MVC workgroup -

11 Nov 2026

Off

Highlights from MVC’s Third Quarter Newsletter

November 11, 2026 | Comments Closed | BCBSM P4P, collaborative-wide meeting, MVC P4P, MVC workgroup, systems VBI, VBI

The Michigan Value Collaborative (MVC) had a busy third quarter of 2026, with new data and reporting resources, expanded value-based improvement efforts, and continued opportunities to connect with members across Michigan. MVC's latest quarterly newsletter, distributed at the end of October, brings together these updates and more. For those who missed the newsletter or aren't yet subscribed to the MVC mailing list, here are a few highlights from the July-September 2026 issue:

One of the quarter's key highlights was its collaborative-wide meeting on Oct. 9 in Livonia, bringing together 87 attendees representing 55 hospitals, 13 multi-hospital systems, and five physician organizations. Under the theme Unlocking Data for QI Impact: Translating Insights into Action, the meeting explored how organizations can use MVC data to identify opportunities, inform improvement strategies, and translate performance insights into meaningful action. The newsletter includes a link to the meeting recap.

Another significant update this quarter was the introduction of MVC's new Systems Value-Based Initiative (VBI). Building on MVC's established hospital-level improvement framework, the new initiative extends value-based improvement efforts across entire healthcare systems. By examining performance across system members, MVC aims to help identify variation, share successful practices, and support quality improvement at a broader scale.

MVC also shared several important updates related to the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. The newsletter highlights that hospitals received their PY2026 mid-year scorecards, marking the first year of the new two-year P4P cycle (PY2026–2027). In addition, MVC published its fifth annual Qualified Entity Certification Program (QECP) public report, which presents aggregated, unidentified data on Michigan hospital performance related to 30-day rehospitalizations following the start of home health care and outpatient follow-up after hospitalization for congestive heart failure or chronic obstructive pulmonary disease. MVC also hosted P4P webinars to discuss the health outcome variation measure and introduce new registry reports for the PY26/27 cycle.

New data and reporting resources were another focus of the quarter. In September, MVC's registry was updated with new payer data, along with the new P4P registry reports. MVC also distributed push reports focused on cardiac rehabilitation and common conditions in September and October, respectively, providing members with additional opportunities to review performance and identify areas for quality improvement.

Beyond data and reporting, MVC continued to bring members together through clinical workgroups, educational programming, and networking opportunities. Quarterly workgroup sessions covered a range of clinical and quality improvement topics, with presentation recaps and materials available through MVC's monthly workgroup blogs. In October, MVC also hosted a networking dinner ahead of its collaborative-wide meeting, giving members an opportunity to build connections and exchange ideas outside of the formal meeting program.

Looking ahead, MVC is seeking member presenters for 2027 events. Hospitals interested in sharing their quality improvement experiences and lessons learned can submit presentation proposals on a rolling basis, with accepted presentations eligible for 0.5 P4P engagement points toward PY27. The newsletter also includes information about upcoming workgroups, site coordinator education modules, and site visits in 2027.

These highlights offer just a glimpse of MVC's recent work and ongoing collaboration with members. Read the full Q3 2026 newsletter for additional updates, resources, upcoming events, and ways to get involved.

Not currently receiving MVC's quarterly newsletter? Subscribe to the MVC mailing list to stay up to date on new resources, program announcements, member activities, and opportunities to engage with the MVC community.

04 Nov 2026

AMI BMC2 CABG Cardiac Rehab cardiac rehabilitation CHF MiCR MVC Push Reports MVC workgroup non-medical drivers of health PCI SAVR TAVR

Off

View Post

MVC October Workgroup Highlights MVC Cardiac Rehab Push Report

November 4, 2026 | Comments Closed | AMI, BMC2, CABG, Cardiac Rehab, cardiac rehabilitation, CHF, MiCR, MVC Push Reports, MVC workgroup, non-medical drivers of health, PCI, SAVR, TAVR

In October, the Michigan Value Collaborative (MVC) hosted a cardiac rehab workgroup featuring MVC’s newly released cardiac rehabilitation (CR) push report. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including cardiac rehab, post-discharge follow-up, rural health, preoperative testing, sepsis, and health in action. View the full MVC event calendar with registration links here.

Cardiac Rehab Workgroup: MVC’s Refreshed Cardiac Rehab Push Report

Since 2019, MVC has prioritized cardiac rehab as a value coalition campaign providing members with focused workgroups, site visits, and data resources to support quality improvement. Since then, MVC has continuously offered multi-payer reporting and benchmarking on a variety of cardiac rehab focused measures, first by offering dedicated push reports refreshed twice each year, followed by the launch of multi-payer reports on the MVC registry and the incorporation of cardiac rehab measures in the MVC Component of the BCBSM Pay-for-Performance (P4P) Program.

MVC continued to update data for its members by refreshing cardiac rehab push reports in September (read September 2026 blog for report details). MVC shared a stand-alone cardiac rehab push report this year, whereas recent years incorporated these data within a larger process measures push report.

During this month’s cardiac rehab workgroup, MVC Associate Program Manager Jana Stewart, MPH, provided a report walkthrough to familiarize MVC members with its data and changes relative to prior versions. In addition to traditional measures of enrollment, the latest report included measures of adherence and completion, in alignment with AACVPR performance measures.

Stewart said this expanded approach highlighted important opportunities for quality improvement along the patient care journey, from initial referral and enrollment processes to downstream retention strategies and patient barriers to participation. The measures were defined as:

Enrollment: The percentage of eligible patients who attend at least one cardiac rehab session within 90 days (Main 5 patients) or 365 days (CHF patients) of hospital discharge
Adherence: The percentage of enrolled patients who completed at least 12 cardiac rehab sessions within 365 days of discharge
Completion: The percentage of enrolled patients who completed at least 36 cardiac rehab sessions within 365 days of discharge

Together, Stewart described how these measures can help hospitals and cardiac rehab partners identify where patients may be falling out of the care pathway, starting with initial referral and enrollment through continued program participation and completion. Stewart encouraged members to use the provided patient characteristics table (Figure 1) to assess differences in cardiac rehab outcomes between different patient groups as well as identify patient gaps driven by non-medical drivers of health. The report also provided hospital-level comparisons with statewide averages, allowing members to assess their performance relative to their peers.

After reviewing the specifics of the updated push report, Stewart provided a brief look at statewide performance on each of these measures for the Main 5 and CHF patient populations. Overall, the findings demonstrated some progress in enrollment while highlighting opportunities to strengthen adherence and completion.

The Michigan Cardiac Rehab Network (MiCR) reported on cardiac rehab adherence and completion rates one year ago at its fall 2025 meeting, which compared participant adherence and completion rates across CR programs. This data presentation revealed a positive association between adherence rate and completion rate, with more consistently higher adherence rates observed amongst sites with higher completion rates (Figure 2). However, there were also sites with high adherence rates and low completion rates, suggesting a high adherence rate does not guarantee a high completion rate.

Benchmarking Statewide Enrollment, Adherence, and Completion

The statewide cardiac rehab enrollment rate provided for Main 5 conditions was 34%, up from approximately 24% when focused improvement efforts began in 2019. However, this remains below the MiCR statewide goal of 40% and well below the Million Hearts goal of 70% for all eligible cardiac rehab participants.

For patients with CHF, the statewide enrollment rate of 6% also still falls short of MiCR’s 10% goal. Unlike enrollment for the Main 5 conditions, CHF enrollment rates have seen little improvement over the last few years. These findings reinforced the importance of an effective referral process, patient education, and continued engagement on the initiation of cardiac rehab for CHF patients. During the discussion, participants emphasized that heart failure patients may need additional time and repeated referrals before they initiate cardiac rehab.

Stewart emphasized how the additional measures of adherence and completion rates offered further insight into patient participation and full benefit from the program after enrollment. For the Main 5 conditions, the statewide adherence rate was 75% for the report's timeframe, meaning that approximately three-quarters of enrolled patients completed at least 12 sessions. However, the statewide completion rate among Main 5 patients was just 24%, reflecting the proportion of enrolled patients who completed 36 sessions within one year. For CHF, rates were similar to those of the Main 5 population—the statewide CHF adherence rate was 68%, while the completion rate was 24%.

