Our Team
2022 Michigan Sites
Welcome
● Alpena
● Clare
● Gladwin
● Gratiot
● West Branch
● Carson
● Clinton
● Eaton
● Ionia
Upcoming
Events
Friday, April 15, 2022
Anesthesiology Clinical Quality Reviewer (ACQR)
Virtual Retreat
Friday, July 15, 2022
ASPIRE Collaborative Meeting (in-person)
Henry Executive Center, Michigan State University
East Lansing, Michigan
Friday, September 16, 2022
ACQR Retreat (in-person)
DoubleTree Hotel
Ann Arbor, Michigan
Friday, October 21, 2022
MPOG Retreat (hybrid)
New Orleans, Louisiana
2022 Calendar is
available at
mpog.org/calendar/
Themes
Cognition
How does surgery affect cognition? Dr. Whitlock
How often do we assess cognition in
the immediate pre-operative period?
Dr. Abess and team,
MPOG research
project
Are we adequately assessing delirium
post-operatively?
Dr. Vlisides
How can ASPIRE assess geriatric
anesthetic quality?
MPOG geriatric
anesthesia
workgroup
Improved
feedback
Does a more targeted message in the provider
feedback email improve measure compliance?
Principal Investigator - Zach Landis Lewis PhD
~Year 1 - Interviewing providers about the their
preferences for feedback and building a
“pipeline” from/to ASPIRE provider feedback
emails
~Year 2 and 3 - Conducting a trial with control
(existing emails) and intervention (updated) emails
~Year 4 - disseminating results
Population
Health
Environmentally sustainability - how can anesthesia
providers play a role in reducing greenhouse gas
emissions, while potentially reducing costs?
Smoking cessation and counseling - how can anesthesia
providers use the “teachable moment” of a surgical
procedure to help patients reduce smoking across the
state of Michigan
Afternoon session
If you do not have one, obtain at the
registration table. You’ll need it to enter the
auditorium.
If you are attending the ASPIRE afternoon
performance review session, please fill out a
confidentiality agreement.
Thank you
April 8, 2022
Quarterly Collaborative
Meeting
Englesbe Disclosures
Work at UofM
Salary support several State,
Federal, and BCBSM sources
Equity stakeholder in Eubu
Health and Perioptions LLC
MSQC Executive Committee – Thank You
• Michael Malian and Lisa Rosario – Beaumont Dearborn
• Jeff Gerken and Barb Nishimiya – Beaumont Farmington Hills
• Rupen Shah and Jacki Machnacki – Henry Ford Hospital
• Perjohan Persson and Chris Narr – McLaren Central Michigan
• Carl Pesta and Angela Dunn – McLaren McComb
• Joel Strehl and Penny Hawkins – Munson
• Amanda Yang and Jennifer Helander – Spectrum Health Butterworth
• James Clancy and Connie Kelly – Spectrum Health Lakeland
• Jennifer Kulick and Paula Dorr – St. Joseph Mercy Chelsea
QI initiative 2016
Baseline
Rate (2016)
Current
Rate
(2021 to date)
Target Rate
Reduce Morbidity Rates (all
procedures)
10.9% 7.5% 9%
Reduce Sepsis Rates (all
procedures)
2.58% 2.89% 2%
Reduce Readmissions (all
procedures)
6.5% 5.8% 5.8%
Reduce ED Visits (all procedures) 8.4% 7.1% 7.3%
Reduce LOS (all procedures) 3.2 days 2.9 days 4.2 days
Reduce Opioid Prescribing 193 OME (2017) 72 OME <180 OME
Improving Colorectal Cancer
Surgery:
• Positive margin
• TME Grade
• 6.2%
• 7.0%
• 4.81%
• 89.8%
• <2%
• 100%
What’s the problem we’re trying to solve?
● The Achilles heel of hernia QI is that there is NO information about really
important hernia details
○ How big is the hernia?
○ Was mesh used?
○ What kind of mesh?
● These are crucial to improving outcomes and standardizing practice
We’ve identified variation in mesh use
We’ve identified sex-based disparities in hernia care
● Women less likely to have
mesh placed and more likely
to experience complications
● Risk of complications actually
increases with hernia size for
women but not for men
● What is driving these
differences?
Explaining Variation in Surgical Outcomes
OPTIMIZE THE
PATIENT
NOT OPERATE ON
PATIENT
FOCUSING ON HERNIA REPAIR APPROPRIATENESS
● We know that patients with
severe obesity have worse
outcomes
● Last year we launched a P4P
to encourage nonoperative
management of patients with
severe obesity and hernias
HAVE LESS
UNHEALTHY
PATIENTS
HAVE LESS
UNHEALTHY
PATIENTS
Tobacco is the single greatest
preventable cause of disease and
premature death in America
today.
MSHIELD is a bridge between Michigan health
systems and our patients’ local communities.
HEALTH SYSTEM COMMUNITIES
DATA
SERVICES
MSQC Elective Procedures 2016 - 2021
We’ve identified sex-based disparities in hernia care
● Women less likely to have
mesh placed and more likely
to experience complications
● Risk of complications actually
increases with hernia size for
women but not for men
● What is driving these
differences?
Surgeon Engagement
