A Note from Leadership

In October, after years of meeting virtually, we traveled to the Frederik Meijer Gardens and Sculpture Park in Grand Rapids for the MISHC Abstractor/Coordinator and MISHC Collaborative Meetings. It was so wonderful to see many of you in person. We delighted in engaging conversation prompted by informative presentations and thoughtful questions.

Thank you for responding to our recent survey in which we inquired about your preferences for next year’s meetings. We look forward to gathering both virtually and in person in 2023 and are eager to use your feedback to develop a strategy and objectives for those meetings.

The past year has brought growth and change as we transitioned from Michigan TAVR to MISHC. We hope that our increased communication has helped to foster a broader sense of community as we have celebrated and shared your successes.

We are proud to partner with you as you develop data-driven QI initiatives and hope that you will take advantage of increased opportunities for publishing your work. You can find our publication guidelines and a link to our publication proposal form on our website.

Our commitment to continuing to provide you with education and networking will not waver as we look forward to many more opportunities to expand the scope of the work we do through your innovative ideas and steadfast passion for improving quality of care and outcomes for patients. Thank you!

Health care workers bustle around patient beds.

Site Spotlight-Henry Ford Hospital Detroit

A group of TAVR professionals at Henry Ford Hospital Detroit, led by Nurse Practitioner Crystal Cusin, wanted to find a way to reduce the length of stay post-TAVR for eligible patients without compromising patient care.

The team identified some barriers that were contributing to longer hospital stays including physicians making rounds too late in the day, an inability to perform transthoracic echocardiograms and get results the same day, and patients being unready to leave the hospital or not having transportation home.

The team worked to overcome these barriers, efforts resulting in the implementation of a protocol that reduces the length of stay by half a day for those eligible. Read more about the team, their efforts, and how it impacts patients on our blog.

VBR Goals

The 2023 VBR goals have been approved by BCBSM and include:

- Rate of NYHA Heart Class documentation for TAVR at 30-day follow-up, goal ≥ 92%

- Rate of cases with contrast dose ≥ 3 CrCl for TAVR, goal ≤ 5%

- Increase TAVR KCCQ documentation at baseline and 30-day follow-up, goal ≥ 95%

Thank you for your partnership in identifying the established goals and your commitment to achieving them. A full list of VBR goals and details can be found on our website.

New Best Practice Protocols

We added new best practice protocols to our website this quarter.

Visit the “Quality Improvement” tab on our website and then click on “Best Practices" to find a list of available protocols, including Management of Blood Loss and Transfusions Following TAVR. The MISHC TAVR Groin Bleed Best Practice Protocol and the Radial and Ulnar Access Bleed Best Practice Protocol are available as zip files including a PDF which can be printed at letter size or pocket-card size. You’ll also find jpg versions for easy download to smartphone picture files. We encourage you to print and share these with your teams.

Learn more about these new protocols on our blog. Thank you to our Best Practice Protocol Task Force for creating these documents.

A birds-eye view of 4 people meeting around a table.

MISHC Meeting Summaries

Visit our blog for links to presentations and summaries from our 4th quarter meetings including:

- The MISHC Coordinator/Abstractor Annual Meeting which was held on Friday October 14th from 10:00 am – 3:00 pm at Frederik Meijer Gardens and Sculpture Park, Grand Rapids, MI.

- The MISHC Collaborative Meeting which was held on Saturday October 15th from 10:00 am – 3:00 pm at Frederik Meijer Gardens and Sculpture Park, Grand Rapids, MI.

- The MiTVT2 and MISHC Coordinator/Abstractor Meeting which was held on November 10th from 11 am – 12 pm.

Older adults dance on a wooden dance floor wearing brightly colored clothing.

Patient Impact - Helping Houston Dance Again

The team at Henry Ford Hospital Detroit recently performed TAVR for 102-year-old World War II Veteran, Houston Pritchett. After a successful procedure, Houston is participating in cardiac rehab with the goal to get back out on the dance floor. We are grateful to Houston for sharing his story and wish him all the best! Visit Click on Detroit for both a video and written account.

Staff Spotlight - Annemarie Forrest

MISHC Program Co-Manager, Annemarie Forrest, draws from 20 years of experience in clinical research and academic health care as she supports staff and works on special projects at the MISHC Coordinating Center. She appreciates that MISHC gives her the opportunity to have a more direct impact on improved patient outcomes and population health.

Annemarie enjoys close collaboration with her colleagues at The Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS) and having a shared sense of purpose across the CQIs. A favorite project over the past year has been developing success stories highlighting the consortium's achievements. “A lot of fantastic work is being done and it is so important we share those successes both with each other and external stakeholders,” she said. Read more about Annemarie on our blog.

New Publications from BMC2

The paper “Rates of Intracoronary Imaging Optimization in Contemporary Percutaneous Coronary Intervention: A Report from the BMC2 Registry” has just been published in Circulation: Cardiovascular Interventions. The study used BMC2 data to look at using intracoronary imaging (ICI) during PCI for stent optimization at both a hospital and physician level. You can read more about this study on the BMC2 website.

The paper, “Impact of Left Ventricular End-Diastolic Pressure on the Outcomes of Patients Undergoing Percutaneous Coronary Intervention” is now in press and available online at The American Journal of Cardiology. The study evaluated the association of LVEDP with patient outcomes after elective or urgent PCI. It concluded that an elevated LVEDP was found in 1/3 of study patients who underwent elective or urgent PCI and that elevated LVEDP is associated with higher rates of in-hospital adverse outcomes, including death. Visit the BMC2 website to learn more.

Upcoming Meetings

The MISHC Mitral Webinar is on March 14th from 6 pm – 7:30 pm.

The MISHC TAVR Webinar is on June 20th from 6 pm – 7:30 pm

The MISHC Coordinator/Abstractor Meeting is on October 13th from 10 am – 3 pm. In person. Location TBD.

The MISHC Collaborative Meeting is on October 14th from 9 am – 3 pm. In person. Location TBD.

Paperclips are scattered across a green cutting map, a stack of pink, green, and yellow post-it notes are in a haphazard pile. The top note states

MISHC Website Tips

Visit MISHC.org to keep up with consortium news and events by clicking the “News and Events” tab. You’ll find a list of our upcoming and past meetings along with agendas.

Our “news” section contains articles about MISHC from outside media. News about MISHC publications and conference presentations has traditionally been shared in our blog section. Moving forward, you’ll find these articles in news, while items like site and staff spotlights, meeting summaries, and best practice protocols will remain on our blog.

We’re excited to share your successes through our website. We hope you’ll use the site as a tool for meeting information and join us for all our educational and networking opportunities.

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.

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.

MISHC is a collaboration between the Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) and Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)

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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