Identifying Barriers and Supporting Patient Participation

During the workgroup discussion, members explored several factors that may affect enrollment, adherence, and completion. Common themes of the discussion included:

Provider endorsement and patient education: A clear recommendation from a physician can help patients understand why cardiac rehab is an important part of their recovery journey.
Financial and transportation barriers: Copays and the challenges of traveling to multiple appointments are known barriers for certain patient populations that may show up as low adherence or completion rates. Further analysis of cardiac rehab performance across payer and demographic groups could help better understand where additional support may be needed.
Flexible scheduling and delivery options: Flexible appointment times and hybrid cardiac rehab delivery models may help patients overcome scheduling and transportation challenges to improve adherence and completion.
Patient stories and testimonials: Participants discussed that patients may not feel ready to participate in cardiac rehab immediately after discharge, making continued outreach and education especially valuable. For patients with CHF in particular, the timing of referrals and reminders can be important. MiCR’s newest Heart-to-Heart initiative offers patient-story videos and testimonials that programs can use to help recruit patients for cardiac rehab, available on MiCR’s YouTube page.

These strategies offer starting points for local quality improvement. Stewart encouraged members to use their new cardiac rehab report findings to identify opportunities, engage relevant clinical and operational partners, and determine which approaches may be most appropriate for their patient populations. Members can also use the MVC registry to explore additional breakdowns of their data. For hospitals interested in more detailed analyses, MVC is available to discuss custom report opportunities.

07 Oct 2026

MVC Coordinating Center MVC workgroup sepsis

Off

View Post

MVC September Workgroup Highlights Sepsis Improvement Journey

October 7, 2026 | Comments Closed | MVC Coordinating Center, MVC workgroup, sepsis

In September, the Michigan Value Collaborative (MVC) hosted a sepsis workgroup featuring a presentation by McLaren Flint Hospital highlighting their sepsis improvement journey. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including cardiac rehab, post-discharge follow-up, sepsis, rural health, preoperative testing, and health in action. View the full 2027 MVC event calendar here.

Sepsis Workgroup: McLaren Flint Hospital

During this month’s sepsis workgroup, Kerri Tomasi-Herman, RN and Ali Arthur, BSN, RN, CCRN, Quality Improvement Specialist RNs at McLaren Flint, presented on the hospital’s work to strengthen sepsis processes over the past two years. Their presentation offered practical examples of how the team has used dashboards, daily auditing, nursing checklists, provider education, and interdisciplinary collaboration to address sepsis performance challenges.

McLaren Flint is a 378-bed hospital and Level III Trauma Center with high emergency department and inpatient volumes. Tomasi-Herman and Arthur began their presentation with a description of a significant transition in sepsis quality improvement beginning in 2025.

Previously, McLaren Flint relied on an on-site clinical abstractor and sepsis coordinator who reviewed sepsis patients, supported completion of the Centers for Medicare and Medicaid Services (CMS) sepsis bundle, and provided real-time assistance to nurses and providers. While they acknowledged this role as an important resource, the team recognized that relying heavily on one individual could mask underlying process issues.

In 2025, McLaren centralized sepsis abstraction across the hospital system. This shifted the role of the local quality improvement team toward real-time monitoring, intervention, feedback, and use of data to drive improvement.

Using Dashboard Data to Identify Opportunity for Improvement

Considering this shift towards real-time monitoring, a tool Tomasi-Herman and Arthur highlighted as key to their new workflow was the McLaren sepsis performance dashboard. The dashboard allows the quality team to see overall compliance as well as performance across different areas, including the emergency department (ED) and inpatient units.

The team uses this information during its monthly sepsis and quality improvement meetings across various clinical areas. Pareto charts help identify the most common causes of sepsis measure fallouts by service area to further pinpoint opportunities for improvement. This more detailed breakdown allows the team to tailor improvement strategies to specific departments and processes. For example, using this data they have found that within the ED, antibiotic administration most commonly contributes to sepsis fallouts, while for inpatient the most common issue is timely initial lactate orders.

The presenters emphasized that making this information visible to providers and hospital leaders has helped create greater awareness of performance and opportunities for improvement. McLaren Flint’s sepsis committee currently includes representatives from quality, medical staff, nursing, emergency medicine, intensive care unit, pharmacy and laboratory services with additional participants engaging when a specific fallout involves their department.

Real-Time Monitoring Helps to Avoid Fallouts

Another major component of McLaren Flint’s approach is daily real-time monitoring. Each morning, the quality improvement team reviews their internal electronic medical record (EMR) sepsis worklist, which identifies patients meeting sepsis-related criteria. The team then follows patients in real time, monitoring whether appropriate orders for blood cultures, antibiotics and other elements of the bundle are completed.

When a potential delay is identified, the team provides real-time reminders to appropriate nurses and providers. They also review cases retrospectively and send follow-ups or documentation addendum requests when appropriate. This combination of real-time intervention and retrospective review allows the team to address individual cases while also identifying recurring process issues.

Reviewing individual fallout cases minute-by-minute offers the opportunity to determine whether the underlying issue was related to workflow, documentation, laboratory processes, or another factor. One example provided by the presenters involved antibiotic orders that were not being reviewed quickly enough by pharmacy. After identifying and bringing this item to the attention of the sepsis committee, the pharmacy department adjusted its process to prioritize validation of antibiotics associated with sepsis and infection-related orders. Since this process has changed, the turnaround time for medication validation has decreased to less than 10 minutes.

Introduction of ED Sepsis Checklist

Because McLaren’s EMR system does not include a built-in sepsis nursing flowsheet or navigator, the team decided to design a paper-based tool. McLaren Flint implemented this sepsis checklist first within their ED. The checklist highlights systemic inflammatory response syndrome (SIRS). SIRS criteria checks for organ disfunction and is intended to prompt nurses to bring potential sepsis concerns to their physician as early as possible.

The checklist has gone through several revisions based on feedback from frontline staff. Together, they have worked to create a simplified tool that functions as a practical guide for nursing staff. These checklists are collected at the end of shifts and compared to patients identified through the EMR worklist to monitor utilization and compliance among staff.

Engagement of Frontline Staff

In addition to engaging frontline staff with the development of the sepsis checklist, McLaren Flint shared a creative strategy for building engagement: the Sepsis Hero Award.

This award was revived to recognize nurses and providers who demonstrate strong sepsis performance and engagement. A recent recipient was acknowledged for high checklist compliance, positive attitude, and having no sepsis fallouts.

This recognition has become a source of positive competition among ED staff, with team members becoming increasingly interested in being recognized for their contributions. This demonstrates the power recognition can have on complimenting data and education by making improvement efforts visible and celebrating frontline participation.

Looking Ahead to Continuous Improvement

Near the end of the workgroup, Tomasi-Herman and Arthur reflected that while McLaren Flint has made great progress, they continue to identify areas for improvement. One challenge they have identified is that their EMR-based automated sepsis alerts do not always align with CMS sepsis requirements, resulting in some false alerts. They have also identified limitations to their EMR configuration and opportunities to strengthen the recognition of sepsis patients receiving care on inpatient floors, particularly when a patient’s condition evolves after admission.

Looking ahead, McLaren Flint plans to continue educating ED staff, including their new medical resident program, promote standardized sepsis documentation, and monitor inpatient sepsis alerts. The team is also working to recruit frontline nurses or providers to serve as sepsis champions and participate in monthly sepsis meetings, continuing to bring frontline perspectives into the hospital’s quality improvement work.

Key Takeaways for MVC Members:

McLaren Flint’s presentation offered several practical strategies that other hospitals may consider when aiming to strengthen their sepsis improvement efforts:

User performance data to identify specific process opportunities – rather than relying solely on compliance rate
Pair real time monitoring with retrospective review – to address potential gaps before they become measurable fallouts
Create simple frontline tools – when EHR functionality does not fully support a desired workflow
Celebrate staff contributions – through recognition and awards
Bring multiple disciplines together – to identify and address system-level barriers
Share performance transparently – with providers, managers, and clinical leaders to build awareness and accountability

09 Sep 2026

ICH intracranial hemorrhagic intitative Michigan Value Collaborative MVC workgroup non-medical drivers of health preoperative testing

Off

View Post

MVC August Workgroups Highlight Preop Testing Reduction with RITE-Size and QI to Improve Outcomes for ICH Stroke Patients

September 9, 2026 | Comments Closed | ICH, intracranial hemorrhagic intitative, Michigan Value Collaborative, MVC workgroup, non-medical drivers of health, preoperative testing

In August, the Michigan Value Collaborative (MVC) hosted two virtual workgroup presentations, a preoperative testing workgroup focused on Henry Ford Health Genesys’ preoperative testing reduction initiative and a health in action workgroup presentation by DMC Detroit Receiving Hospital on their intracranial hemorrhage quality initiative. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including cardiac rehab, post-discharge follow-up, sepsis, rural health, preoperative testing, and health in action.

