A Note from Nicholas Osborne
As the year ends, we are grateful for each of you and your passion and dedication to improving quality of care and outcomes for patients across Michigan.
We are amid a busy meeting season with national and BMC2 meetings offering opportunities for networking, brainstorming, and learning together.
Blue Cross Blue Shield of Michigan shared the successes of BMC2’s efforts to reduce readmission after PCI in the most recent issue of their Value Partnerships Update. We are celebrating the multidimensional impact of Michigan Cardiac Rehab Network (MiCR), our venture with the Michigan Value Collaborative, on nationwide cardiac rehab policy. We are expanding our reach to patients through resources translated into Arabic and Spanish and looking forward to adding additional patient-facing resources to help improve mental health in early 2024.
Read about these accomplishments, tools we’ve developed to assist you in positively impacting your patients, and more, in this special joint October/November issue of the BMC2 Newsletter.
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Success Story - Reducing ReadmissionsAfter PCI
BMC2 PCI’s multi-year quality improvement initiative resulted in fewer hospital readmissions after coronary revascularization procedures, improving long-term outcomes for patients and reducing health care costs. Additionally, BMC2 has championed companion initiatives that impact readmission prevention, including appropriate pre-PCI hydration, prescription of guideline-directed medical therapy for patients with heart failure, and implementation of quality improvement measures and incentive goals to drive cardiac rehabilitation utilization. The impact is estimated at 250 fewer readmissions and a $5.75 million cost savings annually.
The Blue Cross Blue Shield of Michigan Value Partnerships Update
shared BMC2’s success in reducing readmissions after PCI procedures in the October 30th article, “Reducing Readmissions After Heart Procedures." Read more in the Value Partnerships Update article or on our blog.
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National Presentations
ACC Quality Summit - PCI Coordinators, Mari Lee Crandell, BSN, RN and Kari Morris, RN, both of Trinity Health Ann Arbor, Ewa Sztandera, MSN, RN, CCRN, CSC, of Michigan Medicine, and MISHC’s Clinical Quality Improvement Lead, Sheryl Fielding, connected while attending the 2023 ACC Quality Summit in Orlando in October. Check out info about Sheryl’s presentation at the ACC Quality Summit in the MISHC News section, below. Melanie Deron, RN, of Garden City Hospital, and Sara DeWitt MSN, RN, of Holland Hospital also attended the Summit.
Pictured left to right: Ewa Sztandera, Mari Lee Crandell, and Kari Morris
TCT 2023 - Dr. Brett Wanamaker presented data from BMC2 on October 24th at TCT 2023 in San Francisco. In “Chronic Total Occlusion (CTO) Specialist Outcomes in Non-CTO PCI: Insights from BMC2,” Dr. Wanamaker and his collaborators looked at whether operators with CTO PCI experience perform differently compared to other colleagues in non-CTO PCI procedures.
Dr. Wanamaker’s co-authors and collaborators for this study include Brett Wanamaker, MD; Milan Seth, MS; Daniel Menees, MD; Jarrod Frizzell, MD; Kathryn Dawson, MD; Khaldoon Alaswad, MD; David Sutter, MD; Simon Dixon, MD; Babar Basir, DO; Theodore Schreiber, MD; Hitinder S. Gurm, MD; and Devraj Sukul, MD, M.Sc. You can view a PDF of the presentation slides on our website.
AHA Scientific Sessions 2023
Alexandra I. Mansour presented the poster, “Dramatic Impact of a Liaison-Mediated Referral Strategy on Cardiac Rehabilitation Participation After Percutaneous Coronary Intervention: Insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium” during the AHA Annual Scientific Sessions 2023 held November 11 – 13 in Philadelphia.
Co-authors include Milan Seth, MS; Michael Thompson, MD; Mary Casey, MPA; Steven Keteyian, PhD; Frank Smith, MD; Hitinder S. Gurm, MD; and Devraj Sukul, MD MSc. You will find a link to the poster on bmc2.org.
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The Michigan Cardiac Rehab Network Helps Shape National CR Policy
The Michigan Cardiac Rehab Network (MiCR) contributed content to the second edition of the Million Hearts Cardiac Rehabilitation Change Package (CRCP) released in August of 2023.
MiCR’s “Sample Blinded Hospital Report for Cardiac Rehab Performance” was included in the CRCP. This resource supports two key drivers: making cardiac rehab a health system priority and using data to drive improvement. The CRCP also includes the MiCR Cardiac Rehab Toolkit’s section, “Eliminating Transportation as a Barrier to Participation.”
