Past Quality Improvement Work

The MHA Keystone Center has operated projects focused on organ donation, hospital-associated infections, intensive care units, obstetrics, pain management, palliative care and more. Learn about past quality improvement work below, in the Newsroom and on our Reports and Publications page.

Hospital Engagement Network (HEN) 1.0

The MHA Keystone Center was one of 26 state, regional, national or hospital system Hospital Engagement Networks (HENs) contracted by the U.S. Department of Health and Human Services to identify, share and implement best practices to reduce preventable hospital-acquired conditions from Dec. 2011 through 2014. The HENs were funded as part of a $500 million Partnership for Patients initiative from the Centers for Medicare & Medicaid Services (CMS) Innovation Center.  

HEN 1.0 initative core areas of focus were:

  • Adverse drug events (ADE)
  • Catheter-associated urinary tract infections (CAUTI)
  • Central line-associated blood stream infections (CLABSI)
  • Injuries from falls and immobility
  • Obstetrical adverse events
  • Pressure ulcers
  • Surgical site infections
  • Venous thromboembolism (VTE)
  • Ventilator-associated pneumonia (VAP)
  • Preventable readmissions

Read more about HEN 1.0 in a CMS Fact sheet.

Hospital Engagement Network (HEN) 2.0

In 2015, the MHA Keystone Center was one of 17 organizations contracted as a HEN, as part of the Centers for Medicare & Medicaid Services (CMS) national Partnership for Patients campaign. Partnering with the Illinois Health and Hospital Association (IHA) under HEN 2.0, MHA-IHA launched a joint quality improvement program uniting quality improvement strengths of two statewide hospital associations, to guide participating members through a variety of best practices, resources and collaboratives to reduce hospital-acquired conditions by 40% and preventable readmissions by 20% over the course of a year.

HEN 2.0 focused on reducing readmissions and 10 types of inpatient harm:

  • Ventilator-associated events;
  • Sepsis;
  • Obstetrical adverse events, including early elective delivery reduction, post-partum hemorrhage and preeclampsia;
  • Catheter-associated urinary tract infections;
  • Adverse drug events related to opioids, hypoglycemia and anticoagulants;
  • Central-line-associated blood stream infections;
  • Injuries from falls and immobility;
  • Pressure ulcers;
  • Surgical site infections; and
  • Venous thromboembolisms.

Read more about HEN 2.0 in a CMS Fact sheet.

MHA Keystone Center Collaboratives

Catheter-associated Urinary Tract Infection (CAUTI)

The MHA Keystone: Catheter-associated Urinary Tract Infection (CAUTI) collaborative was launched in 2012. With a goal to decrease catheter prevalence and reduce the risk of infection by working with inpatient and emergency department (ED) teams the MHA Keystone Center partnered with the national On the CUSP: Stop CAUTI initiative. An ED pilot ended in April 2013, at which time the MHA Keystone Center focused on reducing CAUTIs by enhancing protocols and interventions to decrease unnecessary placement of urinary catheters. In Sept. 2016 collaborative work moved under the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN).

Intensive Care Unit (ICU)

The MHA Keystone: Intensive Care Unit (ICU) collaborative was launched in 2004. The collaborative focused on reducing central-line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonia (VAP) in ICU patients, implementing the Comprehensive Unit-based Safety Program (CUSP) and improving best practices for ICU care. In Sept. 2016 collaborative work moved under the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN).

Pain Management

The MHA Keystone: Pain Management collaborative was launched in 2015. The MHA Keystone: Pain Management collaborative worked to improve appropriate pain management practices, reduce opioid-related adverse events, decrease the usage of opiates statewide, and enhance patient expectation management. In Sept. 2016 collaborative work moved under the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN).​

Palliative Care

The MHA Keystone: Palliative Care collaborative launched in 2015. In response to the growing need for palliative care in the hospital setting, the MHA Keystone Center partnered with the Palliative Care Quality Network (PCQN) at the University of California, San Francisco. The partnership encouraged Michigan hospitals to participate in a one-year, national continuous learning initiative to promote quality palliative care. With the overarching goal of transforming healthcare by defining and promoting quality palliative care services, the national project helped elevate the success of participating Michigan hospitals. Key to the collaborative was the collection of standardized data with the ability to compare to and learn from others. 

Sepsis

The MHA Keystone: Sepsis collaborative launched in 2010. The collaborative focused on improving awareness, identification and treatment of sepsis in hospitals by centering on the evidence-based model of the Surviving Sepsis Campaign (SSC) sepsis bundles. This included implementation of the three-hour bundle, supporting hospitals to implement evidence-based practices, assisting with CMS bundle compliance processes, seeking areas for specific quality improvement and focusing on customer service based needs of the hospitals. In Sept. 2016 collaborative work moved under the Great Lakes Partners for Patients (GLPP) Hospital Improvement Innovation Network (HIIN).

In 2016, Sepsis Alliance, the first name in sepsis awareness, partnered with the MHA Keystone Center to launch a statewide sepsis awareness campaign in Michigan. Through the Michigan Sepsis Challenge Series, the organizations worked with Michigan hospitals, nurses and a variety of medical professionals to host “Stomp Out Sepsis” 5K walks, runs and other sponsored events across the state. With a goal to raise awareness of sepsis within the community, unite medical professionals and raise funds for sepsis awareness programs the campaign raised over $23,000.

National Collaboratives

CUSP for Mechanically-ventilated Patients — Ventilator-associated Pneumonia (CUSP 4 MVP-VAP)

The Agency of Healthcare Research & Quality (AHRQ) funded a 3-year project, CUSP for Mechanically Ventilated Patients -Ventilator Associated Pneumonia (CUSP 4 MVP-VAP) to help staff in intensive care units use the Comprehensive Unit-based Safety Program (CUSP) to reduce complications of mechanical ventilation that occur in patients, including ventilator-associated pneumonia (VAP). The collaborative focused on reducing ventilator adverse events in hospitals nationwide using interventions proven effective in Michigan. The project concluded in 2016.

Partners Included:

  • The MHA Keystone Center
  • Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality.
  • Harvard Pilgrim Health Care Institute.

On the CUSP: Stop CAUTIs

The Health Research & Educational Trust (HRET) through a contract with the Agency for Healthcare Research and Quality (AHRQ), led a quality improvement collaborative to implement the Comprehensive Unit-based Safety Program (CUSP) and CAUTI prevention practices in hospital units. On the CUSP: Stop CAUTI was a four-year initiative that worked with state/regional organizations and health systems to bring together subject matter experts, providers and researchers in the field.

Partners Included:

  • The MHA Keystone Center
  • Health Research & Educational Trust
  • Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality
  • St. John Hospital and Medical Center
  • University of Michigan Health System

On the CUSP: Stop BSI

The Agency for Healthcare Research and Quality (AHRQ) funded a national effort, On the CUSP: Stop BSI to prevent central line-associated bloodstream infections (BSIs) in U.S. hospitals by implementing a Comprehensive Unit-based Safety Program (CUSP). The goals of this groundbreaking project were to reduce the mean rate of CLABSI nationwide to less than one infection per 1,000 catheter days, to improve safety culture, and to partner with Centers for Disease Control and Prevention to support the measurement and timely feedback of CLABSI and other healthcare-associated infection (HAI) data.

Partners Included:

  • The MHA Keystone Center
  • Agency for Healthcare Research and Quality
  • Health Research & Educational Trust
  • Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality

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