Preoperative Testing Workgroup: Henry Ford Health Genesys

During this month's preoperative testing workgroup, Henry Ford Health’s (HFH) Brooke Wagner, RN, BSN, Clinical Quality Facilitator II, SCQR, and Megan Wadowski, RN, BSN, Principal Quality Consultant, shared how HFH Genesys achieved significant improvement in reducing unnecessary preoperative testing prior to low-risk surgical procedures (e.g., inguinal hernia, lumpectomy, and cholecystectomy) by participating in the RITE-Size initiative.

HFH Genesys became involved in RITE-Size following outreach from the Michigan Surgical Quality Collaborative (MSQC), who indicated the HFH Genesys was eligible to participate in the RITE-Size initiative. HFH Genesys saw this as an opportunity for improvement and met with the RITE-size team for an initial site visit and kick-off meeting.

RITE-Size Coaching & Implementation Strategies

After initial discussions, the RITE-size and HFH Genesys teams identified two areas for improvement: 1) ordering practices and 2) provider workflows. The desired outcome/goal was to reduce unnecessary preoperative testing to better align with evidence-based (EBP) system-wide practices at HFH.

Wagner shared that HFH Genesys was able to pull together a multi-disciplinary team to meet with the RITE-size team, including clinical quality staff, the surgeon champion, chief of staff, and nurse manager for preadmission testing. Their team met and reviewed organizational data and workflows, discussed barriers, and considered ideas for long-term sustainability. By sharing perspectives from providers, nursing, anesthesia, and leadership, they were able to develop action plans and strategies to support continued improvement.

As the HFH Genesys team participated in regular coaching sessions throughout the project with the RITE-size team, they were able to increase awareness and give team members the opportunity to ask questions. Throughout the project, they were able to track fallouts, review trends, and maintain continuous process improvement.

Leveraging MVC Data

Part of the process of educating and increasing awareness among team members included sharing data from a MVC custom report completed earlier this year on HFH Genesys’ historical preoperative testing rates from 2023 – 2025 (partial data). Through this report, they discovered that despite changing from open surgery to robotic hernia surgery in early 2024, historical preoperative testing practices persisted (Figure 1). The team was able to develop an action plan and education for surgical providers where they presented evidence-based best practices for preoperative testing in relation to robotic hernia repairs and quickly saw a reduction in testing rates by the second half of the year.

*Reflects BCBSM/BCN claims through June 30, 2025, and Medicare FFS through March 31, 2025. Michigan Medicaid was provided through Dec. 31, 2024.

In addition to the clinical metrics HFH Genesys utilized, the custom report MVC provided included data for non-medical drivers of health that gave greater insight into their patient populations being treated for these low-risk procedures. Data tables helped HFH Genesys identify a large portion of patients undergoing low-risk hernia repair as patients living in zip codes with multiple barriers to care.

Identifying these barriers allowed HFH Genesys to restructure and simplify discharge instructions to better meet the needs of the patient population by incorporating patient-centered language and clear guidance on setting up follow-up appointments.

Process Change Efforts

By reviewing MVC and MSQC data together, HFH Genesys was able to identify multiple opportunities for improvement. After evaluating existing preoperative testing order sets, they found the original set was outdated and no longer aligned with evidence-based practice recommendations. By updating the electronic medical record (EMR) system, HFH Genesys was able to make a comprehensive update to the order set and preoperative testing policy for their teams.

This updated policy was then implemented across the organization and shared through trainings for providers and associated staff on appropriate testing guidelines and the revised preoperative testing workflows. To maintain continuous improvement through this process, the HFH Genesys team also established ongoing communication with surgical teams to reinforce adherence to the updated processes, which included orientations for new nursing or physician staff. Sharing the policy during the orientation allowed new staff to ask questions, and for the site to provide in-depth explanations on the effectiveness of the preoperative testing policy.

Barriers, Opportunities, and Next Steps

Wagner shared that though they have accomplished improvements in their preoperative testing process, there are barriers the organization continues to experience that may impact 100% adherence to the new policy. Those barriers range from unpredictable staffing fluctuations, administrative associate turnover, and variability in practice patterns among providers.

Despite ongoing setbacks, HFH Genesys looks forward to the future and opportunities ahead. By implementing Epic EMR in November of this year, they will provide enhanced clinical decision support for staff with the updated preoperative testing process coded into the EMR while creating standardized order sets for providers to easily use. These updates will further support adherence to the policy and provide a strong foundation for continued improvement. HFH Genesys will continue to provide communication and collaboration opportunities with providers and leadership on the “why” of the preoperative testing process change. This will be supported by ongoing monitoring and feedback processes to ensure sustained improvement through the Epic EMR implementation in November.

Health in Action Workgroup: DMC Detroit Receiving Hospital

During the August health in action workgroup, DMC Detroit Receiving Hospital’s Maryam Hakemi-King, MSN, AGNP, Stroke Program Lead Nurse Practitioner, presented on DMC Detroit Receiving Hospital’s participation in the American Heart Association’s (AHA) Intracranial Hemorrhage (ICH) Initiative, which focuses on advancing care and improving outcomes for patients with ICH.

ICH Stroke Facts & AHA ICH Initiative

Hakemi-King led the presentation by defining essential facts about hemorrhagic strokes to lay a foundation for the “why” of DMC Detroit Receiving’s participation, including:

Hemorrhagic strokes account for approximately 13% of all strokes; but despite being less common, they are responsible for more than 40% of stroke-related deaths
ICH is associated with a high early mortality rate of 30 – 40%
Recent studies have shown a nationwide increase in ICH incidence among young and middle-aged adults
There has been significant improvement in the care of ischemic stroke over the years, but similar progress has not been seen in the care of ICH patients.

As a result, AHA is actively partnering with 15 sites across the nation to participate in a two-year initiative to improve care and outcomes for ICH patients. The chosen sites are led by physician champions of the initiative and are focused on implementing national models of effective ICH care, including using procedures such as minimally invasive parafascicular surgery (MIPS) and aligning with ICH metrics and measures through AHA’s stroke focused Get with the Guidelines (GWTG) program. DMC teams are working to identify successful models of care through process mapping activities and continuously evaluating ongoing quality improvement initiatives. Participating sites like DMC are focusing on areas such as:

ICH patient triage process
Patient selection criteria for MIPS procedure
Surgical timing and post-operative care
Staff training and education
Evaluating outcomes

Sites discuss and review strengths and barriers to care while investigating all opportunities within each of these domains.

DMC Detroit Receiving Hospital Stroke Program

DMC Detroit Receiving Hospital has a comprehensive stroke center and program, which has seen a 43% increase in ICH admission cases from 2023 to 2025. The stroke center offers comprehensive, around-the-clock care supported by neurointensivists, specially trained neurosurgeons, and close collaboration with the ED, neurology, Neuro ICU, and neurosurgery teams. Its coordinated approach includes a dedicated stroke activation and paging system, a designated PACU holding area, 24/7 minimally invasive brain interventions for eligible patients, and AI-assisted identification of intracerebral hemorrhage (ICH). Structured documentation, quality audits, and monthly case reviews further support continuous improvement and high-quality patient care.

DMC Detroit Receiving worked to integrate the ICH methodology into their program by implementing specific metrics and measures, conducting a more in-depth analysis of patients receiving surgical intervention and their level of functioning at discharge, development of specific ICH consult note documentation and code ICH activation process, and continuing research while developing a new framework for ICH management (Figure 2).

ICH Initiative

Hakemi-King expressed how incorporating the AHA ICH initiative’s metrics and measures are an important focus for DMC Detroit Receiving. As they work to align with the national initiative, several ICH metrics and measures are being tracked, such as timing of patients being taken from arrival to the ED to imaging, taking the patient’s blood pressure in less than 120 minutes of arrival at the ED, and ensuring the ICH severity score is completed less than 6 hours before an intervention (Figure 3).

These established care timeframes help ensure patients receive appropriate care on time. By structuring the patient’s care pathway from imaging to medication administration and blood pressure management, the stroke team prepares the patient to have a more successful discharge process.

The ICH quality initiatives currently in progress include tracking patient door to neuro intensive care unit (NICU) bed timing; tracking and identifying ICH presenting symptoms, which can be different than typical stroke symptoms; introducing early physical, occupational, and speech therapy interventions within the first 24 hours of admission (patient progress reported at monthly meeting); and completing a Pre-Morbid Modified Rankin Score (mRS) on patients at admission, discharge, and 90-days post-admission.

