Thanks to all who attended our March meetings. Did you miss a meeting or do you need a refresher? Read our summaries.
The PCI Coordinator Meeting was held on March 10th from 10 am – 11 am. Amy Shirato welcomed all to the meeting and introduced Dr. Devraj Sukul who reviewed the clinical features of a few of the outcomes collected by BMC2 PCI that can occur during a percutaneous coronary intervention procedure. The complications reviewed were acute closure, no reflow, side branch occlusion and distal embolization.
Sue Vasquez and Mari Lee Crandell shared how their networking, and shared learning, led to improved peak ACT documentation for McLaren Bay Region. You can read their story on our blog. Participants of the meeting were moved to break-out rooms to network and share current projects and challenges.
Kathleen Frazier shared BMC2 updates. The 2022A web-based peer review period began on March 14th and ends on April 11th. Coordinators will be notified of case review completion status. The submission deadline for the 2022A BMC2 PCI internal peer review is May 9th. In the data dictionary, Reopro was removed and Aggrastat added to the rescue IIB/IIIA definition. The “New Atrial Fibrillation” field timeframe was updated to correlate with the other “Outcomes Post Lab” definitions.
BMC2 will no longer be accepting bmc2.org access requests from external abstractors or their supervisors. website access for these individuals must be made by the BMC2 PCI site coordinator. Instructions were provided related to the specific areas of the BMC2 PCI report to utilize when completing the PCI volume section of the annual state of Michigan certificate of need survey.
The MiCR meeting was held on March 15th from 12 pm – 1 pm. Dr. Michael Thompson shared insights on site visits over the past 6 months. Site visits revealed that capacity constraints from limited staff, physical space, and other resources lead to the inability of CR facilities to meet demand. Sites also shared that communication is key with early patient contact, the use of CR liaisons, and automatic referrals all boosting CR enrollment. Costs and transportation challenges can impact patient maintenance in cardiac rehab. Finally, strong physician endorsement and support from administrative leadership can help a program flourish. Dr. Thompson also introduced Michigan Cardiac Rehab (MiCR) Network. BMC2 and MVC cardiac rehab initiatives have formally collaborated as the Michigan Cardiac Rehab (MiCR) Network with the goal to equitably increase participation in cardiac rehabilitation for all eligible individuals in Michigan. The network’s goal is to increase CR participation to 40% for all eligible conditions by 2024.
Annemarie Forrest shared information on resources that will be available to providers in order to support them in achieving the 40% goal. Those resources include the MVC cardiac rehab reports, a best practices toolkit that will be available in April, and an eventual dedicated CR resources website. CR reports were last sent in October of 2021 and the next reports will be released in March of this year. Data includes collaborative-wide CR use within 1-year, quarterly trends, mean days to first CR visit, and the mean number of CR visits within 1 year. The CR best practices toolkit will include a menu of strategies that improve enrollment and attendance in CR. The kit allows teams to select the specific interventions that will be most valuable to their site. It focuses on different phases of CR utilization and includes a glossary, links to associated resources, and metrics for evaluating QI success. The forthcoming CR resources website will be a one-stop-shop for the Michigan Cardiac Rehab Network resources and links to external resources. It will include both provider and patient pathways.
The Vascular Surgery Coordinator Meeting was held on March 16th from 11 am – 12 pm. Dr. Frank M. Davis from Michigan Medicine presented “Aortic Endoleaks: What Are They and Why Should We Care.” He explained that there are 5 types of endoleaks and that the most common is the Type 2 endoleak which accounts for 75% of all endoleaks. Dr. Davis also shared the SVS EVAR surveillance guidelines which suggest baseline imaging at 1 month, 12 months, and annually after EVAR with contrast-enhanced CT. It’s important to monitor patients for endoleaks because they can cause sac expansion, a need for reintervention, and mortality.
“Opioid Prescribing and Pain Management After EVAR and CEA” was presented by Dr. Mark Bicket of Michigan OPEN. Dr. Bicket reviewed BMC2 opioid prescribing data from 2018 – 2021, examined the 2022 goal, and discussed options for how to teach patients to recover from surgery. While the goal is currently fewer than 10 opioid pills at discharge for opioid naïve patients, the number of opioids will be reduced to fewer than 4 moving forward. He explained that it is important to set the expectations of patients and normalize the prescription of fewer opioids, adding that research has found that administration of acetaminophen and ibuprofen together often is more effective than opioids. Both talks can be found on the BMC2 YouTube channel.
March 16th was the deadline for Q4 2021 data entry. Reports will be posted within 2 weeks. Look for them on or before March 30th.