Demonstrating our Commitment MHA Keystone Center for Patient Safety & Quality: an entity dedicated to the implementation of evidence- based best practices MHA Patient Safety Organization (PSO): patient safety data collection and analysis organization MI Hospital Inform: comprehensive price and quality information website >
MHA Keystone Center Created by Michigan hospitals in March 2003 to improve care and reduce costs through the implementation of evidence-based best practices. Brings together hospitals, state and national patient safety experts. Each collaborative implements the Comprehensive Unit- based Safety Program (CUSP) intervention, which integrates communication, teamwork and leadership to establish a culture free of patient harm.
MHA Keystone Center Initiatives Collaboratives –MHA Keystone: Intensive Care Unit (ICU) –MHA Keystone: Gift of Life –MHA Keystone: Hospital-Associated Infection (HAI) –MHA Keystone: Surgery –MHA Keystone: Obstetrics (OB) –MHA Keystone: Emergency Room (ER) National projects –On the CUSP: Stop Bloodstream Infection (BSI) –On the CUSP: Stop Catheter-associated Urinary Tract Infection (CA-UTI) Special project –Michigan STate Action on Avoidable Rehospitalizations (MI STA*AR)
MHA Keystone: Intensive Care Unit (ICU) Reduces central-line-associated bloodstream infections (CLABSI) and ventilator-associated pneumonia (VAP). CLABSI effort saved an estimated 36 lives and $6.4 million from March 2010 to March 2011. VAP effort saved 79 lives and $2.2 million. “Business Case for Quality” study revealed that initial estimates of the lifesaving and cost-saving benefits of MHA Keystone: ICU were roughly $1.1 million per year. A joint septic shock initiative launched between MHA Keystone: ICU and MHA Keystone: ER.
MHA Keystone: Hospital-Associated Infection (HAI) Seeks to prevent HAIs, which occur in approximately one of every 20 hospitalized patients. Interventions to reduce CA-UTI are separated into two prevention bundles. –The timely removal of nonessential catheters and appropriate care of necessary catheters. –Appropriate placement of catheters and proper insertion technique. Estimated 26 percent reduction of patients with urinary catheters and 30 percent improvement in appropriate use.
MHA Keystone: Gift of Life Improves the organ donation process using evidence- based best practice. In 2010, 289 Michigan organ donors contributed 792 transplanted organs. Organ donation conversion rate increased to 83 percent. Donor Drive 2010: Michigan hospitals added 11,800 people to the registry, up from 3,800 in 2009.
MHA Keystone: Surgery Focuses on eliminating surgical-site infections, preventing defects in care, eliminating mislabeled specimens and improving the safety and teamwork climate. From January to December 2010, briefings and debriefings were held for roughly 91 percent of surgeries. Collaboration with the MHA PSO. From May 2010 to May 2011, the surgical specimen defect rate decreased more than 50 percent.
MHA Keystone: Obstetrics (OB) Focuses on eliminating preventable fetal and maternal harm due to complications of labor induction and management of the second stage of labor. Resulted in a 51 percent improvement in five-minute Apgar scores indicating the health of newborns. Reduced elective inductions before 39 weeks from roughly 2.9 percent to 1.7 percent and reduced elective cesarean sections before 39 weeks from nearly 17.5 percent to 11.5 percent from March 2010 to March 2011.
MHA Keystone: Emergency Room (ER) Aims to prevent harm to ER patients by improving safety practices and attitudes, reducing boarding/overcrowding and wait times, and supporting the early treatment of sepsis using evidence-based best practices. Resulted in a 29 percent decline in the rate of patients who left without being seen. MHA Keystone: ICU and MHA Keystone: ER launched a joint septic shock initiative.
Special and National Projects MI STA*AR (special project) –Goal is to reduce 30-day rehospitalization rates by 30 percent and increase patient and family satisfaction –Participating hospitals received report of statewide rehospitalization rates and hospital-specific rehospitalizations On the CUSP: Stop BSI (national project) –Aims to reduce the average rate of CLABSIs by 80 percent –CLABSI rates dropped 33 percent On the CUSP: Stop CA-UTI (national project) –Goal to reduce CA-UTI rates by 25 percent over two years –Began with 12 participating states and, in fall 2011, is expanding to include all 50 states, the District of Columbia and Puerto Rico
MHA PSO Certified in January 2009. Nearly every Michigan hospital is an active member. There are two key functions of PSOs: –To allow providers to seek expert help in understanding patient safety events and preventing their recurrence in a protected legal environment. –To create a system of data collection to combine and analyze the data and share findings. Currently, there are 81 listed PSOs throughout the country.
MHA PSO Data Collection The most prevalent serious adverse events in Michigan hospitals and health systems are falls, medication errors and surgical/invasive procedure errors. Standardized patient alert wristbands. Introduced a wrong-site surgery toolkit. Collected reports of medication-related serious adverse events to identify trends.
MHA PSO Member Value Developed automated data submission. Worked to expand its membership to collect and analyze data for nonacute-care-hospital providers. Educational events on topics including surgical events, radiation dosage and adverse event management.
MHA PSO Safe Tables Convened the first of many planned “Safe Table” meetings, a novel and interactive approach to enhancing the safety and quality of health care. Held for Michigan’s children’s hospitals that specialize in pediatric and neonatal care. Plans to expand to additional hospitals and health systems.
MI Hospital Inform Empowers consumers to make better informed health care decisions. Data on patient satisfaction, surgical infections and the most common causes of hospitalizations. Pricing information.
Issues & Opportunities As health care reform takes hold and the delivery system experiences a fundamental shift, no state’s providers may be as well prepared as Michigan’s. Variation –Adopting methods that create consistency and reduce variation to the point of appropriateness. –Actively pursuing increased hospital-physician alignment. –Transparency through MI Hospital Inform. Value-based Purchasing –Value-based payment versus volume-based payment. Rehospitalizations
Questions For more information about >’s quality and accountability efforts: > > > For more information about the MHA’s quality and accountability efforts: Sam R. Watson Senior Vice President, Patient Safety and Quality (517) 323-3443 firstname.lastname@example.org www.mha.org