DMC Detroit Receiving Hospital is also in the process of implementing their Code ICH protocol. Code ICH is like other traditional Code Stroke processes but is specifically developed to focus on ICH patient care and is activated upon positive identification of a brain bleed on imaging. According to Hakemi-King, the introduction of the new protocol at their site has so far seen an increased rate of identification of ICH patients upon admission, a significant reduction in time from door to NICU bed, and improvement in care coordination and efficiency for these patients. Hakemi-King also shared that their site has just submitted their abstract on this research project to AHA for the 2027 International Stroke Conference and will be able to highlight more specific outcomes once the research timeframe has concluded.

Next Steps

Overall, Hakemi-King said the initiative is strengthening care for patients at Detroit Receiving with intracerebral hemorrhage (ICH) across the continuum—from improving ED workflows through Code ICH to conducting 90-day follow-up calls that assess functional outcomes and recovery interventions. The program focuses specifically on patients presenting through the ED, with strong frontline engagement supported by hands-on leadership, staff education, and regular review of performance gaps. Although exact patient volumes are not yet available, recent data suggest a relatively young population with a roughly even male-to-female distribution. For smaller hospitals preparing patients for transfer to a comprehensive stroke program, Hakemi-King emphasized two critical priorities: promptly managing systolic blood pressure to the recommended range and, when possible, initiating anticoagulant reversal before transfer.

05 Aug 2026

CHF COPD MVC Push Reports MVC workgroup pneumonia post-discharge follow-up rural hospitals sepsis

View Post

MVC July Workgroups Highlight Sepsis Discharge Planning in CAHs and MVC’s Follow-Up Push Report

August 5, 2026 | 0 Comments | CHF, COPD, MVC Push Reports, MVC workgroup, pneumonia, post-discharge follow-up, rural hospitals, sepsis

In July, the Michigan Value Collaborative (MVC) hosted two virtual workgroup presentations. The first, a rural health workgroup focused on MyMichigan Health’s system-wide sepsis discharge planning follow-up initiative implementation at critical access hospital (CAH) sites. The second, a post-discharge follow-up workgroup, provided a walk-through of MVC’s recent Follow-Up push report including recommendations on practical applications of the report to identify opportunities for improvement. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including cardiac rehab, post-discharge follow-up, sepsis, rural health, preoperative testing, and health in action.

Rural Health Workgroup: MyMichigan

During MVC’s first workgroup of July, Stephanie Pins-Schallip, MSA, CPHQ, Director of Value Based Care for MyMichigan Health System, shared how their health system developed and implemented a standardized post-discharge follow-up process for patients hospitalized for sepsis. Recognizing the lasting physical and cognitive effects many sepsis patients experience after discharge, Pins-Schallip explained how this initiative was designed to target care transitions, reinforce discharge education, and connect patients with appropriate follow-up care across all MyMichigan Health hospitals. Pins-Schallip also explained how this initiative aimed to drive at both MVC and Michigan Hospital Medicine Safety Consortium (HMS) goals and found ways to benefit sites within the system not engaged with these CQI incentive programs.

Rather than developing separate workflows at each hospital, MyMichigan Health pursued a standardized, system-wide approach. This allowed hospitals of varying sizes, including rural and critical access facilities, to implement consistent practices while also leveraging shared resources. The first step of the initiative was identifying a reliable phone number to provide on discharge paperwork that would connect patients to “on call” Hospitalist providers. By utilizing the health system’s existing 24/7 Transfer Center phone number and nurses already staffing this communication center hub, this minimized the need for additional personnel while also providing patients with a reliable point of contact after leaving the hospital.

Pins-Schallip reviewed a selection of sepsis patient calls to the Transfer Center noting that the volume of calls since initiation of the program have been fewer than five. However, the time between a patient calling and resolution of their question is estimated to be on average less than one hour. To date, patient concerns primarily revolve around antibiotic prescription questions.

Throughout implementation, Pins-Schallip noted that the team emphasized collaboration across departments, including hospitalists, nursing, care management, information technology, and executive leadership. Strong physician engagement and support from MyMichigan’s chief medical officer were instrumental in successfully implementing standardized workflows across the health system. With a relatively recent “go live” for this program of July 2026, Pins-Schallip explained that regular feedback gathered from frontline staff and patient data will allow the team to continue to refine the process over time and adapt workflows based on operational experiences.

During the discussion portion of the workgroup, participants enquired about adapting the workflow for other patient populations, implementation at smaller or independent hospitals, and strategies for gaining physician buy-in. Pins-Schallip encouraged organizations to begin with existing resources whenever possible, noting that many hospitals already have personnel or infrastructure that can be leveraged for post-discharge outreach. The importance of executive sponsorship and continuous evaluation were also identified as key strategies to ensure new workflows remain sustainable and effective.

Post-Discharge Follow-Up Workgroup: MVC Coordinating Center

The second workgroup in July featured a walkthrough of MVC’s new Follow-Up push report, presented by Janet Zhang, MPH, MVC Data Analyst, and Rachel Folk, MHA, MVC Site Engagement Coordinator. Developed to support hospitals interested in further understanding opportunities for improvement, the report provides hospital- and system-level insights into post-discharge follow-up patterns for patients hospitalized with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), pneumonia, and sepsis. The report evaluates patterns of follow-up completed within three, seven, and 14-days after discharge using claims data from Blue Cross Blue Shield of Michigan and the Centers for Medicare & Medicaid Services.

To begin, Zhang reviewed the design of the report outlining how hospitals can use the system-level report to identify variation in follow-up performance across hospitals within the same system. At the system level this report can help leaders recognize opportunities to share successful practices across sites. At the hospital level, the report provides additional context through patient demographic information, non-medical drivers of health, and analyses stratified by payer and follow-up status. Together, these visualizations help members identify where opportunities to optimize follow-up may exist and prioritize improvement efforts.

Next, using a blinded sample report, Folk demonstrated how members can translate their own report findings into actionable quality improvement opportunities. Using the sample blinded report as a template, the remainder of the presentation guided participants through the next steps to finding actionable insights including the identification of areas of opportunity. In this particular report, Folk identified the following areas of opportunity:

Sepsis has the lowest overall follow-up rates at three, seven and 14-days after discharge.
All conditions show lower rates of seven and 14-day follow-up for Medicaid FFS and Dual Eligible payers.
COPD and sepsis patients that attend follow-up within 14-days after discharge have lower 30-day risk-adjusted, price-standardized total episode payments.

As a next step, Folk walked participants through samples of related goal setting and suggested action items for two priority metrics: COPD 7-day follow-up and sepsis 14-day follow-up.

Between COPD and sepsis, the evidence-based action items reviewed included:

Schedule follow-up appointments before discharge
Confirm medication and follow-up provider access prior to discharge
Referral placement for smoking cessation and rehab as indicated
Document and review medical care action plans
Connect high-risk patients to care management follow-up
Flag patients discharged to home without home health as high priority

As part of an interactive discussion, participants were asked to vote on the follow-up intervention they’d most likely implement to drive further discussion.

Throughout the discussion, participants shared experiences and challenges related to improving post-discharge follow-up within their organizations. While several members identified building structured outreach workflows for high-risk patients and scheduling follow-up appointments before discharge as high-priority areas, others discussed practical barriers to these interventions including coordinating care with independent primary care practices, transportation challenges, and difficulty reaching patients by telephone after discharge. Participants also exchanged ideas such as utilizing nurses on light duty to conduct follow-up calls, incorporating virtual and remote monitoring for rural populations, and partnering with home health agencies to reinforce patient education.

The discussion also highlighted opportunities to maximize the value of MVC reports by combining claims data-based insights with internal quality dashboards and other collaborative initiatives. Members expressed continued interest in additional education on integrating MVC reports with other quality improvement efforts and using benchmarking data to communicate opportunities and progress with organizational leadership.

01 Jul 2026

artificial intelligence BMC2 Cardiac Rehab cardiac rehabilitation Michigan Cardiac Rehabilitation Network MiCR MVC workgroup

Off

View Post

MVC June Workgroups Highlight Cardiac Rehab Telehealth & Using AI for Physician Feedback and QI in the ED

July 1, 2026 | Comments Closed | artificial intelligence, BMC2, Cardiac Rehab, cardiac rehabilitation, Michigan Cardiac Rehabilitation Network, MiCR, MVC workgroup

In June, the Michigan Value Collaborative (MVC) hosted two virtual workgroup presentations. The first was a cardiac rehabilitation (CR) workgroup that doubled as a Michigan Cardiac Rehab network (MiCR) telehealth forum focused on virtual group CR programming with a live action demonstration. The second workgroup, health in action, focused on how artificial intelligence (AI) can be utilized to improve follow-up care for patients. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including CR, post-discharge follow-up, sepsis, rural health, preoperative testing, and health in action.

