Recognizing Advancements in Cardiovascular Patient Safety and Quality in Michigan

Debbie Reinheimer

| 4 min read

If you have received heart care in Michigan over the last two decades, it is highly likely your care has been positively influenced by BMC2, an internationally recognized statewide consortium of 39 Michigan hospitals and nearly 700 physicians. This unique consortium – funded by Blue Cross Blue Shield of Michigan – turns competitors into collaborators who collect and share data and then develop and implement best practices that improve quality and outcomes for patients statewide.
In fact, BMC2 annually impacts approximately 30,000 Michigan patients who have angioplasties, vascular surgeries or valve surgeries, and those who undergo cardiac rehabilitation after their procedure. Over the years, BMC2 participants have experienced increased safety through reductions in surgical site infections, kidney injury, bleeding and vascular complications, among others. BMC2 efforts have also resulted in a lower risk of patients’ readmission and death.

Prestigious national recognition

For major achievements in healthcare quality, The Joint Commission and National Quality Forum (NQF) recognized BMC2 with the 2023 John M. Eisenberg Patient Safety and Quality Award at the local level.
The Eisenberg Awards recognize groundbreaking initiatives that are consistent with the aims of the National Quality Strategy: better care, healthy people and communities, and smarter spending. The achievements of each recipient represent initiatives that healthcare providers and leaders at every level can learn from to improve care for patients.
BMC2 is recognized for its remarkable improvements in the documentation of radiation use, a decrease in high-dose radiation exposure, and opioid pill prescribing rates.

Ensuring radiation safety

To help physicians see where to guide the wires during a cardiac catheterization procedure, they often use a technique called fluoroscopy which uses radiation. Exposure to radiation can increase the risk of developing cancer.
Participants in BMC2 have developed recommendations for ways to reduce patient and staff exposure to harmful high-dose radiation. As a result, BMC2 sites achieved an overall 43% decrease in cases with high-dose radiation exposure.

Lowering opioid use

BMC2 participants have successfully reduced the number of opioid pills they prescribe to their patients who receive vascular surgery. Prescribing the most appropriate amount of opioids helps prevent patients from developing new, persistent opioid use which is a common complication after surgery. It also helps to keep excess, unused prescriptions out of the community where they can be used inappropriately.
BMC2 data showed improvement in the rate of patients with a prescription of less than 10 opioid pills by approximately 30% between 2018 (62%) and 2021 (91%).

Getting critical patient input

Physicians and other participants in BMC2 formed a Patient Advisory Council in 2021, and this has enabled them to gain insight into the patient experience that guides and shapes the work BMC2 does as a consortium. Work with the Patient Advisory Council has led to many helpful resources including:
  • Development of the Michigan Cardiac Rehabilitation (MiCR) Best Practices Toolkit
  • Creation of a risk-prediction tool to facilitate shared decision-making among patients, providers, and caregivers
  • Improved, streamlined, and user-friendly percutaneous coronary intervention (PCI) discharge instructions
  • Patient-facing materials
  • New resources to encourage patient participation in cardiac rehabilitation

More than 25 years of quality collaboration

Blue Cross Blue Shield of Michigan launched BMC2 in 1997 with five Michigan hospitals in a collaborative effort to improve quality, cost and outcomes of angioplasty procedures. Since then, the consortium has grown to include every non-federal hospital in the state that performs coronary angioplasty. The initial successes seen in BMC2 inspired Blue Cross Blue Shield of Michigan to launch more than 20 additional statewide collaborative quality initiatives, each one focusing on a common and costly medical or surgical area that needs improvement.
“Through the innovative, cooperative structure of the BMC2 CQI, participants have generated scientific learnings and best practices that have contributed significantly to the international evidence base for high quality cardiac care,” said James Grant, M.D., senior vice president and chief medical officer at Blue Cross Blue Shield of Michigan. “BMC2 success has been the pacesetter for all other CQIs, and we couldn’t be prouder.”
The Eisenberg Award panel was impressed by BMC2’s dissemination of its work. BMC2 data has supported more than 100 publications in peer-reviewed medical journals and more than 100 presentations at national and international conferences.
The panel noted that this kind of collaborative, best-practice approach improved outcomes, reduced costs, and could be replicated by other states. The panel was inspired by BMC2’s inclusive scope across so many clinicians, physicians, teams, and sites, acknowledging the collaborative is “working to improve care, at every institution, and for every patient. It's remarkable.”
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association