A Note from Hitinder Gurm
We were pleased to welcome Dr. Nicholas Osborne as the new director of BMC2 Vascular Surgery, effective January 1st. Dr. Osborne has long been an engaged member of the consortium and we are grateful that he has joined the Coordinating Center in a leadership capacity. You can learn more about Dr. Osborne and his vision for BMC2 Vascular Surgery on our website.
As we move closer to spring, we are making headway on our new database that will utilize the REDCap environment. We are excited to begin testing this database soon and launch it in early April. Visit our website for current project highlights.
We released our 2022 Annual Report this month and were reminded of the incredible impact you have made through your participation in the consortium over the past year. The quality improvement goals and projects and the publications and presentations that highlight this work are a testament to your commitment to improving the lives of patients in Michigan and beyond. THANK YOU, as always, for your work and collaborative spirit.
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Site Spotlight - McLaren Port HuronThe team at McLaren Port Huron is a proud member of a community hospital providing leading-edge care. “Many of us have long tenures with the hospital and live in the community we work in,” explained Extended Stay Unit Cardiovascular Lab Manager Pattie Dziubinski. “We are driven to provide the highest quality of care to our family, friends, and neighbors.”
McLaren Port Huron has been an engaged member of the BMC2 PCI community since 2008 and MISHC since 2021; they joined BMC2 Vascular Surgery on January 1, 2023. “We value the collaboration we have experienced with McLaren Port Huron PCI. We are excited about the contributions the hospital will make as the newest participants of BMC2 Vascular Surgery," said BMC2 Managing Director Annemarie Forrest.
The group is eager to have registry data-informed evidence of the advanced vascular services and high-quality care they deliver and to share their successes in improving patient outcomes with those they serve.
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New Resources for IVUS/OCT ImagingThe consortium has developed a series of documents to support appropriate and effective use of IVUS/OCT imaging.
Visit our website's “Best Practices” page to find a link to the “IVUS/OCT Imaging Education Packet Zip File with Multiple Resources.” The first page of this document provides data on consortium use of IVUS/OCT for Q2 2022 and an outline of the 2023 IVUS/OCT P4P goal. On the second page, you’ll find QR codes and links to best practice protocols, videos, publications, and a guidance document. This document is available as a PDF for printing and as jpegs for easy viewing on your phone or tablet.
Also available on the “Best Practices” page is a link to PDFs and jpegs of the IVUS/OCT Poster which includes guidelines for using IVUS/OCT for PCI optimization both pre- and post-PCI. This poster is available in two versions with one including MLD and MAX.
We encourage you to download, share, print, and post these resources.
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BMC2 in the NewsBlue Cross Blue Shield of Michigan has highlighted BMC2 in a post on the MI Blues Perspectives blog. The article explains what a recent study of BMC2 data has taught us about the impact of cannabis use on outcomes after lower extremity bypass. A quote by the study’s first author, Dr. Drew Braet, shares how BMC2 is the perfect data set, allowing us to look at multiple outcomes, including heart attack and stroke. Visit the news section of our website for links to both the MI Blues Perspectives blog post and the PubMed listing of the study manuscript which is published in Annals of Vascular Surgery.
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New PublicationA new paper from BMC2, published in Catheterization and Cardiovascular Interventions, outlines a study that analyzed trends in PCI in both the United States and the United Kingdom.
Authors Brett Wanamaker, Ahmad Shoaib, Milan Seth, Devraj Sukul, Mamas Mamas, and Hitinder Gurm found a higher prevalence of diabetes and other comorbidities in the Michigan cohort than in patients in the British Cardiovascular Intervention Society (BCIS) database.
There was a greater adoption of transradial PCI in the U.K. than in the U.S., and use of mechanical support was divergent, with use falling to 0.9% of cases in the U.K. while use in Michigan rose to 3.95%.
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National PresentationDr. Margaret E. Smith presented data from BMC2 during the Southern Association for Vascular Surgery (SAVS) 47th Annual Meeting on Saturday, January 21.
