Spectrum Health Medical Group

Grand Rapids, Michigan, United States

Spectrum Health Medical Group

Grand Rapids, Michigan, United States
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Spectrum Health underwent a rigorous onsite review in May, 2017 when Joint Commission experts evaluated compliance with stroke-related standards and requirements. "By achieving this advanced certification, Spectrum Health has thoroughly demonstrated the greatest level of commitment to the care of its patients with a complex stroke condition," says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president and CEO, The Joint Commission. "Certification is a voluntary process and The Joint Commission commends Spectrum Health for successfully undertaking this challenge to elevate the standard of its care for the community it serves." "The American Heart Association/American Stroke Association congratulates Spectrum Health on achieving Comprehensive Stroke Center certification," said Nancy Brown, chief executive officer, the American Heart Association/American Stroke Association. "Meeting the standards for Comprehensive Stroke Center certification represents a commitment to deliver high quality care to all patients affected by stroke." "Spectrum Health is pleased to receive advanced certification from The Joint Commission and the American Heart Association/American Stroke Association," said Tamer Abdelhak, MD, division chief, inpatient neurology, Spectrum Health. "The certification provides us with the framework to create a culture of excellence." Established in 2012, Advanced Certification for Comprehensive Stroke Centers is awarded for a two-year period to Joint Commission-accredited acute care hospitals. The certification was derived from the Brain Attack Coalition's "Recommendations for Comprehensive Stroke Centers" (Stroke, 2005), "Metrics for Measuring Quality of Care in Comprehensive Stroke Centers" (Stroke, 2011) and recommendations from a multidisciplinary advisory panel of experts in complex stroke care. Stroke is the number five cause of death and a leading cause of adult disability in the United States, according to the American Heart Association/American Stroke Association. On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 795,000 people suffer a new or recurrent stroke each year. The Joint Commission Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission accredits and certifies more than 21,000 health care organizations and programs in the United States. An independent, nonprofit organization, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at www.jointcommission.org. The American Heart Association/American Stroke Association The American Heart Association and the American Stroke Association are devoted to saving people from heart disease and stroke – America's No. 1 and No. 5 killers. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based American Heart Association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. The American Stroke Association is a division of the American Heart Association. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter. The familiar Heart-Check mark now helps consumers evaluate their choices in hospital care. Each mark given to a hospital is earned by meeting specific standards for the care of patients with heart disease and/or stroke. The Heart-Check mark can only be displayed by hospitals that have achieved and defined requirements set by the American Heart Association/American Stroke Association. For more information on the American Heart Association/American Stroke Association Hospital Accreditation Program visit www.heart.org/myhospital. Spectrum Health Spectrum Health is a not-for-profit health system, based in West Michigan, offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of 12 hospitals, including Helen DeVos Children's Hospital; about 180 ambulatory and service sites; about 3,200 physicians and advanced practice providers, including about 1,400 members of the Spectrum Health Medical Group; and Priority Health, a health plan with about 796,000 members. Spectrum Health is West Michigan's largest employer, with 25,400 employees. The organization provided more than $326 million in community benefit during its 2016 fiscal year. Spectrum Health was named one of the nation's 15 Top Health Systems—and in the top five among the largest health systems—in 2017 by Truven Health Analytics®, part of IBM Watson Health™. This is the sixth time the organization has received this recognition. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/spectrum-health-butterworth-hospital-awarded-advanced-certification-for-comprehensive-stroke-centers-300479793.html

Craner J.R.,Spectrum Health Medical Group | Craner J.R.,Mayo Medical School | LeRoy M.A.,Mayo Clinic Health System
Families, Systems and Health | Year: 2017

Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article. Method: A continuously populating database for psychotherapy services was implemented across 5 primary care clinics in a large health system to assess several levels of patient care, including service utilization, symptomatic outcomes, and session-by-session use of psychotherapy principles by providers. Results: Each phase of implementation revealed challenges, including clinician time, dissemination to clinics with different resources, and fidelity of data collection strategy across providers, as well as benefits, including the generation of useful data to inform clinical care, program development, and empirical research. Discussion: The feasible and sustainable implementation of data collection for routine clinical practice in primary care has the potential to fuel the evidence base around integrated care. The current project describes the development of an innovative approach that, with further empirical study and refinement, could enable health care professionals and systems to understand their population and clinical process in a way that addresses essential gaps in the integrated care literature. © 2017 American Psychological Association.

