The Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) Collaborative Quality Improvement Initiative in Percutaneous Coronary Interventions

Abstract

The past decade has been characterized by increased scrutiny of outcomes of surgical and percutaneous coronary interventions (PCIs). This increased scrutiny has led to the development of regional, state, and national databases for outcome assessment and for public reporting. This report describes the initial development of a regional, collaborative, cardiovascular consortium and the progress made so far by this collaborative group. In 1997, a group of hospitals in the state Michigan agreed to create a regional collaborative consortium for the development of a quality improvement program in interventional cardiology. The project included the creation of a comprehensive database of PCIs to be used for risk assessment, feedback on absolute and risk-adjusted outcomes, and sharing of information. To date, information from nearly 20,000 PCIs have been collected. A risk prediction tool for death in the hospital and additional risk prediction tools for other outcomes have been developed from the data collected, and are currently used by the participating centers for risk assessment and for quality improvement. As the project enters into year 5, the participating centers are deeply engaged in the quality improvement phase, and expansion to a total of 17 hospitals with active PCI programs is in process. In conclusion, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium is an example of a regional collaborative effort to assess and improve quality of care and outcomes that overcome the barriers of traditional market and academic competition.

Blood Transfusion and In-hospital Outcomes in Anemic Patients with Myocardial Infarction Undergoing Percutaneous Coronary Intervention

“…Details of the data collection and quality assurance processes have been reported elsewhere. 7,8 In brief, data forms were reviewed for accuracy and completeness and any incomplete form was returned to the collecting site for clarification. In addition, all centers were audited twice a year.…”

Contemporary Use of Prasugrel in Clinical Practice

“…Details of the data collection are described in previous publications. [5][6][7] A dedicated staff member collected the data and forwarded them to the coordinating center. Medical records of all patients undergoing coronary artery bypass grafting as well as those patients who died in the hospital were reviewed by auditors from the coordinating center to ensure accuracy.…”

Association of a Continuous Quality Improvement Initiative With Practice and Outcome Variations of Contemporary Percutaneous Coronary Interventions

“…The registry has been incorporated into the quality assessment and quality improvement programs of participating institutions, and it was approved by the Institutional Review Board of the University of Michigan and by local institutional review boards. 5 …”