“Real World Application of WIfI Scores in Chronic Limb Threatening Ischemia Patients” outlined the results of a study in which the authors worked to determine the adoption of the wound, ischemia, and foot infection (WIfi) classification system and the impact of patient factors, procedural approach, and WIfI risk assessment on short- and long-term outcomes.
The study determined that in our large statewide collaborative, increasing WIfI scores correlate with worse short- and long-term outcomes. While high-risk patients are most likely to undergo open surgical revascularization (OSR), the risk of amputation increases significantly more in the peripheral vascular intervention (PVI) group as the WIfI score increases. This suggests that high-risk patients may be better served with OSR.
Given the difference in outcomes among patients screened with the WIfI classification, compared to those without, application of the WIfI system may not only risk stratify patients but may also lead to improved procedural selection.
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American Heart MonthThis American Heart Month we honor you and your commitment to collaborating with us to improve quality of care and outcomes for patients across Michigan. We look forward to continuing our mission which can only be attained with your participation and support.
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BMC2-OPEN Collaboration UpdateIn 2022, OPEN and BMC2 worked with Alosa Health to launch a pilot program of a targeted educational intervention for improving pain management and appropriate opioid prescribing. Providers (MDs and APPs) were offered the opportunity to participate in a 30-minute session to learn more about evidence-based multimodal pain management strategies specific to vascular surgery. The one-on-one sessions were tailored to provider-specific needs. Providers had the opportunity to receive continuing medical education credits and a $200 incentive for their engagement.
Outcomes from the pilot suggest that we could improve how we determine:
- Quantity of opioid pills needed after surgery
- Opioid use before surgery
- Postoperative opioid refill needs
- New persistent opioid use after surgery
Providers who completed the session evaluation reported that the session enhanced their ability to successfully manage pain, provide patient education on pain management, and decrease reliance on opioids. They would also recommend that colleagues participate in a session.
Currently, BMC2 and OPEN are collaborating to analyze prescribing patterns and impact of the educational sessions. Stay tuned for more information on outcomes and findings later this year!
There is still an opportunity to participate. Sign up by completing this form!
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Updated Smoking Cessation Resources from HBOM Available via BMC2.Org
Healthy Behavior Optimization of Michigan (HBOM) has updated its series of resources available to support health care providers and patients with smoking cessation. You can utilize them by:
- Adopting their completely reusable tobacco cessation resource library. The library includes a tool to assess a patient’s willingness to quit, information on nicotine replacement therapy and medication options, a smoking diary, and more.
- Ordering tobacco cessation referral supplies: HBOM’s posters, referral cards, and tobacco cessation decision guides are completely free to you, while supplies last!
- Taking Michigan Quitlink’s free online CME courses for health care providers.
- Visiting the tobacco cessation provider page – with additional downloads and resources for point-of-care tobacco cessation referral.
If you have questions or want more information, you can contact the BMC2 Coordinating Center or reach out to HBOM directly at info@hbomich.org.
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MISHC NewsThe MISHC paper, “The Relationship Between Hospital Stroke Center Designation and TVT Reported Stroke: The Michigan TAVR Experience,” was published in JACC: Cardiovascular Interventions.
The study concluded that Michigan Transcatheter Aortic Valve Replacement Collaborative TVT stroke rates were significantly higher at sites with Joint Hospital Commission stroke designation status; however, other reported important clinical outcomes did not differ significantly based on this designation.
Comprehensive stroke center designation is a possible factor in stroke rate detection differences between TAVR institutions and might be a factor in the observed differences in stroke rates between TAVR trials and those reported in TVT. Additionally, these data suggest that comparison between hospitals based on post-TAVR stroke rates is potentially problematic.
Learn more about this study by P. Michael Grossman, Devraj Sukul, Shelly C. Lall, Pedro A. Villablanca, Francis Shannon, Milan Seth, Stanley J. Chetcuti, Himanshu J. Patel, and G. Michael Deeb at PubMed.
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BMC2 Meeting SummariesThe BMC2 PCI Monthly Coordinator Zoom Meeting was held on January 12th. BMC2 PCI Clinical Quality Improvement Lead, Kathleen Frazier, discussed the new BMC2 REDCap Database and explained the differences between the old and new databases. She also reviewed the 2023 field changes.
