High value care program

Clinical Practice Update: Reducing Daily CXRs in the ICU

April 1, 2022- A systems-based project to reduce unnecessary daily chest x-rays in ventilated ICU patients has been approved with the input and review of McLaren physician leaders on the Critical Care Task Force and HVC Steering Committee. More information can be found on the Reducing Daily CXRs in the ICU page.

New HVC Toolkit: Blood Management

January 18, 2022- Critical blood shortages have prompted a need to renew blood management efforts across McLaren Health Care. The McLaren HVC Team has assembled a Blood Management Toolkit with resources to help promote blood conservation.

Announcing the Third Annual HVC Summit

May 12, 2021- The third annual McLaren High Value Care Summit has been scheduled to be held virtually on September 29th, 2021. Hospital leadership and High Value Care team members are encouraged to attend. All employees, Graduate Medical Education students, residents, and fellows are invited to submit abstracts for posters by August 13, 2021. Click here to download the poster submission instructions. Please direct questions and submissions to Dr. Carlos Rios-Bedoya.

Clinical Practice Update: High Sensitivity Troponin

February 11, 2021- A systems-based project to implement a high sensitivity Troponin assay in conjunction with an evidence based algorithm for ACS patients has been approved with the input and review of McLaren physician leaders on the Troponin Working Group and HVC Steering Committee. More information can be found on the High Sensitivity Troponin Practice Update page.

Clinical Practice Update: Vitamin D Testing

January 13, 2021- A systems-based project to reduce the overuse of inappropriate Vitamin D testing has been approved with the input and review of McLaren physician leaders on the Lab Formulary Task Force and McLaren Steering Committee. More information can be found on the Vitamin D Testing Practice Update page.

Winter 2020/2021 HVC Newsletter

January 4, 2021- The Winter 2020/2021 edition of the High Value Care Newsletter has been released! This edition's topics include:

• 2020 HVC Summit: A recap of the event and presentation of HVC projects/abstracts featured at the summit.

• HVC Program Update: Current and future state of the HVC program from Dr. Tim Hannon, CEO of Healthcare Forward.

• Incorporating Value-Based Care into Oncology: Dr. Erlene Seymour shares her perspective on three HVC initiatives specific to Oncology.

Click here to access the Winter 2020/2021 Newsletter

2020 HVC Summit

September 23, 2020- After a delay due to the coronavirus pandemic, McLaren hosted its second annual High Value Care Summit virtually on September 23rd, 2020. Phil Incarnati, CEO of McLaren Health, kicked off the summit with comments on the importance of McLaren's HVC program. Attendees then learned about the state of the program from Dr. Mike McKenna, CMO of McLaren Health, and Dr. Tim Hannon, CEO of Healthcare Forward, as well as a review of HVC opportunities in oncology from Dr. Erlene Seymour.

Subsidiaries submitted 12 posters and abstracts to present at the summit, all of which can be found on the HVC Research page. A recording of the presentation is available on the summit's landing page, and participants can get CME credit for attending by filling out the form at this link.

Fall 2020 HVC Newsletter

September 17, 2020- The Fall 2020 edition of the High Value Care Newsletter has been released! This edition's topics include:

• High Value Care in the Time of COVID-19: HVC program leadership reflects on how High Value Care is still applicable even in the ongoing COVID-19 pandemic.

• Finding the Right COVID-19 Testing Platform: Bart Buxton and Dr. Dennis Spender discuss how the system chose the Cepheid platform for COVID-19 testing.

• BioFire FilmArray: Helping Patients Recieve Appropriate Antibiotic Therapy: Steven Johnson discusses the BioFire FilmArray's role in High Value Care.

Click here to access the Fall 2020 Newsletter

COVID-19 Resources

April 7, 2020- In response to the COVID-19 pandemic, the McLaren HVC Program has compiled web based resources including guidelines, protocols and literature reviews. Now, more than ever, ensuring the appropriate use of tests and treatments through High Value Care is critical to conserve medical supplies and lessen the burden on nursing, lab and imaging staff.

2020 Annual HVC Summit Postponed

April 2, 2020- Due to restrictions on travel and large gatherings amid the COVID-19 pandemic, the Annual High Value Care Summit has been postponed indefinitely from its original date of May 5, 2020. A new date will be announced once the summit has been rescheduled. In the meantime, poster submissions are still being accepted.

