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MHA Keystone

doctor and patientThe Michigan Health and Hospital Association’s (MHA) Keystone Center for Patient Safety and Quality was created in March 2003 as a division of the MHA Health Foundation. The center was created in response to growing concern about patient safety and health care quality, and in recognition of the willingness of Michigan hospitals to collaborate to improve care.

MHA Keystone exists to improve patient safety and the quality of health care delivery through the application of science and implementation of best-practice evidence to save lives and reduce costs. The MHA Keystone Center accomplishes this through partnerships with patient safety experts, such as Johns Hopkins University. MHA Keystone is unique in its ability to bring a large number of hospitals together in a single improvement initiative. Through MHA Keystone, Michigan hospitals are gaining national prominence for their willingness to collaborate and effectively improve patient safety and quality of care.

Garden City Hospital is actively involved in the following Keystone Collaboratives:

  • Intensive Care Unit (ICU)
  • Hospital Associated Infection (HAI)
  • Surgery
  • Obstetrics (OB)
  • Emergency Room (ER)

Intensive Care Unit (ICU) - Initiated 2003MHA Keystone: ICU aims to reduce central line-associated bloodstream infections (CLABSI) and ventilator associated pneumonias that occur in ICU patients. This collaborative was selected first because the federal Centers for Disease Control and Prevention estimate that there are more than 200,000 CLABSI cases in the United States each year, which lead to longer hospital stays, increased health care costs and a greater risk of patient death.

To date, MHA Keystone: ICU remains the largest regional partnership of ICUs ever assembled in a single patient safety initiative. Efforts are currently under way to develop and implement processes to significantly reduce sepsis (blood poisoning) deaths. Because hyperglycemia, commonly known as high blood sugar, is common in ICU patients, this has also recently been added as an area of focus. In 2011, we began an initiative to reduce sepsis.

MHA Keystone: HAI - Initiated 2007MHA Keystone: HAI focuses on appropriate hand hygiene, reducing catheter-associated urinary tract infection (CA-UTI) and avoiding CLABSIs. The measures include appropriate use of alcohol-based hand rubs, appropriate use of gloves, and timely removal of nonessential catheters.

Surgery - Initiated 2008MHA Keystone: Surgeryhas set goals which include eliminating surgical-site infections, preventing mislabeling of specimens, preventing defects in care (including serious adverse events such as wrong-site surgery and retained foreign objects), and improving/reinforcing the culture of safety. Collaborative interventions focus on methods to improve communication among the surgical team. Briefings are conducted before surgery to confirm that the correct patient is in the operating room, to verify the surgical site, to ensure the proper equipment is accessible and to outline possible complications. Debriefings are conducted by the surgical team immediately following the procedure to identify defects and to discuss the patient’s future needs, ensuring a smooth transition to postoperative care.

Obstetrics (OB) - Initiated 2010MHA Keystone: OB seeks to prevent harm to mothers giving birth and their newborn babies. This collaborative primarily focuses on timely interventions for elective induction of labor, coordinating a safe progression of labor, and appropriate responses to fetal issues. The interventions include improving patient safety through influencing attitudes and practices.

Emergency Room (ER) - Initiated 2010MHA Keystone: ER focuses on preventing patient harm in hospital emergency rooms by improving safety, reducing overcrowding, and treating sepsis (blood poisoning) in the early stages. This initiative helps ensure that the most critically ill patients receive treatment first and reduces the likelihood that a patient will leave a hospital before receiving appropriate care. In 2011, we began an initiative to reduce sepsis.