Cardiac Rehab – MiCR Telehealth Forum

MVC and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) co-lead MiCR, an initiative to improve CR utilization across Michigan. In April, MiCR launched a new virtual forum series to help programs implement and sustain telehealth services under recently extended Medicare reimbursement policies. MVC’s June workgroup hosted the second MiCR telehealth forum in the series, this time featuring a demonstration of group virtual CR by Henry Ford Health’s Steven Keteyian, PhD, Director of Cardiac Rehabilitation & Preventive Cardiology, and Robert Berry, MS, ACSM-CEP FAACVPR, Clinical Coordinator for Cardiac Rehabilitation. The demonstration was followed by a discussion led by MiCR’s Co-Directors, Jessica Golbus, MD, MS, and Mike Thompson, PhD, MPH.

Telehealth Group Example

The workgroup began with a live mock CR telehealth session led by Berry and Keteyian. Three actors representing patients (played by MVC’s Jessie Souva, MSN, RN, C-ONQS; Emily Woltmann, PhD, MSW; and Rachel Folk, MHA) were guided through a simulated telehealth group CR session.

After presenter introductions, Berry began the group CR class greeting the patient actors, who each represented a specific patient profile and common cardiac condition (Figure 1).

To begin the session, Berry checked in with each patient on the Zoom session to document the type of exercise or equipment they would be using. As Figure 2 shows, the group session looked similar to a Zoom meeting with all patients exercising simultaneously from locations they established with their instructor in advance. Each patient confirmed their exercise modality, weight, and heart rate as they engaged in their chosen activity. Throughout the exercise process, patients were asked questions about how the exercise was feeling and whether it was causing any pain or discomfort. If a patient was having symptoms, Berry would follow up with more specific questions to help pinpoint the problem area and would give advice for either modifying the exercise, utilizing intentional breathing techniques, or taking a break.

The patients had an opportunity to ask Berry follow-up questions before the end of the session such as:

How will I know when it’s safe to push harder?
Should I continue with CR exercises if my energy level is low today?
When/how do I share my tracked vitals and symptoms with my providers?
How do I get in touch with you between sessions?
Can I still participate in virtual sessions if I’m at my home in Florida?

Following the live demonstration, Golbus and Thompson led participants in a question-and-answer discussion that further clarified how virtual and telehealth CR programs can work. Keteyian and Berry shared that patients must be at their home address for certain payers (Medicare/Medicaid), but patients with other insurance such as Blue Cross Blue Shield of Michigan (BCBSM) can be at any location within the state of Michigan.

Some attendees wondered about confidentiality considerations during the group session. Henry Ford Health said their programming has not required participants to sign an additional Health Information Portability Insurance Portability and Accountability Act (HIPAA) release form; however, they do remind patients to be aware of what information they share in the presence of others during the group session. For people who may be uncomfortable sharing personal information such as weight, different wording can be used. For example, “has your weight changed since your last visit?”

For patients who are unsure about participating in a virtual setting, Keteyian pointed out that they often have the patient come into the facility for the first session to participate as if they were at home in a virtual environment. This often alleviates any concerns about fully participating in a telehealth setting in the future. For those patients who do not have exercise equipment at home, Berry shared that patients can usually find some form of exercise equipment to borrow from a family member, church, or neighbor, or will choose to walk during their session.

A poll of participants showed the current state of CR programming for sites represented at the forum (Figure 3-4), with most sites indicating an interest in exploring both group and individual telehealth CR.

Health in Action Workgroup – Michigan Medicine

MVC was joined by the University of Michigan’s Alexander Janke, MD, MHS, MSc, Assistant Professor of Emergency Medicine, and Florian Schmitzberger, MD, MS, Clinical Assistant Professor of Emergency Medicine, for the health in action workgroup. Their presentation focused on how AI can be used for clinical feedback and quality improvement workflows in various healthcare settings.

Janke shared that emergency clinicians often make high-stakes clinical decisions when treating patients but then have limited feedback on how their patients do as they move through their care pathway. The rapid patient traffic through the emergency department (ED) continuously pulls these providers into new patient cases, preventing them from having the time to manually review past patient charts. A feedback loop project was intended to help address practice variation, missed learning opportunities, and potential quality blind spots. In preparation for the launch of the project, Michigan Medicine sought approval from the institutional review board (IRB), utilized a large language model (LLM) that is HIPAA compliant, and completed a health information technology services review. They also gathered clinical intelligence committee input, Epic database integration support, and input from the division of clinical informatics.

Methods

Previous approaches to reviewing patient progress included manual chart reviews (time consuming), self-imposed reminders via Epic’s in-basket messaging system, or by hearing about a patient’s follow-up by word-of-mouth. With the introduction of AI as a feedback tool, clinicians would have access to LLMs that can read charts faster than a human reviewer, create tailored summaries for the emergency medicine context, and provide another means for learning by supporting clinicians within their limited time. The AI feedback process follows this flow:

Flag the case – A clinician marks a patient of interest during the shift via a health education research (HER)-integrated workflow
Wait – A specified time later—three to 14 days—the platform queries downstream documentation
AI summary – The University of Michigan generative pre-trained transformer (GPT) Toolkit (HIPAA-compliant LLM) generates a tailored clinical summary with a structured prompt
Deliver – An email arrives in the clinician’s institutional inbox and includes a patient identifier for recall, an emergency medicine-focused summary, and answers to any free-text questions
Reflect – The clinician reviews, learns from the outcome, and adjusts future practice enabling the adaptive learning cycle

The process begins with the provider flagging a patient case they would like educational feedback on in the future. Flagging a case is done in the “Disposition View” of the clinician decision tree in Epic (Figure 5). After the waiting period of the patient progressing through levels of care and finally discharging from the hospital, the HIPAA compliant UM GPT will send the provider a summary directly to their institutional email.

Results

Currently the program includes 170+ unique users including faculty, residents, and physician assistants, who are averaging approximately 40 – 70 requests each week, and 30+ power users (a clinical or other staff member who maximizes Epic electronic health record (EHR) efficiency using advanced tools and navigation).

The top three case follow up themes for requested summaries included diagnosis/etiology (~40%), disposition/course/ICU (~17%), and test/imaging results (~10%). With strong approval in the emergency department and endorsement from other committees, the goal is to expand this feedback program to multiple areas within the institution.

Next Steps & Discussion

Janke presented two pathways in which they would like to proceed with expanding the AI feedback program. The first would be horizontal scaling across the institution, including integration into the graduate medical education program for internal medicine/hospitalist care. Second, they would like to apply their approach to a quality measure from the Michigan Emergency Department Improvement Collaborative (MEDIC).

The presenters addressed participant questions about sharing learnings between providers, patient record privacy, and potential applications in other areas like pediatric care and fall prevention, with participants suggesting connections with the Michigan Hospital Medicine Safety Consortium (HMS) metrics and exploring CEUs as incentives for provider participation.

24 Jun 2026

collaborative-wide meeting MiCR MVC Coordinating Center MVC workgroup

Off

View Post

MVC Thanks Presenters from the First Half of 2026

June 24, 2026 | Comments Closed | collaborative-wide meeting, MiCR, MVC Coordinating Center, MVC workgroup

The MVC Coordinating Center wishes to express its heartfelt appreciation for the 39 generous healthcare professionals who stepped forward to present during MVC’s first and second quarter virtual workgroups, spring collaborative-wide meeting, and Michigan Cardiac Rehabilitation network (MiCR) virtual forums on telehealth rehabilitation. The MVC Coordinating Center would not be able to deliver the variety of high-quality educational opportunities without the contribution of these dedicated volunteer presenters. We know that MVC’s members and partners have many demands on their time from within their own organizations and beyond. Nonetheless, these 39 guest speakers shared their data, innovative approaches, best practices, and insights to support our shared goals of peer learning and high-value care delivery for Michigan patients. We appreciate you contributing in this important way. You DO make a difference!

