1. Together we can do so much February 5th , 2016:
Alone we can do so little;
Together
we can
do so much
-Helen Keller
February 5th , 2016:
One Day in the Life of BCBSM’s CQI Program - Four CQIs Addressing Quality of Care for Michigan Residents

2. February 5th Meeting of the Michigan Bariatric Surgery Collaborative (MBSC)
Launched: 2005
Participants (sites): 38 of 40 hospitals
Participants: 66 bariatric surgeons
Data collection: ~62,000 surgeries to date
95% of all bariatric surgeries in Michigan
CQI Specifics
155 attendees
49 surgeons, 74% of MBSC surgeons
37 of 38 hospitals
Topics:
Preventing blood clots
Understanding/reducing ED visits
Tool to assist patients in choosing type of bariatric surgery
February 5, 2016 Meeting
Improvements are inception to present for all CQIs
To date, an estimated 3,464 patients avoided an unnecessary procedure (IVC filter); yearly, 433 Michigan patients are impacted
490 patients did not experience a readmission; that’s ~61 patients per year
Select Improvements to Date

3. February 5th Meeting of the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI)
Launched: 2012
Participants (sites): 59 of 61 hospitals
Participants: 430 orthopedic surgeons and trauma-orthopedic surgeons
Data collection: ~100,000 cases to date
93% of all knee and hip replacements in Michigan
CQI Specifics
185 attendees
55 physicians (representing their practices and hospitals)
58 of 59 facilities
Topics:
Improving readmission rates
Addressing patient factors pre-surgery to improve outcomes
Most effective way to capture patient reported outcomes
February 5, 2016 Meeting
An estimated 5,200 patients avoided blood transfusions; 2,400 in 2014
2,500 patients avoided a nursing home stay post-surgery
Select Improvements to Date
Total spend on knee and hip replacements is projected to be over $7 billion annually in the US

4. February 5th Meeting of the Michigan Anticoagulation Quality Improvement Initiative (MAQI2)
Launched: 2009
Participants (sites): 6 anticoagulation facilities*
Participants: 35 physicians, nurses, and pharmacists
Data collection: ~25,000 cases to date
5% of all anticoagulation cases in Michigan
CQI Specifics
*Represent various types of delivery in hospitals and freestanding clinics
26 attendees
7 physicians
6 of 6 facilities
Topics:
Blood clots – choice of drug when there is a clot
Understanding/reducing ED visits
Efficacy of new oral anticoagulant drugs
February 5, 2016 Meeting
48,000 patients did not receive unnecessary testing (International Normalized Ratio testing)
8,200 visitors from all 50 states were educated on anticoagulation guidelines via the MAQI2 toolkit
The mobile app version of the toolkit has been downloaded ~1,000 times
Select Improvements to Date
Blood clot prevention and treatment is one of AHRQ’s top 10 issues impacting patient safety

5. February 5th Meeting of the Michigan Spine Surgery Improvement Collaborative (MSSIC)
Launched: 2013
Participants (sites): 27 of 36 hospitals
Participants: 156 neurosurgeons and orthopedic surgeons
Data collection: ~36,000 cases to date
80% of all spine surgeries in Michigan
CQI Specifics
91 attendees
25 physicians (representing larger practices and hospitals)
27 of 27 facilities
Topics:
Dependency on drugs for pain pre & post-surgery
Infection at the surgical site
How to avoid adverse events (harm to a patient as a result of care)
February 5, 2016 Meeting
Total spend on spine surgery is projected to be approximately $13 billion annually in the US
This is a new CQI. Due to the type of data collected, as well as factors such as length of treatment, timing rules, and tracking of patient outcomes, it takes time for the dataset to mature and become robust enough for analyses to occur and quantitative results to be realized.
Select Improvements to Date

6. So Much Can be Accomplished in One Day…
Over 450 people, including 136 physicians, representing more than 60 hospitals, came together to work together to improve health care quality.
These 4 CQIs are a sample of a larger portfolio of over 20 statewide initiatives with hospitals and physicians. These programs have saved Michigan $793 million, the Blues $284 million and have quantified improvements (e.g. Complications reduced or avoided, as well as deaths averted).
In just one day, 450+ professionals dedicated to making care better for Michigan patients convened to discuss best practices and commit to taking action across the continuum of pre-op, intra-op, and post-op care by:
Reducing and effectively treating blood clots – one of the top issues impacting patient safety
Reducing visits to the emergency room
Improving care by reducing complications; determining the best medications; helping patients choose the best surgery; and helping patients improve their health to be better prepared for surgery
Savings are for 5 of the longest standing CQIs over a 6-year period.
MSSIC - New Hudson
MAQI2 - Commerce
MBSC - Plymouth
MARCQI - Livonia
If this can happen in a day, imagine the impact in a week…in a month…in a year… in several years…
The CQIs are a win for those who seek care, those who provide care, and those who pay for care.