The BMC2 Vascular Surgery Monthly Coordinator Zoom Meeting was held on January 18th. BMC2 Vascular Surgery Clinical Quality Improvement Lead, Rebecca Fleckenstein, discussed the new BMC2 REDCap Database and explained the differences between the old and new databases. She also reviewed the 2023 field changes and peer review timeline.
The BMC2 PCI Consortium-wide Webinar was held on February 9th from 6 pm – 7:30 pm. We welcomed Dr. Kevin J. Croce, of Brigham and Women's Hospital who presented about practical use of IVUS/OCT, and Dr. Nicklaus K, Slocum from Munson Medical Center who shared his talk about the REVIVED study and percutaneous coronary intervention in low EF patients. You can view the talks by Dr. Croce and Dr. Slocum on our YouTube channel.
For more information on these meetings including links to talks, visit our website for the January and February 2023 meeting summaries.
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Upcoming MeetingsThe BMC2 PCI Coordinator Meeting will be held on March 9th from 10 am - 11 am. Visit our website to view the agenda.
The BMC2 Vascular Surgery Coordinator Meeting will be held on March 15th from 11 am – 12 pm. Visit our website to view the agenda.
The BMC2 PCI Annual Coordinator Meeting will be held on May 5th from 10 am – 3 pm at the Matthaei Botanical Gardens in Ann Arbor.
The BMC2 PCI Collaborative Meeting will be held on May 6th from 10 am – 2:30 pm at the Kensington Hotel in Ann Arbor.
The BMC2 Vascular Surgery and MVS Physician Meeting will be held in person at Boyne Falls Resort on May 17th from 11:30 am – 5 pm. Non-physician participants are invited to attend.
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Welcome New SitesAs shared in the Site Spotlight, McLaren Port Huron has joined BMC2 as part of the Vascular Surgery Registry.
Additionally, McLaren Oakland has joined BMC2 as a Primary PCI Center. We welcome Marcy Gottesman and Theresa Atkinson in QI/management, Primary Site Coordinator, JoAnn Alfonsi, and Participating Physician, Blair DeYoung.
We are excited to recognize the team at the Michigan Vascular Institute of Michigan (MOVI) as our newest site in BMC2 PCI. Led by Physician Champion Ashok Kondur, and supported by Site Coordinator Andrea Matney and Administrator Kyle Sheiko, MOVI began treating patients for elective PCI procedures in October 2022.
Please join us in welcoming McLaren Port Huron, McLaren Oakland, and MOVI to the BMC2 community.
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Welcome New CoordinatorsPCI
David Ryder, MSN, RN, Bronson Methodist Hospital
Ewa Sztandera BSN, RN, CCRN, CSC, Michigan Medicine
Jennifer Woeber, MSN, RN, Henry Ford Jackson Vascular Surgery
Vascular Surgery
Kyle Combs, BSN, RN, BA Henry Ford Macomb
Julie Hess, BSN, RN, Henry Ford Jackson
Tara Kays, BSN, RN, McLaren Port Huron
Kathleen Walsh, Henry Ford, Jackson
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Opportunities for ParticipationFree 1-1 Counseling Offered by Michigan OPEN - To support appropriate prescribing for vascular surgery patients, OPEN is offering BMC2 vascular surgeons the opportunity to participate in tailored, one-on-one counseling sessions. Sessions provide unbiased, evidence-based information about medications and prescribing. Participants will be compensated for their time. Fill out this form for more information or to sign up.
Patient Engagement at BMC2 - We are seeking additional patients that represent the diversity of our state to join our BMC2 PCI Patient Advisory Council. We are particularly interested in adding a patient who experienced complications as well as a patient who had a routine PCI to our team. Can you recommend a patient to this group? There is no up-front commitment and patients will be compensated for their time.
We have created a patient-facing poster with information about the council and how to get involved. You can download the poster from our website and use the file digitally or make hard copies to display in your offices or cardiac rehab facilities. If you prefer, contact the coordinating center and we will print copies for you and mail them to you upon your request. You can learn more about patient responsibilities and what we are looking for in a patient advisor by visiting our blog.
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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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