Join us in giving these folks a well-deserved round of applause:

Cardiac Rehab Workgroup

Robert Berry, MS, ACSM-CEP, FAACVPR, Clinical Coordinator Cardiac Rehabilitation, Henry Ford Health Henry Ford Hospital
Zach Johnson, BS, ACSM-CEP, Lead Exercise Physiologist for Cardiac and Pulmonary Rehab Programs, Corewell Health
Steven Keteyian, PhD, Bioscientific Clinical Staff, Division of Cardiovascular Medicine, Henry Ford Health Henry Ford Hospital
Laura Meiste, RN, BSN, Manager of Cardiac and Pulmonary Rehab, Holland Hospital
Greg Scharf, BS, CEP, CCRP, Cardiopulmonary Rehab System Manager, MyMichigan Health
Mike Thompson, PhD, FAHA Associate Professor of Cardiac Surgery, Michigan Medicine
Tyelor Wymer, CEP, BS, Cardiology Supervisor, University of Michigan Health-Sparrow

Health in Action Workgroup

Jennifer Hengy, BSN, RN, Internal Quality Improvement Specialist Sr., Corewell Health Farmington Hills
Alexander Janke, MD, MHS, MSc, Assistant Professor of Emergency Medicine, University of Michigan
Eugene Laveroni, MD, Chief of Surgery, Corewell Health Farmington Hills
Florian Schmitzberger, MD, MS, Clinical Assistant Professor of Emergency Medicine, University of Michigan
Leslie Smith, RPh, JD, BCPS, BCIDP, Clinical Pharmacist Specialist, Corewell Health Farmington Hills

Post-Discharge Follow-Up Workgroup

Steven Frazier, BA, RN, ACM-RN, Director of Quality and Patient Safety Post-Acute, MyMichigan Health System
John Hagan, DO, Medical Director - Care Coordinating Center, MyMichigan Health System

Rural Health Workgroup

Heather Baumeister, BSN, RN, CRHCP, Director of Healthcare Practices, McKenzie Health System

Sepsis Workgroup

Tami Garcia, MSN, RN, Sepsis Process Lead, Michigan Medicine
Carly Redstone, MSN, RN, Sepsis Coordinator, Michigan Medicine

Spring Collaborative-Wide Meeting Panelists

Alex Callaway, MBA, CPHQ, CPPS, Regional Quality Director, Munson Health System
Emily Nerreter, MBA, CPC, CRC, Pay for Performance & Registries Manager, Henry Ford Health System
Stephanie Pins-Schallip, MSA, CPHQ, Director of Value Analysis & Enhancement, MyMichigan Health

Spring Collaborative-Wide Meeting Breakout Session Speakers

Belinda Dokic, CPhT, BA, MBA, Post-Acute Care Manager, Trinity Health Alliance of Michigan
Cindy Ingersoll, RN, BSN, CCM, Post-Acute Care Manager, Trinity Health Alliance of Michigan
Adrien Ross, MSN, RN, CPHQ, Lead, Quality Improvement Specialist, Corewell Health
Heidi Steinhebel, RN, BSN, CCM, Senior Associate Director of Care Management, Trinity Health IHA Medical Group
Caitlin Valley, MHA, MPH, CHES, Director of Quality and Population Health, Trinity Health IHA Medical Group
Larrea Young, MDes, Multimedia Design Project Manager, Healthy Behavior Optimization for Michigan

Spring Collaborative-Wide Meeting Poster Presenters

Jennifer Bennett, MBA, BSN, RN, Lead Quality and Patient Safety Coordinator, Henry Ford Health Madison Heights-Warren Hospital
Sara Hagerman, BSN, RN, Community Hospital Quality Lead, University of Michigan Health – Sparrow Carson
Ginger Johnson, OTR, Manager Post-Acute Care, Populance, Henry Ford Health System
Mike Johnson, Primary Care Practice Administrator, Munson Healthcare East Region
Liz Monk, System Director of Patient Care Manager, Munson Healthcare
Gloria Rey, PA-C, MPH, Director Post-Acute Care, Populance, Henry Ford Health System
Audra Stoker, PMP, Manager Post-Acute Care Network Development, Populance, Henry Ford Health System

Virtual Networking Event

Richard Wylde, MSc, Deputy Director of Improvement at Leeds and York Partnership NHS Foundation Trust

MiCR Virtual Forums on Telehealth Cardiac Rehabilitation

Robert Berry, MS, ACSM-CEP FAACVPR, Clinical Coordinator of Cardiac Rehabilitation, Henry Ford Health
Samantha Fink, BS, Administrative Manager, Domino’s Farms Cardiology, Michigan Medicine
Steven J. Keteyian, PhD, Bioscientific Clinical Staff, Division of Cardiovascular Medicine, Henry Ford Hospital
Diane Perry, MS, ACSM-CCEP, CHWC, Certified Clinical Exercise Physiologist, Michigan Medicine
Kat Steenson, MS, Clinical Exercise Physiologist, Henry Ford Health

As a reminder, past workgroups and virtual networking event recordings can be viewed on MVC’s YouTube channel, and presentation slides and materials from MVC’s spring collaborative-wide meeting can be viewed here.

Do you have valuable information to share?

Whether you are new to presenting or a seasoned pro, the MVC Coordinating Center is here to support you every step of the way. From exploring topic ideas to preparing information and managing event logistics, our team makes the experience of presenting easy and comfortable. The P4P points you can earn as a presenter are a great benefit to your organization, too. For more information about presenting, contact the MVC Coordinating Center or submit a proposal here.

03 Jun 2026

Michigan Value Collaborative MVC workgroup sepsis

Off

View Post

May Workgroup Highlights Building and Sustaining a Systemwide Sepsis Team

June 3, 2026 | Comments Closed | Michigan Value Collaborative, MVC workgroup, sepsis

In May, the Michigan Value Collaborative (MVC) hosted a virtual sepsis workgroup featuring a presentation on the evolution of Michigan Medicine’s enterprise-wide sepsis initiative and the lessons learned while building a sustainable, multidisciplinary sepsis program. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Sepsis Workgroup – Michigan Medicine

Sepsis remains one of the leading drivers of mortality across healthcare systems, including Michigan Medicine. When sepsis can be treated, this not only reduces patient mortality, but also length of stay, readmissions, morbidities, and overall health of patients, so it comes as no surprise that Michigan Medicine recognized the need to make modifications to their current approach to sepsis management. Presenter Tami Garcia, MSN, RN, Sepsis Team Manager at Michigan Medicine explained how they began by moving away from siloed approaches to care. Early efforts focused on understanding existing workflows across Michigan Medicine’s enterprise and identifying inconsistencies in sepsis care. This included the recognition, escalation, and treatment of sepsis across adult, maternal, emergency and inpatient care settings.

While the team had a foundation set up with dashboards and procedural guides for screening, there had never been a team dedicated to ensuring consistent sepsis care across the system. Rather than immediately deploy new tools or mandates, this new team prioritized “Gemba walking” to meet providers where they work to better understand barriers, workflows, and frontline realities. As Garcia explained, “we need to build changes with our staff, not to our staff.” Garcia credited this approach to helping the sepsis team identify opportunities to standardize care while also building trust with bedside clinicians.

Building Trust as a Quality Improvement Strategy

A major theme throughout Garcia’s presentation was the importance of developing trust in quality improvement work. She emphasized that credibility and relationships became foundational to the success of this sepsis initiative. In addition to Gemba walking, the team focused on:

Maintaining a visible unit presence
Responding quickly to staff concerns
Closing communication loops
Listening to frontline staff frustrations
Incorporating clinician feedback into workflow design

One notable outcome of this approach involved the reduction in excessive Epic alerts that historically contributed to alarm fatigue among nursing staff. Rather than dismissing the concerns, the team partnered with clinicians and informatics specialists to reduce unnecessary alerts and improve usability. This example is related to just one of the four main lessons learned by the sepsis team:

Trust-building is a deliverable
Tools must fit a workflow, otherwise they become workarounds
Sustainment requires ownership
Reducing burden (e.g., alarms) is improvement, not compromise

Standardizing Sepsis Recognition and Response

Following this period of learning and trust-building, the Michigan Medicine sepsis team began implementing a series of targeted interventions designed to improve reliability and timeliness of care.

Some key initiatives included:

Re-establishing multidisciplinary sepsis huddles in the adult emergency department
Enhancing Epic tools and workflows (adult, pediatric, etc.)
Launching maternal sepsis screening and nurse-initiated patient care orders
Implementing non-invasive fluid responsiveness technology in ICUs
Establishing nurse sepsis champions and physician ambassador programs
Creating neonatal sepsis response workflows in the NICU

Garcia highlighted the adult emergency department sepsis huddles as one of the team’s most impactful initiatives. The huddles bring nurses and providers together immediately after a positive sepsis screen to rapidly determine next steps and initiate treatment plans. This converts concern into coordinated action and normalizes escalation. Combined with streamlined order workflows and decision-support tools, timeliness of care and collaboration between disciplines have been improved.

Measurable Improvements in Sepsis Outcomes

Measurable improvements in both process and outcome measures since the formation of the dedicated sepsis team in 2022 were then reviewed. The reported improvements included:

Adult emergency department SEP-1 bundle compliance increased from approximately 50% in 2022 to almost 80% in 2026
Severe sepsis and septic shock mortality rates decreased from 26.2% in 2022 to 20.1% in 2025
Maternal sepsis screening rates exceeded 90% for OB triage and 78% for inpatient screens
Pediatric sepsis alert burden was reduced significantly from over 35,000 OPA’s in 2022 to just under 20,000 in 2025
Reduced the frequency of first antibiotic administration in neonatal populations at >120 minutes from over 40% to under 15% between the beginning and end of 2025

Garcia repeatedly credited frontline teams for these successes, emphasizing that sustained improvement depended on empowering all team members, especially clinicians, rather than relying solely on centralized oversight.

