If you owned a business, it would be unlikely that you would regularly meet with your competitors to talk about best practices in order to better serve your customers.
Yet Michigan health care providers from competing systems do this regularly to improve health care delivery, on measures from cost to quality. And you, the customer, benefit greatly.
One way providers work together is through statewide quality improvement initiatives, spearheaded and supported by Blue Cross Blue Shield of Michigan. Known as Collaborative Quality Initiatives, these statewide partnerships are developed and executed by Michigan physicians. They engage thousands of doctors and 90 hospital partners and use comprehensive clinical registries, which include patient risk factors, processes of care and outcomes of care.
This level of collaboration is unique to Michigan.
“These initiatives don’t happen in most states,” said Tom Leyden, director, Value Partnerships Programs. “We have the largest collection of clinical registries in the country, if not the world. We also have the largest hospital quality improvement program in the nation.”
There are 23 CQIs currently operating, covering various areas of care with high costs or high variation in treatment. There are more than 7 million Michigan cases currently captured in CQI databases.
CQIs have gained national attention and led to implementation in other states based on the established Michigan model. Their success is highlighted in a new article published in the New England Journal of Medicine’s Catalyst Innovations in Care Delivery journal.
HOW DO CQIS IMPROVE CARE?
By bringing providers together, best practices can be identified and standardized across health care systems, which ultimately benefits patients in Michigan and beyond through efforts to disseminate the CQI learnings broadly.
“CQIs are important for several different reasons,” Leyden said. “They address areas of care that are high cost. They also collect data on surgical cases that helps the Michigan provider community identify the link between the processes of care, or procedures, and the outcomes – all things that ultimately benefit our members, and beyond that, every patient receiving care in the state of Michigan.”
Three recent examples prove the value of the CQI network:
- COVID-19: Because of the existing CQI network, hospitals across the state were able to work together to launch the MI-COVID-19 registry, which was awarded the Blue Cross and Blue Shield Association’s Fast Network Best Practice Prize. The goal of the registry was to quickly obtain data to understand patients with COVID-19 and help support clinical decision-making across Michigan. Because of the registry and a resulting study, treatment guidelines were updated to avoid unnecessary prescribing of antibiotics. Additional findings have been shared with the American Heart Association, the New York Hospital Association and through peer-reviewed literature. “If we didn’t have this CQI platform, I’m not sure how we could have responded to COVID as well as we did as a state,” Leyden said.
- Reducing opioid use after surgery: A CQI focused on general surgery reduced the use of opioids post-surgery for certain procedures by 75%. “Reducing the use of opioids prescribed post-surgery greatly reduces the risk of causing a situation where an individual develops a resulting long-term opioid use disorder as a complication of surgery,” Leyden said.
- Best practices for recovery after surgery: Through a knee and hip replacement collaborative, it was determined that while there were several providers using extended care facilities because it was thought to provide a better outcome for patients, they actually did not. Sharing this data with the CQI members achieved 53% fewer discharges to extended care facilities post-surgery.
For Leyden, Collaborative Quality Initiatives are a win-win for everyone involved.
“It’s a win for our customers, members and providers,” he said. “CQIs reduce cost and complications, while creating an overall quality improvement health care delivery mechanism for our provider partners. Most of all, CQIs have helped the state of Michigan by providing the best health care possible.”