Winter 2020 HVC Newsletter

February 12, 2020- The Winter 2020 edition of the High Value Care Newsletter has been released! This edition's topics include:

• • • Overview of the new Appropriate Use Criteria Program for Advanced Diagnostic Imaging: Dr. Kevin Carter discusses the latest clinical practice update surrounding imaging appropriate use criteria.

    • Update on the Critical Care Task Force: Dr. Andrew Staricco provides an update on the newly-formed Critical Care Task Force.

    • Subsidiary Spotlight: Bay Region: A profile on the effort to reduce lab and blood utilization rate at McLaren Bay Region.

Click here to access the Winter 2020 Newsletter

Clinical Practice Update: Imaging Appropriate Use Criteria

December 11, 2019- Beginning in January 2020, the Centers for Medicare and Medicaid Services (CMS) will require documentation of Appropriate Use Criteria (AUC) for outpatient and ED orders for advanced imaging studies. McLaren is implementing a systems-based project to require documentation of AUC for outpatient and ED advanced imaging studies. Click here to access the educational toolkit supporting these recommendations as well as a downloadable infographic.

Fall/Winter 2019 HVC Newsletter

December 1, 2019- The Winter 2019 edition of the High Value Care Newsletter has been released! This edition's topics include:

• • • The Past, Present, and Future of High Value Care: Drs. McKenna and Hannon give a review of the McLaren HVC program achievements to date as well as future state of the program.

    • Bringing High Value Care to Critical Care: A preview of the work to come from the newly-established Critical Care Task Force.

    • Subsidiary Spotlight: Northern: A profile on the effort to reduce repetitive and unnecessary labs at McLaren Northern Michigan.

Click here to access the Winter 2019 Newsletter

Poster Presentation at 2019 HVPAA National Conference

November 16, 2019- Members of the McLaren High Value Care Steering Committee submitted a poster to the 2019 High Value Practice Academic Alliance National Conference in Baltimore, MD. The poster, which can be found in on the HVC Research page, detailed the structure of McLaren's HVC program and progress to date.

Clinical Practice Updates: C. difficile, Stool O & P Test Restrictions

September 11, 2019- The HVC Steering Committee has approved evidence based projects to reduce overdiagnosis and overtreatment of C. difficile and to reduce inappropriate stool O & P testing for parasitic infections. Click here to access the C. dfficile testing educational toolkit supporting these recommendations including a downloadable infographic, and click here to access the stool O & P testing educational toolkit.

Summer 2019 HVC Newsletter

August 2, 2019- The Summer 2019 edition of the High Value Care Newsletter has been released! This edition's topics include:

• • • High Value Care Summit Presentation Recap: Presentation highlights from the first annual McLaren HVC Summit

    • Summit Poster Presentations: Feature of all posters from the summit, also available at this link

    • Subsidiary Spotlight: Lapeer Region: A profile on the early strides made in Lapeer's HVC program

Click here to access the Summer 2019 Newsletter

First Annual McLaren HVC Summit

April 17, 2019- McLaren has hosted its first annual High Value Care Summit at corporate headquarters in Grand Blanc, MI. Approximately 75 attendees representing every subsidiary spent the morning learning about the current and future states of McLaren's High Value Care program, value-based purchasing from the perspective of the Michigan Hospital Medicine Safety Collaborative, and imaging wisely. Additionally, staff and residents from all subsidiaries submitted a total of fourteen HVC-related posters which were presented throughout the morning. They can be found on this page.

Clinical Practice Update: Inpatient Thrombophilia Test Restrictions

March 25, 2019- The HVC Steering Committee recently approved evidence-based restrictions on inpatient thrombophilia testing that are consistent with Choosing Wisely recommendations. Click here to access the educational toolkit supporting these recommendations as well as a downloadable infographic.