Expanding Frontline Ownership Through Sepsis Champions

One of the most promising developments discussed was the creation of the RN Sepsis Champion Program. Nurses serving as sepsis champions support local reliability, providing peer-to-peer education, reinforcing workflows, and helping to disseminate best practices within their units. Garcia described how this program has expanded rapidly across the Michigan Medicine organization and has already demonstrated improvements to bundle compliance and mortality outcomes in pilot units. Champions are especially important given high turnover rates and shifting operational pressures in healthcare. With monthly meetings, shared educational resources, and ongoing collaboration, champions help maintain momentum and create local ownership of sepsis improvement efforts.

Looking ahead, Michigan Medicine plans to sustain workflows, expand sepsis huddles, and strengthen support for sepsis champions and physician ambassadors. Garcia closed the presentation by reinforcing that successful sepsis improvement, or perhaps any quality improvement initiative, depends on partnership, humility, and continuous learning. As Garcia explained, “We really want to continue to partner with our teams to make sure they understand why we’re here, that they trust we’re here for the best of everybody -them and their patients.”

22 Apr 2026

MVC Coordinating Center MVC registry MVC workgroup preoperative testing quality improvement

Off

View Post

April Workgroup Features Preoperative Testing Multipayer Report Registry Demonstration

April 22, 2026 | Comments Closed | MVC Coordinating Center, MVC registry, MVC workgroup, preoperative testing, quality improvement

In April, the Michigan Value Collaborative (MVC) hosted a virtual preoperative testing workgroup featuring a presentation by the MVC Coordinating Center focused on utilizing MVC’s multi-payer preoperative testing registry reports. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Preoperative Testing Workgroup – MVC Coordinating Center

The MVC registry includes many different reports for members to utilize when investigating various conditions, procedures, and outcomes. One of the more recent additions includes the preoperative testing reports which include claims data from multiple payers in one location. Reports that were highlighted in the preoperative testing workgroup included the preoperative testing table report, preoperative testing trends report, and preoperative testing utilization rankings report.

Each report offers members multiple filters to modify the data shown including episode start dates, payer selection, specific conditions (or the option to choose all), several common preoperative tests, such as blood tests, cardiac tests, chest x-ray, electrocardiography (EKG), pulmonary function tests, and urinalysis, and patient demographics (age, gender, race/ethnicity, comorbidities).

MVC Site Engagement Coordinator and workgroup presenter Emily Bair, MS, MPH, RDN, introduced the workgroup by sharing a preoperative testing utilization trend graph that included data on all MVC members and all available payers. The graph demonstrated that since the implementation of the preoperative testing value-based initiative in 2020, MVC members have seen a 6% decrease in unnecessary preoperative testing utilization for specific low-risk procedures. Based on available claims data, preop testing rates across the collaborative have declined from approximately 44% to 38% since 2022.

MVC’s preoperative testing measure definition includes the following:

Numerator: episodes of care where preoperative testing (e.g., urinalysis, pulmonary function, chest x-ray, electrocardiography, certain blood tests, and certain cardiac tests) occurred in the 30 days prior to MVC-defined low-risk laparoscopic cholecystectomy, inguinal hernia repair, and lumpectomy procedures.
Denominator: Elective and outpatient MVC-defined cholecystectomy, inguinal hernia repair and lumpectomy episodes with length of stay between 0 – 2 days.

The preoperative testing initiative, known as the RITE-Size initiative, has been an ongoing collaborative effort between MVC, the Michigan Surgical Quality Collaborative (MSQC), Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE), and the Michigan Program on Value Enhancement (MPrOVE). MVC and MSQC data registries were updated with preoperative testing metrics to improve visibility for members, give access to diverse data, and offer unique customization tools for preoperative testing reports. The MVC engagement team has an ongoing effort to engage and educate members on all of the resources available to them through our registry and data reports. To learn more about attendee usage of MVC data, Bair polled participants to assess whether they had accessed the preoperative testing reports, and if so, whether they used the data in any quality improvement (QI) efforts at their site or system (Figures 1 and 2).

The polling discussion revealed that while many attendees had registry access, 44% had not utilized these multi-payer reports for quality improvement work. Those that did utilize the reports (23%) shared that they use them for efforts such as system-level benchmarking across their hospitals.

Following the polling results, Bair shared unblinded data from Bronson Health System’s MVC multi-payer registry reports and MVC common conditions push report, covering how differing case counts can impact preoperative testing rate performance, especially when looking at conditions separately. Case volume is a common concern for smaller hospitals, such as critical access sites, when trying to extrapolate useful claims data. As larger health systems are acquiring smaller hospitals like critical access sites, though, they may need to shift how the data can and should be interpreted. Using yearly trending can increase the denominator for case data and give a more accurate visual representation of utilization or performance over time, whereas looking at data on a monthly or quarterly timeframe can show volatility due to case counts having high variability over short time ranges.

MVC welcomes workgroup presenters from across Michigan to share their expertise, success stories, initiatives, and solution-focused ideas with MVC members. Please reach out to us by email if you are interested in being a workgroup presenter or submit an online presentation proposal.

27 Mar 2026

CAH Chronic Disease Management critical access hospitals MVC workgroup PCP RPM rural health Transitions of Care

Off

View Post

March Workgroups Highlight Rural Remote Patient Monitoring and Post-Discharge Follow-Up Innovations

March 27, 2026 | Comments Closed | CAH, Chronic Disease Management, critical access hospitals, MVC workgroup, PCP, RPM, rural health, Transitions of Care

In March, the Michigan Value Collaborative (MVC) hosted two workgroups highlighting innovative strategies to improve care transitions and expand access to care across Michigan. A rural health workgroup explored how McKenzie Health System implemented remote patient monitoring to support patients with chronic conditions. MVC’s post-discharge follow-up workgroup featured a presentation from MyMichigan Health on the development of a continuing care clinic designed to improve post-discharge follow-up and reduce hospital readmissions.

Together, these presentations demonstrated how healthcare organizations can leverage care coordination, technology, and new care delivery models to improve patient outcomes across the continuum of care. The MVC Coordinating Center hosts one to two workgroup presentations per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Rural Health Workgroup – McKenzie Remote Patient Monitoring

The first workgroup of the month featured a presentation led by Heather Baumeister, BSN, RN, CRHCP, Director of Healthcare Practices at McKenzie Health System, who shared how her organization implemented a remote patient monitoring (RPM) program to better support patients living in rural communities.

McKenzie Health System includes a 25-bed critical access hospital (CAH) located in Sandusky, Michigan. The organization also operates six primary care clinics across multiple communities throughout the Thumb region offering several specialty services such as gastroenterology, orthopedic care, general surgery, and behavioral health. Like many rural health systems, McKenzie serves a geographically dispersed patient population where travel distance and limited healthcare resources can make frequent in-person visits difficult. To help bridge these gaps, Baumeister said, the organization relies heavily on care coordination.

McKenzie currently employs three full-time and one part-time registered nurse care coordinators who support primary care clinics across the system. Baumeister described how these coordinators conduct daily follow-ups with patients seen in the emergency department and help connect patients without an established primary care provider to appropriate outpatient care. Care coordinators also participate in monthly readmission review meetings to identify patients who may benefit from additional care management services and reduce avoidable hospitalizations.

Launching a Remote Patient Monitoring Program

To expand its ability to monitor patients between visits, McKenzie Health System participated in an 18-month pilot program focused on RPM for rural health systems. After completing the pilot, McKenzie established a long-term partnership with an RPM vendor to manage several operational aspects of McKenzie’s RPM program, including device shipping, monitoring, nurse outreach for readings outside clinical thresholds, uploading data into the electronic health record (EHR), and billing services. Baumeister said this helped clinicians at McKenzie to integrate RPM into their care model without needing to manage the technical infrastructure internally.

Providers refer patients to the program through the organization’s EHR. After receiving a referral, the RPM vendor enrolls the patient and distributes the appropriate monitoring devices. Patients enrolled in the program receive connected monitoring devices that automatically transmit readings directly to the monitoring platform after patients begin taking measurements. Devices currently used include blood pressure cuffs, weight scales, blood glucose monitors, and pulse oximeters. If readings fall outside predetermined ranges, a monitoring nurse contacts the patient to assess symptoms and determine whether clinical intervention is needed. If necessary, the nurse escalates the case to the patient’s provider according to established care protocols.