Womble P.R.,University of Michigan | Dixon M.W.,University of Michigan | Linsell S.M.,University of Michigan | Ye Z.,University of Michigan | And 4 more authors.
Journal of Urology | Year: 2014

Purpose While transrectal prostate biopsy is the cornerstone of prostate cancer diagnosis, serious post-biopsy infectious complications are reported to be increasing. A better understanding of the true prevalence and microbiology of these events is needed to guide quality improvement in this area and ultimately better early detection practices. Materials and Methods Using data from the MUSIC registry we identified all men who underwent transrectal prostate biopsy at 21 practices in Michigan from March 2012 to June 2013. Trained data abstractors recorded pertinent data including prophylactic antibiotics and all biopsy related hospitalizations. Claims data and followup telephone calls were used for validation. All men admitted to the hospital for an infectious complication were identified and their culture data were obtained. We then compared the frequency of infection related hospitalization rates across practices and according to antibiotic prophylaxis in concordance with AUA best practice recommendations. Results The overall 30-day hospital admission rate after prostate biopsy was 0.97%, ranging from 0% to 4.2% across 21 MUSIC practices. Of these hospital admissions 95% were for infectious complications and the majority of cultures identified fluoroquinolone resistant organisms. AUA concordant antibiotics were administered in 96.3% of biopsies. Patients on noncompliant antibiotic regimens were significantly more likely to be hospitalized for infectious complications (3.8% vs 0.89%, p = 0.0026). Conclusions Infection related hospitalizations occur in approximately 1% of men undergoing prostate biopsy in Michigan. Our findings suggest that many of these events could be avoided by implementing new protocols (eg culture specific or augmented antibiotic prophylaxis) that adhere to AUA best practice recommendations and address fluoroquinolone resistance. © 2014 by American Urological Association Educaton and Research, Inc.

Womble P.R.,University of Michigan | Linsell S.M.,University of Michigan | Gao Y.,University of Michigan | Ye Z.,University of Michigan | And 5 more authors.
Journal of Urology | Year: 2015

Purpose Recent data suggest that increasing rates of hospitalization after prostate biopsy are mainly due to infections from fluoroquinolone-resistant bacteria. We report the initial results of a statewide quality improvement intervention aimed at reducing infection related hospitalizations after transrectal prostate biopsy. Materials and Methods From March 2012 through May 2014 data on patient demographics, comorbidities, prophylactic antibiotics and post-biopsy complications were prospectively entered into an electronic registry by trained abstractors in 30 practices participating in the MUSIC. During this period each practice implemented one or both of the interventions aimed at addressing fluoroquinolone resistance, namely 1) use of rectal swab culture directed antibiotics or 2) augmented antibiotic prophylaxis with a second agent in addition to standard fluoroquinolone therapy. We identified all patients with an infection related hospitalization within 30 days after biopsy and validated these events with claims data for a subset of patients. We then compared the frequency of infection related hospitalizations before (5,028 biopsies) and after (4,087 biopsies) implementation of the quality improvement intervention. Results Overall the proportion of patients with infection related hospitalizations after prostate biopsy decreased by 53% from before to after implementation of the quality improvement intervention (1.19% before vs 0.56% after, p=0.002). Among post-implementation biopsies the rates of hospitalization were similar for patients receiving culture directed (0.47%) vs augmented (0.57%) prophylaxis. At a practice level the relative change in hospitalization rates varied from a 7.4% decrease to a 3.0% increase. Fourteen practices had no post-implementation hospitalizations. Conclusions A statewide intervention aimed at addressing fluoroquinolone resistance reduced post-prostate biopsy infection related hospitalizations in Michigan by 53%. © 2015 American Urological Association Education and Research, Inc.