BMC2 members, Henry Ford Health System and Holland Hospital, also contributed CRCP content.
Learn more in the "news" section of bmc2.org.
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New PCI Advisory Council Convenes
We are excited to begin engaging with the new PCI Advisory Council. Members of the Advisory Council include interventional cardiologists, Chadi Alraies, Dilip Arora, Joseph Chattahi, Elizabeth Pielsticker, and Anwar Zaitoun; primary site coordinator, Carol Peters; quality manager, Linda Kline; patient representative, Hal Morgenstern; and BMC2 PCI Strategic Advisor, Dr. Ryan Madder.
This team of a diverse group of leaders representing the varied interests and priorities across Michigan will allow the consortium to better serve its members and ensure we focus on high-impact, high-value initiatives. Members represent the diverse geography of the State of Michigan to ensure diversity of experience and opinion and will serve 2-year staggered terms. To learn more about the Advisory Council, read our blog.
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BMC2 Value Based Reimbursement
The 2025 BMC2 PCI and Vascular Surgery Value Based Reimbursement (VBR) Metrics have been approved by Blue Cross Blue Shield of Michigan and will be effective January 1st, 2024. You will also find more details below and can also access the measures on bmc2.org under “Quality Improvement” and “Performance Indexes” and then BMC2 VBR Goals. Thank you for your input in choosing these goals and for your unwavering commitment to improving quality of care and outcomes for patients in Michigan.
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Patient-Facing Resources for PCI Patients Now Available in Arabic and Spanish
The BMC2 resource, “Lifetime Plan for Living with Heart Artery Stents” is now available in Arabic and Spanish. This document, a collaboration with members of our PCI Patient Advisory Council, outlines important steps for caring for oneself after a PCI procedure with items for each day and at one week, one month, and one year and beyond. The document also includes links to resources from the American Heart Association and the Michigan Tobacco Quitline.
Also now available in Arabic and Spanish is “What you need to know after your Percutaneous Coronary Intervention (Heart Stent.)” This 2-page document, including post-PCI procedure discharge instructions and a corresponding infographic, was originally released in April.
Thanks, as always, to our PCI Patient Advisory Council for helping us identify ways to better care for our patients.
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Incorporating Use of Nicotine Replacement Therapies in Patient Smoking Cessation
To assist you with improving outcomes for your patients via the 2025 VBR measure for smoking cessation, we are sending a variety of resources, curated by Healthy Behavior Optimization for Michigan (HBOM), throughout November.
Weekly emails will include links to research supporting referral of nicotine replacement therapies (NRT), quotes from BMC2 participants who have incorporated referring NRT into their practice, materials to share with patients, and more.
We encourage you to read the information provided and share it with colleagues and patients.
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The Michigan Tobacco Quitlink Celebrates 20 Years
The Michigan Tobacco Quitlink is a free and confidential service that offers several different programs designed to help Michiganders quit tobacco based on the level of support needed, including phone and online coaching.
In 2022, 27% of Tobacco Quitlink phone coaching participants quit using tobacco. However, Quitlink enrollees who participated in four or more coaching calls had a quit rate of 34%, illustrating that Quitlink participants who stuck with their program had a better chance of quitting tobacco for good. We encourage you to tell your patients about the Tobacco Quitlink when offering smoking cessation resources. Learn more about the Tobacco Quitlink on our blog.
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SVS Clinical Practice Guidelines Added to BMC2.org
The Society for Vascular Surgery (SVS) Clinical Practice Guidelines offer information about caring for patients after vascular surgery procedures. We heard your request for this information and added it to bmc2.org. Visit our “Quality Improvement” page and then click on “External Resources.” From there, click on the “Vascular Surgery” tab and you will find the SVS Practice Guidelines listed with other resources under “Guidelines.”
SVS has also created an app for on-the-go access to the Clinical Practice Guidelines. To download, search “SVS iPG” in the Apple App Store.
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BMC2 Meeting SummariesThe BMC2 VS and MVS Collaborative Meeting was held at the VistaTech Center at Schoolcraft College on November 2nd from 11:30 am – 5 pm. Presentations included BMC2 and VQI data reviews, a Research and Publication Strategy Committee report with breakout sessions for brainstorming research ideas, and information about vascular surgery research opportunities. We also heard about creating a BMC2 health equity dashboard, the lessons learned from the BMC2 peer review, and had a review of smoking session measures and resources, including a success story from Bronson Medical Center. A PDF of these presentations is available in our private file directory on Nextcloud. You can access the directory via the link sent in the meeting follow-up email. View meeting photos via this slideshow.