Implementing the program in a rural context presented several challenges. Baumeister described how unreliable internet near Michigan’s lakeshore, difficulty reaching patients by phone, and excessive measurement were challenges in delivering the program.

Benefits of RPM Program

Baumeister said the RPM program is particularly beneficial for patients managing chronic conditions like congestive heart failure, diabetes, hypertension, chronic obstructive pulmonary disease, and obesity. This is because remote monitoring enables care teams to detect early warning signs of health deterioration that might otherwise go unnoticed between routine visits so providers can intervene proactively. Baumeister gave examples such as adjusting medications, scheduling follow-up appointments, or providing additional education before conditions worsen.

She also noted that many patients became more engaged in their own care through the program, as regular monitoring helped them better understand how lifestyle choices affect their health. View the complete workgroup recording using the video below.

Post-Discharge Follow-Up Workgroup – MyMichigan Health Continuing Care Clinic

MVC’s second March workgroup featured a presentation by Steven Frazier, MHA, BA, RN, ACM-RN, Director of Quality and Patient Safety for Post-Acute Services at MyMichigan Health, and Dr. John Hagan, DO, Family Medicine Physician and Medical Director of the Continuing Care Clinic at MyMichigan Health. Their presentation highlighted the MyMichigan Health Continuing Care Clinic (CCC), a program designed to ensure patients receive timely follow-up care after hospitalization and to reduce hospital readmissions. Frazier previously presented about the establishment of the CCC program at MVC’s May 2024 collaborative-wide meeting, and this month provided a number of updates on progress in the program to date.

MyMichigan Health serves more than one million Michigan residents across a 26-county region, with multiple medical centers and roughly 1,100 hospital beds. Despite this extensive network, MyMichigan recognized that many patients faced barriers to obtaining timely follow-up care after leaving the hospital, citing limited appointment availability with primary care providers as well as patients without established providers struggling to navigate the healthcare system.

Frazier and Hagan said internal MyMichigan data revealed hospital readmissions were often occurring 12-13 days after discharge, highlighting a critical window when follow-up care could potentially prevent complications. Research also suggested that follow-up with a physician within seven days of discharge could significantly reduce both readmission and mortality risk for patients hospitalized with conditions such as heart failure, myocardial infarction, and COPD.

Launching and Evolving the Continuing Care Clinic

To address these gaps in care, MyMichigan Health opened the CCC in Midland, Michigan in August 2023. The clinic now operates with two locations (Midland and Alma) and three providers, supported by a multidisciplinary care team. The clinic was designed to function as a transitional care bridge, ensuring patients receive follow-up care within seven days after discharge while they wait to reconnect with their primary care providers. Services currently range from follow-up visits and assistance with establishing a primary care provider to behavioral health support and advance care planning.

Since its launch, the clinic’s role has expanded beyond its original focus on hospital discharge visits to support patients who are transitioning between primary care providers, are new to the community’s providers, need additional support navigating the healthcare system, or are seeking follow-up after emergency or urgent care visits. This evolution has allowed the clinic to function as a comprehensive transitions-of-care hub within the MyMichigan Health system.

Early Results and Impact

According to Frazier and Hagan, the CCC has already demonstrated encouraging results, saying that the program helped the health system achieve lower readmission rates compared to peers and maintain short scheduling lead times for follow-up appointments. Additionally, MyMichigan has seen an improvement in operational efficiency and budget performance with the expansion of services to additional geographic regions within the system. The program has also helped bring new patients to the MyMichigan Health network by connecting individuals without primary care providers with internal ongoing care relationships.

Patient feedback has been an important indicator of the clinic’s success, the presenters noted. Patient testimonials were shared during the presentation that emphasized how the clinic helped patients better understand their diagnoses, feel supported during recovery, and access care more easily after discharge. Patients described the clinic as a valuable resource that provided compassionate care and guidance during a vulnerable time in their healthcare journey. View the complete workgroup recording using the video below.

Key Takeaways for MVC Members

The March workgroups highlighted two practical approaches to improving patient outcomes across the care continuum, with several key themes emerging. For one, remote patient monitoring is expanding access to care by helping teams identify early warning signs and better manage chronic conditions—especially in rural communities. At the same time, dedicated transition clinics are strengthening post-discharge care by ensuring timely follow-up and support after hospitalization.

Across both models, strong care coordination remains essential, supported by multidisciplinary teams, clear communication, and sometimes newer technologies. Just as important, patient engagement continues to drive better outcomes by empowering individuals to take a more active role in their care.

Through these shared examples, MVC workgroups continued to support collaboration and help organizations across Michigan identify actionable strategies to improve quality, outcomes, and value. If you are interested in pursuing a healthcare quality improvement project, MVC has data specialists available to help you navigate our data resources and create custom analytics reports to support your efforts. Please reach out to us by email [LINK] if you would like to learn more about MVC data, engagement offerings, or would like to present at a future MVC workgroup.

Archive

Cardiac Rehab Workgroup: MVC’s Refreshed Cardiac Rehab Push Report

Figure 1. Slide highlighting Table 1 patient characteristic data from September 2026 cardiac rehab push reports

Figure 2. Cardiac Rehab Adherence and Completion Rates at Centers Across Michigan

MVC Cardiac Rehab Workgroup: Oct. 20, 2026

Sepsis Workgroup: McLaren Flint Hospital

Figure 1. McLaren Flint’s PDCA Cycle Approach to Sepsis Improvement

Figure 2. McLaren Flint’s Sepsis Performance Over the Past 2 Years

Figure 3. McLaren Flint’s Sepsis Checklist for Emergency Room (ER) Staff

MVC Sepsis Workgroup: Sept. 15, 2026

Preoperative Testing Workgroup: Henry Ford Health Genesys

Figure 1. Preoperative Testing Rates for Outpatient Laparoscopic Cholecystectomy, Inguinal Hernia Repair, and Lumpectomy in the 30 Days Prior to Admission at Henry Ford Genesys, 2023-2025 by Half-Year, All Payers

MVC Preoperative Testing Workgroup: Aug. 11, 2026

Health in Action Workgroup: DMC Detroit Receiving Hospital

Figure 2. DMC Detroit Receiving Hospital’s Integration of the ICH Initiative into Clinical Practice

Figure 3. ICH Metrics and Measures

MVC Health in Action Workgroup: Aug. 27, 2026

Rural Health Workgroup: MyMichigan

Figure 1. Process for 24/7 Transfer Center Calls

MVC Rural Health Workgroup: July 14, 2026

Post-Discharge Follow-Up Workgroup: MVC Coordinating Center

Figure 2. MVC Follow-Up Push Report Details

Figure 3. Screenshot of Follow-Up Intervention Interactive Discussion

MVC Post-Discharge Follow-Up Workgroup: July 23, 2026

Cardiac Rehab – MiCR Telehealth Forum

Figure 1. Patient Profiles for Cardiac Rehabilitation Mock Session

Figure 2. Screenshot of Mock Telehealth CR Session

Figure 3. Polling Question: What format of virtual CR is your site considering?

Figure 4. Polling Question: What best describes your site's status on starting a virtual CR program?

MiCR Telehealth Virtual Forum: June 9, 2026

Health in Action Workgroup – Michigan Medicine

Figure 5. Disposition View in Epic MyChart

Figure 6. Structured Validation of 200 AI-Generated Case Summaries

MVC Health in Action Workgroup: June 25, 2026

Sepsis Workgroup – Michigan Medicine

Figure 1. Michigan Medicine’s Sepsis Team Standard Work and Governance Framework

Figure 2. Michigan Medicine’s ER Workflow and Sepsis Huddle Process Map

MVC Sepsis Workgroup: May 21, 2026

Preoperative Testing Workgroup – MVC Coordinating Center

Figure 1. Poll: Have You Accessed MVC’s Multi-payer Reports?

Figure 2. Poll: Have You Used MVC’s Multi-payer Reports to Support QI?

Rural Health Workgroup – McKenzie Remote Patient Monitoring

Launching a Remote Patient Monitoring Program

Benefits of RPM Program

MVC Rural Health Workgroup: March 3, 2026

Post-Discharge Follow-Up Workgroup – MyMichigan Health Continuing Care Clinic

Launching and Evolving the Continuing Care Clinic

Early Results and Impact

MVC Post-Discharge Follow-Up Workgroup: Mar. 19, 2026

Key Takeaways for MVC Members

Subscribe to our blog!

Search

Contact Us

Mission

Website Accessibility Statement