Dattilo R.,St Francis Heart And Vascular Center | Himmelstein S.I.,Memphis Heart Clinic | Cuff R.F.,Spectrum Health Medical Group
Journal of Invasive Cardiology | Year: 2014

OBJECTIVE: This study compares treatment results of orbital atherectomy (OA) vs balloon angioplasty (BA) for calcified femoropopliteal (FP) disease. BA for calcified FP disease is associated with increased dissection rates and suboptimal results. OA is hypothesized to decrease these acute complications via lesion compliance change. METHODS: Fifty patients (65 lesions) with calcified FP disease were randomized to OA plus BA vs BA alone and followed for 12 months. The primary endpoint was freedom from target lesion revascularization (TLR), including adjunctive stenting, or restenosis as evidenced by duplex ultrasound at 6 months. RESULTS: Mean maximum balloon pressure was 4.0 atm in the OA arm vs 9.1 atm in the BA arm (P<.001). In subjects with residual stenosis >30%, the operator chose to stent 2/38 lesions (5.3%) in the OA arm vs 21/27 lesions (77.8%) in the BA arm (P<.001). Freedom from TLR (including adjunctive stenting) or restenosis was achieved in 77.1% of lesions in the OA group vs 11.5% in the BA group (P<.001) at 6 months, and 81.2% vs 78.3% at 12 months, excluding adjunctive stenting (P>.99). CONCLUSIONS: Compared to BA alone, OA plus BA yields better luminal gain by improving lesion compliance and decreases adjunctive stenting in the treatment of calcified FP disease. At 12 months, the occurrence of TLR or restenosis was similar in both groups despite the large disparity in stent usage at the time of initial treatment.

Jackson E.A.,University of Michigan | Munir K.,University of Michigan | Schreiber T.,Wayne State University | Rubin J.R.,Wayne State University | And 5 more authors.
Journal of the American College of Cardiology | Year: 2014

Objectives This study sought to examine sex-related differences in outcomes related to peripheral vascular intervention (PVI) procedures. Background Percutaneous PVI is frequently performed for the treatment of peripheral arterial disease (PAD). However, little is known about sex-related differences related to PVI procedures. Methods We assessed the impact of sex among 12,379 patients (41% female) who underwent lower extremity (LE)-PVI from 2004 to 2009 at 16 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PVI registry. Multivariate propensity-matched analyses were performed to adjust for differences in baseline characteristics, procedural indications, and comorbidities on the basis of sex. Results Compared with men, women were older and have multilevel disease and critical limb ischemia. In a propensity-matched analysis, female sex was associated with a higher rate of vascular complications, transfusions, and embolism. No differences were observed for in-hospital death, myocardial infarction, or stroke or transient ischemic attack. Technical success was more commonly achieved in women (91.2% vs. 89.1%, p = 0.014), but because of a higher complication rate, the overall procedural success rates were similar in men and women (79.7% vs. 81.6%, p = 0.08). Conclusions Women represent a significant proportion of patients undergoing LE-PVI, have a more severe and complex disease process, and are at increased risk for adverse outcomes. Despite higher complications rates, women had similar procedural success compared with men, making PVI an effective treatment strategy among women with LE-PAD. © 2014 by the American College of Cardiology Foundation Published by Elsevier Inc.

Froehler M.T.,University of Iowa | Fifi J.T.,St Lukes Roosevelt Hospital | Majid A.,Hyper Acute Stroke Research Center | Bhatt A.,Spectrum Health Medical Group | And 2 more authors.
Neurology | Year: 2012