Announcing the McLaren High Value Care Newsletter

March 12, 2019- The McLaren High Value Care program leadership is proud to announce the inaugural edition of the HVC newsletter. This edition's topics include:

• • • Committing to High Value Care: An overview of High Value Care and how it applies to McLaren's mission, "Doing What's Best"

    • Repeat Lab Testing: How Much Is Too Much? The first project of the HVC program, a review of appropriate frequencies for lab tests and how overuse can be addressed

    • MHC Annual HVC Summit: The first annual High Value Care Summit to be held in Grand Blanc, MI on April 17th, 2019

Click here to access the Winter/Spring 2019 newsletter

Clinical Practice Update: Asymptomatic Bacteriuria

January 7, 2019- The McLaren HVC Steering Committee has approved an evidence-based algorithm to reduce the overdiagnosis and overtreatment of asymptomatic bacteriuria (ASB). Urinary tract infections are among the top three diagnostic categories driving antibiotic use in the United States, and the estimated rate of overtreatment of ASB is 30- 60%. The harms of unnecessary antimicrobial use are well documented and include antibiotic-associated diarrhea, resistance of microorganisms, adverse drug reactions, and increased health care costs.The recommendations being implemented are consistent with those of the Michigan Hospital Safety Medicine Consortium and were reviewed by McLaren physician leaders at multiple levels: Asymptomatic Bacteriuria Working Group, Subsidiary HVC Teams, and the HVC Steering Committee. For detailed information on this Clinical Practice Change as well as a downloadable infographic click here.

First Annual High Value Care Summit

December 1, 2018- The first annual McLaren High Value Care Summit has been scheduled for April 17th, 2019 at McLaren Corporate Headquarters. Hospital leadership and High Value Care team members are encouraged to attend. All employees, Graduate Medical Education students, residents, and fellows are invited to submit abstracts for posters by March 1, 2019. Participants will be selected and notified by March 15th, 2019. Click here to download the poster abstract guidelines and click here to download the submission form.

• • • Employees can direct questions and submissions to Danette Hayman or Chandan Gupte

    • GME students, residents, and fellows can direct questions and submissions to Dr. Carlos Rios-Bedoya

'Pause the Draws' Awareness Campaign Kicks Off

October 2, 2018- 'Pause the Draws' is the first of many campaigns to promote awareness among clinical staff, employees and patients about ongoing High Value Care initiatives across McLaren Health Care. Repetitive lab testing on inpatients is common and can have a variety of negative consequences, and is a target of a number of Choosing Wisely lists. For hospitalized patients, targeting high volume repetitive daily tests is a logical, evidence based and patient-centered intervention that can have a significant impact. Click here to learn more and to access toolkit resources.

McLaren Fall Leadership Conference- High Value Care Breakout Session

September 25, 2018- Dr. Tim Hannon and Chandan Gupte had the opportunity to present two breakout sessions at the annual McLaren Fall Leadership Conference held at Soaring Eagle Casino and Resort in Mt. Pleasant, MI. More than 150 attendees from across the System were introduced to McLaren's High Value Care program through the premier of Dr. Michael McKenna's program overview video. This was followed by a discussion of the need for High Value Care, elements of the HVC program, and a walkthrough of the McLaren HVC website. Attendees are invited to fill out a short followup survey, click here to reach it.

First Annual Blood Management Workshop

September 19, 2018- The first annual Blood Management Workshop was a success! Held at McLaren Corporate in Grand Blanc, approximately 20 attendees with representation from every Subsidiary spent the day learning about transfusion best practices and blood management program implementation. Topics presented included anemia management, role of the Transfusion Safety Officer, and transfusion reaction recognition and response. Attendees are invited to fill out a short followup survey, click here to reach it.

New Choosing Wisely Recommendations for Blood Management

July 25, 2018- The Society for the Advancement of Blood Management has released a Choosing Wisely list with five recommendations to augment the existing 17 recommendations related to blood transfusion. The recommendations include preoperative anemia management, preventing iatrogenic anemia from excessive lab testing, avoiding plasma transfusion in the absence of active bleeding, encouraging the use of antifibrinolytics in surgical patients, and making transfusion alternatives a part of informed consent. Click here for a copy of the list.

Task Force Recommends Restrictions on 67 Lab Tests

June 20, 2018- Restrictions on the frequency of ordering will be placed on 67 lab tests based on best practices and with with the input and review of McLaren physician leaders at multiple levels: Repetitive Testing Task Force, HVC Steering Committee, and Subsidiary HVC Teams. For a full list of lab tests and restrictions click here. For a sharable Infographic click here. For more information, support tools and contact info click here.

Blood Management Workshop Scheduled September 19

June 7, 2018- A Blood Management Workshop has been scheduled for Wednesday, September 19th at McLaren Corporate Headquarters. Blood management champions (physician, nursing, lab) from all Subsidiaries are strongly encouraged to attend.