WINNER | Michigan Health & Hospital Association

When a large Michigan hospital successfully implemented prenatal care interventions, it wanted to share the positive outcomes with others, so it turned to the Michigan Health & Hospital Association. Its Keystone Center for Patient Safety & Quality fosters a culture that does not compete, but instead supports teamwork among clinical units and hospitals across the state.

The center's collaborative interventions, which saved thousands of lives and hundreds of millions of dollars, helped earn the state association the 2012 Dick Davidson Quality Milestone Award for Allied Association Leadership, presented by the American Hospital Association.

"In our process, we look for sustainable change, not the flavor of the month," says Spencer Johnson, president of the Michigan Health & Hospital Association based in Lansing. "Our goal was not only to lead in evidence-based medicine, but to make it stick."

The various efforts ensured safer delivery for newborns, prevented surgical-site and intensive care unit infections, and much more. Because of that success, the Michigan model is being exported to other states.

"The results they're achieving are then shared with the hospital field and are used to accelerate the learning curve for the entire country," says Scott A. Duke, Davidson award committee chairman and chief executive officer of Glendive Medical Center in eastern Montana.

In its award application submitted last December, the Michigan association included a lengthy list of measures that demonstrated improvement over the previous 24 months. Among them, decreases in both elective inductions and cesarean deliveries before 39 weeks, patients who leave the emergency room without being seen, ventilator-associated pneumonia, surgical case defects and rehospitalizations. Also, more people were added to the organ donor registry because of efforts by the association and its member hospitals.

The MHA Keystone Center's project to prevent central line-associated bloodstream infections and catheter-associated urinary tract infections are being replicated nationally in conjunction with the Health Research & Educational Trust and clinical partners such as Johns Hopkins.

The Michigan association complemented the work of its MHA Keystone Center by creating a patient safety organization, which collects information involving patient harm events in a confidential and secure manner under certification by the Agency for Healthcare Research and Quality. As of December 2011, the organization had tracked an estimated 12,000 harm events or near misses that allow for identifying new ways to make care safer.

Accountability to consumers of health care is also a hallmark of the association. A free transparency website enables patients, families and the general public to look up quality and price data for any hospital in the state.

"For nearly a decade, Michigan hospitals have created cultures that support teamwork, encourage collaboration and save lives," says Sam R. Watson, the association's senior vice president of patient safety and quality. "Our state's dedicated hospital clinicians, administrators and trustees will continue to voluntarily collaborate to make Michigan patients among the safest in the nation."

In South Carolina, Healing the Sick and promoting the health of all

WINNER | South Carolina Hosptail Association

In 2007, an initiative called South Carolina Mission: Lifeline was launched to deliver swifter care to patients who were experiencing a heart attack. Under the auspices of the South Carolina Hospital Association, it led to the regionalization of heart attack care and a unified data management system for acute cardiac care indicators. The statewide average door-to-balloon time dropped from 93 minutes to 60 minutes — a 35 percent improvement — over a five-year period.

For that and other accomplishments, the state association received the American Hospital Association's 2012 Dick Davidson Quality Milestone Award for Allied Association Leadership.

"It was not so much what others didn't achieve. It's the breadth of the initiatives, which led this year's winners to rise to the top and be selected," says Scott A. Duke, chief executive officer of Glendive (Mont.) Medical Center and an AHA board member serving as chair of the Davidson Award.

Other successful initiatives undertaken by the South Carolina Hospital Association include a campaign to eliminate bloodstream infections. Focusing on shared learning among previously competitive facilities, the campaign standardizes best practices for insertion and management of central lines and holds front-life staff more accountable for patient care. As a result, the state achieved a 67 percent decrease in central-line infections over a two-year period.

Elevating the care of sick patients isn't enough. "We also have to improve the health of our population, and we have to reduce the per capita cost of health care," says J. Thornton Kirby, president and CEO of the association based in Columbia, S.C.

That includes managing diabetes and pediatric asthma and reducing childhood obesity and health care disparities. "The valuable work is yet to come," Kirby says. "There are so many other areas to tackle."

Along these forward-thinking lines, the association embarked on a safe surgery project. A statewide team already was working on it when Atul Gawande, M.D., an associate professor at Harvard Medical School and the Harvard School of Public Health, tapped South Carolina to be the launch state for his Safe Surgery 2015 initiative.

All the state's hospitals have committed to routine use of the surgical safety checklist by the end of 2013 and expect to save more than 500 lives in South Carolina per year.

Collaboration is at the heart of South Carolina Hospital Association's success. Each year, the number of partners has increased to an extensive roster of health-related and other organizations, which includes the Medicaid agency, BlueCross BlueShield of South Carolina, the health department, office of rural health, the association representing federally qualified health centers, the state chamber of commerce, the Institute of Medicine, all three research universities and medical societies.

Their collaborative effort is dubbed Every Patient Counts.

"If we're going to do a program, we're committed to doing it statewide and in a way that reaches every patient, regardless of who they are, where they are, what age they are, and what need they have," says Rick Foster, M.D., the association's senior vice president for quality and patient safety.

About the Award

The Dick Davidson Quality Milestone Award for Allied Association Leadership is presented annually to a state, regional or metropolitan hospital association which, through its programs and activities, demonstrates exceptional organizational leadership and innovation in quality improvement and has made significant contributions to the measurable improvement of quality within its geographic area. For information, visit and click on AHA Awards.