A Note from Leadership
We are pleased to share our inaugural Michigan Structural Heart Consortium (MISHC) newsletter with you! This communication will be sent on a quarterly basis. We are excited about this means of sharing the successes of the consortium and hope you will find this publication a rich source of information.
You can expect to see articles that celebrate the work of our teams at hospitals across the State of Michigan, highlight recent publications that feature MISHC data, and shine a light on MISHC presentations at national meetings. We will introduce you to members of the MISHC staff, provide outlines of new best practice protocols, share tips on navigating the newly developed MISHC website, and welcome new coordinators. As this is your newsletter, we also welcome your suggestions and story ideas.
This is an exciting time for the consortium as we expand our scope by adding mitral valves to the procedures we report on, giving us an opportunity to make an even bigger impact on cardiovascular patients across the state. We thank you for the work you do each day to improve quality of care and patient outcomes. We look forward to communicating with you via this newsletter, our MISHC blog, and social media in the coming months and years.
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Spotlight on Munson Healthcare
The team at Munson Healthcare in Traverse City, Michigan believes that collaboration is key. While their structural heart program has been in place since 2012, Structural Heart Coordinator, Deb Provost, with her background in quality improvement, was always looking for opportunities to take patient care to the next level. She had a desire to collect data in real-time and there was a need for robust data collection and improved documentation for all structural heart procedures. When she was contacted by Edwards Lifesciences regarding an opportunity to undergo a benchmark project, Deb was intrigued. A team of peers would review metrics from the entire program, including information on mortality and other TVT data, and look for areas for improvement. She took the idea back to her team, and Munson became the first program in Michigan to collaborate with Edwards Lifesciences in this way. Visit our blog to continue reading.
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Sheryl Fielding Receives Staff Award for Excellence
For the Michigan Structural Heart Consortium’s (MISHC) Clinical Quality Improvement Lead and nurse educator, Sheryl Fielding, it has been exciting to watch TAVR procedures change since the beginning of Michigan TAVR in 2015. Sheryl has enjoyed watching the rapid changes and improvements in the field. Her commitment to education and collaboration and always exemplary work performance recently earned her a Michigan Medicine Department of Internal Medicine Staff Award for Excellence. Read more about Sheryl and her accomplishments on our blog.
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New VBR Goals
2023 VBR goals will include:
1. Rate of NYHA Heart Class documentation for TAVR at 30-day follow-up, goal ≥ 92% 2. Rate of cases with contrast dose ≥ 3 CrCl for TAVR, goal ≤ 5%
Additionally, we would like you to review the following possibilities and send us your site’s vote for a third VBR goal by Friday, July 8th. Surveys for voting were sent to coordinators and physician champions by email on June 23rd. Your choices are:
- TAVR follow-up documentation at 1 year, goal ≥ 90% - Increase TAVR KCCQ documentation at baseline and 30-day follow-up, goal ≥ 90%
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New Best Practice Protocol - Nephropathy Post-TAVR
The new best practice protocol (BPP) for nephropathy post-TAVR is now available on mishc.org. This BPP includes an outline of predictors of nephropathy post-TAVR in MISHC data as well as VARC2 and BMC2 definitions of Acute Kidney Injury (AKI). A hydration protocol and information on contrast limits are also included. You can view the complete BPP on our website. Thank you to our Best Practice Protocol Task Force for creating this document.
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MISHC in the News
Blue Cross Blue Shield of Michigan’s Value Partnerships Update for June featured an article on the rebranding of Michigan TAVR to the Michigan Structural Heart Consortium (MISHC) and the consortium’s expansion to include mitral valve procedures. You can read the full article in the Value Partnerships Update.
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News from BMC2
An article on the newly formed MiCR Network is included in the Blue Cross Blue Shield of Michigan Value Partnerships Update for June. The network, a collaboration between BMC2 and the Michigan Value Collaborative (MVC), strives to increase cardiac rehab participation for all eligible patients in Michigan through resources and education. Read “Efforts of BMC2 and MVC align to form Michigan Cardiac Rehab Network” to learn more about this partnership, the new goal of 40% referral to cardiac rehab, and to gain access to the new Cardiac Rehab Toolkit.
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MISHC Publication
The results of the study showed that a patient-specific volume threshold based on the patient’s kidney function is a practical way to avoid the risk of kidney damage. Find more information on our blog.
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Paper on Cardiac Rehab Published by Our Partners at MVC
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National Meeting
Dr. Shinichi Fukuhara presented “Valve Reoperation after Native and Valve-in-Valve Transcatheter Aortic Valve Replacement: A Statewide Experience” during the American Association for Thoracic Surgery’s 102nd Annual Meeting which was held in Boston from May 14 – 17. Visit our blog for more information and a list of co-authors.
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MISHC Meeting Summaries
The MISHC Mitral Physician Meeting was held on March 3rd from 6 pm – 7:30 pm.
The MISHC Coordinator/Abstractor Meeting was held on March 16th from 1 pm – 2 pm.
The MISHC Coordinator/Abstractor Meeting was held on May 25th from 11 am – 12 pm.
The MISHC TAVR Physician Meeting was held on June 22nd from 6 pm – 7:30 pm.
The MI TVT2 Educational Meeting was held on June 24th from 10 am – 11 am.
Thanks to all who attended our meetings in the first quarter. Did you miss a meeting or do you need a refresher? Read our summaries for more information, including links to full presentations on YouTube when available.
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Upcoming Meetings
The MI TVT TAVR Readmission Prevention Meeting is on June 30 from 11 am – 12 pm. Join us for this roundtable of high performers sharing their readmission prevention processes.
The next MISHC Coordinator/Abstractor Annual Meeting is on Friday, October 14th from 1 pm – 5 pm at Frederik Meijer Gardens and Sculpture Park, Grand Rapids, MI.
The next MISHC Collaborative Meeting is on Saturday, October 15th from 10 am – 3 pm at Frederik Meijer Gardens and Sculpture Park, Grand Rapids, MI.
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Welcome New Coordinators
Marcie Minoletti, BBA Quality Improvement Specialist STS/MSTCVT Adult Cardiac Data Abstractor Quality Management Department
Emily Naquin, RN Clinical Quality Nurse-TAVR Quality Benchmarking and External Reporting St. Joseph Mercy Hospital
Stacey Pipitone, RN, BSN Quality and Patient Safety Ascension Providence Hospital
Megan Roslund, RN Performance Improvement Coordinator Ascension St. John Hospital
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MISHC Website Tips
Visit our newly updated MISHC website for coordinator resources, publications and presentations, news, events, and more. Under our “Quality Improvement” tab, you’ll find our “Best Practices.” Visit our blog for more information and to view all of our MISHC best practice protocols.
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Social Media Spotlight
MISHC is now on social media! You can subscribe to our YouTube channel and follow us on Twitter and LinkedIn where we will share information on best practice protocols, links to MISHC meeting presentations, site spotlights, and more.
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Call for Participation
Do you have photographs of your teams in the cath lab or performing other tasks? We would love to feature you on our website! Send photos to the Coordinating Center at info.mishc@umich.edu.
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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 Walker at ehorn@umich.edu.
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Support for MISHC 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 MISHC 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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