention will be on the federal budget: healthcare will be in the background unless temporarily an element of a mass tragedy. Each trade group will tout its accomplishments to regulators and pimp their advocacy punch list. Each company will gin-out news releases and commentary about the future of the system will default to think tanks and focused on a single issue of interest.
That’s the problem. In this era of social media, polarization, and mass transparency, these old ways of communicating no longer work. Left unattended, they undermine the value proposition on which the U.S. system is based.”
The MHA will host a virtual member from 2 to 3 p.m. on Nov. 9 to outline the MHA 2023 – 2024 strategic action plan approved by the MHA Board of Trustees.
The Centers for Medicare and Medicaid Services recently released an updated 2024 Medicare & You Handbook which provides information for patients regarding traditional Medicare, Medicare prescription drug plans, Medicare Advantage and more.
Patient Safety: A Case-based Innovative Playbook for Safer Care (Second Edition) is a recently published book that serves as a must-read resource for those seeking to enhance patient care and create a culture of safety within the healthcare industry.
MHA staff including Sam R. Watson, CPPS, CAE, senior vice president, field engagement, Gary Roth, DO, FACOS, FCCM, FACS, chief medical officer and Adam Novak, director, safety initiatives at the MHA Keystone Center, are contributors to the publication, sharing their expertise and findings in the foundational works of patient safety. Their insightful contribution can be found within the first chapter of the publication, which touches on topics of high reliability, patient experience and more.
The book can be purchased through SpringerLink, with the option of purchasing the electronic version or a physical copy.
Members with questions may contact Sam R. Watson at the MHA.
Pregnancy and infant loss tragically impacts individuals and families at all walks of life across the state and country.
Carlie Austin, BSN, RN, Maternal Infant Health Policy Specialist at the MHA.
While every case is different, this is often a result of miscarriage, ectopic pregnancy, stillbirth, neonatal death, birth defects, sleep-related incidences, illness and accidents, among other causes. Pregnancy and Infant Loss Awareness Month observed in October focuses on sharing resources, supporting those grieving and honoring those lost.
Carlie Austin, BSN, RN, maternal infant health policy specialist, MHA, answers commonly asked questions about pregnancy and infant loss in the clinician Q & A below as a practicing neonatal ICU nurse in Detroit, Michigan. Questions include:
What are some signs that a person who has experienced pregnancy or infant loss may be struggling?
How can members of the care team support grieving patients and their families?
The MHA Legislative Policy Panel met Oct. 11 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting focused on state legislative updates for the new members of …
The Michigan Senate Finance, Insurance and Consumer Protection Committee continued to hear testimony during the week of Oct. 9 on Senate Bills 530 and 531. Introduced by Sen. Mary Cavanagh (D-Redford Township) and Sen. Sarah …
The American Nurses Association – Michigan (ANA-Michigan) publicly announced their opposition Oct. 11 to Senate Bill 334 and House Bill 4550, which require state mandated ratios for hospital nurses. The ANA-MI joins the MHA and …
The Drug Enforcement Administration (DEA) announced pandemic-era rules allowing controlled substances to be prescribed via telemedicine will be extended through Dec. 31, 2024. This extension follows significant opposition to the DEA’s plan to curtail these …
The MHA Keystone Center recently released its 2022-2023 Annual Report, showcasing its dedication to advancing patient and workforce safety alongside member organizations. The report highlights the healthcare safety and quality improvements made through MHA Keystone Center-led …
Save the date for a Diversity, Equity and Inclusion in Healthcare certificate program scheduled for Dec. 7 and Dec. 8 from 11 a.m. to 3 p.m. EST. The event, hosted by the MHA and other …
The Michigan Care Access Referral Exchange (MiCARE), hosted by Bamboo Health’s OpenBeds solution, will be discontinued effective Oct. 31, 2023. The goal of MiCARE was to create a comprehensive network of behavioral health treatment providers, …
The MHA released a new episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan discussing key issues that impact healthcare and the health of communities. The October 2023 episode, …
“In Las Vegas this week, 10,000 healthcare entrepreneurs, investors, purchasers and industry onlookers are gathered to celebrate the business of U.S. healthcare. It follows the inaugural Nashville Healthcare Sessions last month that drew a crowd to Music City touting “the premier healthcare conference set in the most relevant, exciting, and welcoming city in the south.“ …
The root causes of the system’s poor performance are understood and considered: they’re daunting. But that does not impede the willingness of private investors to make bets presuming the future of the U.S. healthcare is not a repeat of its past.“
The MHA received media coverage the week of Oct. 9 on rural healthcare challenges and legislation proposing state mandated nurse-to-patient staffing ratios. The Detroit Free Press published an article Oct. 12 on the closure of …
The MHA Keystone Center recently released its 2022-2023 Annual Report, showcasing its dedication to advancing patient and workforce safety alongside member organizations. The report highlights the healthcare safety and quality improvements made through MHA Keystone Center-led initiatives.