The BMC2 PCI Coordinator Webinar was held on November 9th from 10 am – 11 am and included cardiac rehab liaison success stories from Tara Richter, BS, MBA of Ascension Borgess, and Dawn Light, RN, BSN, of Ascension St. John. BMC2 Project Manager, Mary Casey, shared cardiac rehab resources from MiCR. A PDF of the presentations is available in our private file directory on NextCloud. You can access the directory via the link sent in the meeting follow-up email.
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Upcoming MeetingsThe MiCR Stakeholder Meeting will be held on November 17th from 10 am – 3 pm at the Trinity Health Ann Arbor Intensive Cardiac Rehab Facility.
The BMC2 VS Coordinator Webinar will be held on December 13th from 11 am – 12 pm and will include a review of 2024 database changes.
The PCI Coordinator Webinar will be held on January 11th from 10 am – 11 am.
The PCI Physician Webinar will be held on February 15th from 6 pm – 7:30 pm.
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Welcome New Vascular Surgery Coordinators
Kathy Walsh, MSN, RN - Henry Ford Jackson
Anna Cooley, BSN, RN - Sparrow Health
Matt Glombowski, RN - McLaren Port Huron
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Welcome New Site - MyMichigan Medical Center Alpena
We are excited to welcome MyMichigan Medical Center Alpena to the BMC2 team effective October 23rd. With the addition of Alpena, all sites in Michigan large enough to host PCI service now offer PCI procedures at their locations. We are thrilled that patients in NE Michigan have a local PCI option. Alpena shares BMC2 site management with their neighbor, MyMichigan Midland. The site's BMC2 Physician Champion is Dr. Stephen Mattichak. The QI/management lead is Annette Fruge and Shane Talbot is the PCI coordinator.
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MISHC News
Publication- Data from MISHC and the Michigan Value Collaborative was recently published in JACC: Advances. “Predictors and Variation in Cardiac Rehabilitation Participation After Transcatheter Aortic Valve Replacement,” outlines results from a study revealing that just 30.6% of patients who underwent TAVR participated in cardiac rehabilitation within 90 days after discharge. This is despite cardiac rehab being found to increase quality of life and decrease mortality.
Study authors include Devraj Sukul, MD, MSc; Jeremy Albright, PhD; Michael P. Thompson, PhD; Pedro Villablanca, MD; Steven J. Keteyian, PhD; Jessica Yaser; Duane Berkompas, MD; Alphonse DeLucia, MD; Himanshu S. Patel, MD; Stanley J. Chetcuti, MD; and P. Michael Grossman, MD. The publication is available open access on ScienceDirect.
Presentation - MISHC Clinical Quality Improvement Lead, Sheryl Fielding, BSN, RN presented with Holly A. Dalton, MSN, RN, of Baylor Scott and White Health during the ACC Quality Summit held October 11 – 13 in Orlando, Florida. Their interactive session “It Takes a Village to Care for TVT Nation!” discussed best practice ideas to optimize your structural heart disease program. You can find Sheryl’s portion of the talk on the presentations page of mishc.org.
Meeting Summaries - The MISHC Coordinator/Abstractor Meeting was held on Friday, November 10th from 10 am – 3 pm in the Dome at Arbor Lakes, Ann Arbor. Joan Michaels, MSN, Director of Cardiac Registries at the American College of Cardiology, joined us to share TVT updates. We also heard QI project presentations, a TEER and TMVR overview, and learned about surgical valve sizes and types. The MISHC Collaborative Meeting - combined with the Michigan Society of Thoracic and Cardiovascular Surgery (MSTCVS) Collaborative Meeting – was held on Saturday, November 11th, 2023 from 9 am – 12 pm at the VistaTech Center at Schoolcraft College. The meeting included a panel on guideline recommendations and controversial topics in post-TAVR antithrombotic therapy and a case review and debate. You will find both of these meetings in our private file directory on NextCloud. You can access the directory via the link sent in the meeting follow-up email.
Upcoming Meeting - Dr. P. Michael Grossman will present on atrial fibrillation and TAVR during the MiTVT2 Meeting on December 5th at 8:30 am.
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We Want to Hear From You!Do you have something to share via our newsletter? We want to hear from you! Email Elizabeth Horn at ehorn@umich.edu.
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Support for BMC2 is provided by Blue Cross and Blue Shield of Michigan and Blue Care Network as part of the BCBSM Value Partnerships program.
Although Blue Cross Blue Shield of Michigan and BMC2 work collaboratively, the opinions, beliefs, and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees.
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