Report highlights include:
An introduction to the Michigan Caregiver Navigation Toolkit, an implementation guide developed to support Michigan hospitals and health systems seeking to initiate or expand caregiver support programming.
An overview of the Safe Patient Handling Conference, an MHA Keystone Center PSO event, with live simulations demonstrating patient mobility best practices.
A summary of the Emergency Department Medication for Opioid Use Disorder Initiative, an MHA Keystone Center-supported program that prioritizes person-centered treatment for opioid use disorder patients.
Printed copies are available upon request.
Members with questions about the report should contact the MHA Keystone Center.
“Do the right thing. It will gratify some people and astonish the rest.”–Mark Twain
Last month’s CEO Report focused on our grave concerns with legislative proposals to mandate nurse staffing ratios, and the negative impact they would have on patient access to care. And we spent the entire month of September laser-focused on telling our story to elected officials, the media, business and healthcare trade groups and many others who care about the Michigan healthcare ecosystem. This advocacy work will continue, without question.
But the hallmark of the MHA and our members is to not simply advocate against bad public policy, but rather, to voluntarily do the right thing when it comes to the best interests of the patients and communities we serve. And when it comes to the safety and quality of the care we provide in Michigan hospitals, we indeed have a very special story to tell.
This year marks the 20th anniversary of the inception of the MHA Keystone Center, which was originally created in 2003 as a first-of-its-kind collaboration among hospitals to identify and implement practices that improve healthcare safety and quality and reduce cost. Acting as our safety and quality organization today, the MHA Keystone Center voluntarily identifies safety and quality improvement opportunities and develops solutions among Michigan hospitals to improve experiences for both patients and healthcare workers alike. The extraordinary partnerships among MHA Keystone Center hospitals have saved many lives as well as healthcare dollars.
It needs to be stressed that there is no mandate requiring participation; all Michigan hospitals and thousands of their team members voluntarily participate in MHA programs to improve the safety and quality of healthcare because of their missions to care for the sick and vulnerable. Because of our long history of success, a growing number of hospitals in other states are now part of MHA-led safety and quality initiatives. In addition, the hospital-based collaborative efforts first pioneered by the MHA Keystone Center have now been replicated in 48 of the 50 U.S. states and various other countries.
These initiatives are driven by evidence-based best practices and strongly supported by data. One great example of how engaged hospitals have seen great improvements on safety and quality outcomes is through the MHA Keystone Center’s leadership of the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN). Michigan hospitals saved 3,350 lives and avoided 25,304 harm events within hospitalized patients over a three-and-a-half-year period from Sept. 2016 to March 2020. In addition, our track record of outcome improvements includes the following:
Reduced the rate of CAUTI (catheter-associated urinary tract infection) events by 49% between 2012 – 2018.
Decreased CLABSI (central line associated blood stream infection) rates within ICUs by 35% between 2015 – 2018.
Reduced early elective deliveries by 68% between 2010 – 2018.
Reduced C. Diff rates by 15% from 2014 to 2017.
Reduced postoperative pulmonary embolisms and/or deep vein thrombosis by 22% from 2014 to 2016.
Reduced colorectal surgical site infections by 27% from 2014 to 2016.
This successful work led to the subsequent creation of the Superior Health Quality Alliance (Superior Health), which includes the MHA Keystone Center, along with our counterparts at the Illinois, Wisconsin and Minnesota hospital associations, and several other related organizations in the Midwest. Superior Health is funded by the federal government, which has clearly valued the ROI that is created by this work, both for Medicare and Medicaid patients for which they have a direct responsibility, as well as all patients.
On top of this work, the MHA Keystone Center has led hospitals on a high reliability journey for almost ten years now. Striving towards implementing and maintaining a high reliability culture means hospitals are focused on attaining zero preventable harm to patients, families and caregivers, making Michigan a safe place to receive care. Factors such as the pandemic, workforce shortages and increased rates of violence against healthcare workers all have emerged as challenges to this work. However, MHA Keystone Center member hospitals remain steadfast in their quest to reduce unintended harm in their facilities. One great example of how hospitals implement a high reliability culture is by stressing the importance of speaking up to prevent potential harm to patients or other staff members. Dozens of healthcare workers from hospitals throughout Michigan have been recognized by the MHA Keystone Center Speak-up! Award since it was launched in 2016. It is heartening that hospitals across the state, both large and small, urban and rural, have embraced an organizational culture that promotes and even celebrates anyone within the organization who speaks up to prevent harm.
Our to-do list in this realm is long and is constantly evolving. Based on the current needs of our membership, we are now focusing on reducing health disparities as our state strives to achieve health equity; improving maternal health outcomes; establishing age-friendly health systems; implementing solutions to address the opioid epidemic; facilitating person- and family-centered care; improving workplace safety; and providing emotional well-being support to healthcare workers through a partnership with the Duke Center for Healthcare Safety and Quality that has so far assisted 5,000 healthcare workers from 144 organizations throughout Michigan.
We know each of these efforts impact the health and well-being of countless Michiganders today. Thankfully, we have diverse funding support for our work; in addition to the federal government’s role noted above, the MHA Keystone Center has been funded by the Michigan Health Endowment Fund, and from our own hospitals who pay an annual fee for the services provided by our MHA Keystone Center PSO, a federally-certified Patient Safety Organization which collects adverse event data. But special recognition needs to be given to Blue Cross Blue Shield of Michigan (BCBSM), and their CEO Dan Loepp. Their initial support was instrumental in getting the MHA Keystone Center off the ground all those years ago, and we are now operating under a third round of very significant financial support from BCBSM that has been critical to our success.
Finally, I would like to acknowledge the great leadership of Sam Watson, our senior vice president of field engagement, and Sarah Scranton, our vice president of safety & quality, as well as the entire MHA Keystone Center Board of Directors, and of course the incredibly talented and dedicated MHA Keystone Center staff. We are proud to work every day with so many hospital leaders and clinicians who are dedicated to doing the right thing for patients and healthcare workers. At the end of the day, this is mission-driven work that all Michiganders can be proud of.
The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan discussing key issues that impact healthcare and the health of communities.
The episode airs during National Recovery Month. Over the last decade, opioid use disorder (OUD) has risen exponentially across the state and country, impacting people at all walks of life, across all communities, and worsening existing health disparities and inequities.
In the episode, Michelle Norcross, MSA, senior director of safety and quality at the MHA Keystone Center and Marissa Natzke, senior project manager of health and human services at the Community Foundation for Southeast Michigan (CFSEM), discuss one of the tools that continues to impactful in this space: Medication for Opioid Use Disorder (MOUD). This pathway to recovery involves medications that relieve withdrawal symptoms and substance cravings. In many cases, MOUD treatment is paired with interventions like counseling or peer support so that a person is able to address the social and psychological factors that influence recovery.
Throughout the episode, Norcross and Natzke share details about an innovative partnership between the MHA Keystone Center and CFSEM that brings MOUD programming to hospital emergency departments (EDs). They discuss what this path to recovery looks like specifically, along with the strong, positive impact ED MOUD programming is having on OUD patients in Michigan hospitals.
The episode is available to stream on Spotify, YouTube, Apple Podcasts and SoundCloud. To learn more about ED MOUD programming, visit the CFSEM website. If you or someone you know is struggling with opioid use disorder, visit Michigan.gov/opioids or call the SAMSHA National Hotline, a 24-hour, 365-day-a-year, treatment referral hotline at 1-800-662-HELP (4357).
The MHA Keystone Center recently released the Michigan Caregiver Navigation Toolkit to guide hospitals and health systems implementing and maintaining caregiver navigation programs. These initiatives are designed to support caregivers in their role by providing connections, resources and education.
The Michigan Caregiver Navigation Toolkit aims to serve as a resource for healthcare staff looking to develop or improve the caregiver navigation program across their system. Although caregiving is relevant across all age groups, this toolkit is primarily intended for use on adults ages 18 years or older, with a special focus on older adults. The toolkit allows users to assess current structures to identify gaps and opportunities for improvement in caregiver support. It also provides guidance to create actionable plans for program development and expansion.
Healthcare Worker Protections Headed to Governor
Michigan Hospitals Invested $784 Million in Community and Voluntary-based Activities to Improve Health, Well-being of Residents
C.S. Mott Children’s Hospital MRI Technologist Receives Speak-up! Award
MHA CEO Report — Registration is Representation
Six Majority Beliefs about the U.S. Health System Compromise its Value Proposition
Auto No-Fault Hearings Continue, Interstate Compacts Advance
MHA Keystone Center 2022-2023 Annual Report Highlights Quality and Safety Priorities
MHA Podcast Covers Program Year Priorities: Behavioral Health, Workforce Restoration, Health Equity and More
MHA in the News
The MHA released another episode of the MiCare Champion Cast, which features interviews with healthcare policy experts in Michigan discussing key issues that impact healthcare and the health of communities.