The initial treatment of patients with acute ischemic stroke (AIS) focuses on rapid recanalization, which often includes the use of endovascular therapies. Endovascular treatment depends upon micronavigation of catheters and devices into the cerebral vasculature, which is easier and safer with a motionless patient. Unfortunately, many stroke patients are unable to communicate and sufficiently cooperate with the procedure. Thus, general anesthesia (GA) with endotracheal intubation provides an attractive means of keeping the patient comfortable and motionless during a procedure that could otherwise be lengthy and uncomfortable. However, several recent retrospective studies have shown an association between GA and poorer outcomes in comparison with conscious sedation for endovascular treatment of AIS, though prospective studies are lacking. The underlying reasons why GA might produce a worse outcome are unknown but may include hemodynamic instability and hypotension, delays in treatment, prolonged intubation with or without neuromuscular blockade, or even neurotoxicity of the anesthetic agent itself. Currently, the choice between GA and conscious sedation should be tailored to the individual patient, on the basis of neurologic deficits, airway and hemodynamic status, and treatment plan. The use of institutional treatment protocols may best support efficient and effective care for AIS patients undergoing endovascular therapy. Important components of such protocols would include parameters to choose anesthetic modality, timeliness of induction, blood pressure goals, minimization of neuromuscular blockade, and planned extubation at the end of the procedure © 2012 American Academy of Neurology.

Mogayzel Jr. P.J.,Johns Hopkins Medical Institutions | Dunitz J.,University of Minnesota | Marrow L.C.,Cystic Fibrosis Foundation | Hazle L.A.,Cystic Fibrosis Foundation | Hazle L.A.,Spectrum Health Medical Group
BMJ Quality and Safety | Year: 2014

Cystic fibrosis (CF) is a multisystem, lifeshortening genetic disease that requires complex care. To facilitate this expert, multidisciplinary care, the CF Foundation established a Care Center Network and accredited the first care centres in 1961. This model of care brings together physicians and specialists from other disciplines to provide care, facilitate basic and clinical research, and educate the next generation of providers. Although the Care Center Network has been invaluable in achieving substantial gains in survival and quality of life, additional opportunities for improvements in CF care exist. In 1999, analysis of data from the CF Foundation's Patient Registry detected variation in care practices and outcomes across centres, identifying opportunities for improvement. In 2002, the CF Foundation launched a comprehensive quality improvement (QI) initiative to enhance care by assembling national experts to develop a strategic plan to disseminate QI training and processes throughout the Care Center Network. The QI strategies included developing leadership (nationally and within each care centre), identifying best CF care practices, and incorporating people with CF and their families into improvement efforts. The goal was to improve the care for every person with CF in the USA. Multiple tactics were undertaken to implement the strategic plan and disseminate QI training and tools throughout the Care Center Network. In addition, strategies to foster collaboration between care centre staff and individuals with CF and their families became a cornerstone of QI efforts. Today it is clear that the application of QI principles within the CF Care Center Network has improved adherence to clinical guidelines and achievement of important health outcomes.

Luke B.,Michigan State University | Brown M.B.,University of Michigan | Wantman E.,Redshift Technologies | Lederman A.,Redshift Technologies | And 6 more authors.
New England Journal of Medicine | Year: 2012

BACKGROUND: Live-birth rates after treatment with assisted reproductive technology have traditionally been reported on a per-cycle basis. For women receiving continued treatment, cumulative success rates are a more important measure. METHODS: We linked data from cycles of assisted reproductive technology in the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database for the period from 2004 through 2009 to individual women in order to estimate cumulative live-birth rates. Conservative estimates assumed that women who did not return for treatment would not have a live birth; optimal estimates assumed that these women would have live-birth rates similar to those for women continuing treatment. RESULTS: The data were from 246,740 women, with 471,208 cycles and 140,859 live births. Live-birth rates declined with increasing maternal age and increasing cycle number with autologous, but not donor, oocytes. By the third cycle, the conservative and optimal estimates of live-birth rates with autologous oocytes had declined from 63.3% and 74.6%, respectively, for women younger than 31 years of age to 18.6% and 27.8% for those 41 or 42 years of age and to 6.6% and 11.3% for those 43 years of age or older. When donor oocytes were used, the rates were higher than 60% and 80%, respectively, for all ages. Rates were higher with blastocyst embryos (day of transfer, 5 or 6) than with cleavage embryos (day of transfer, 2 or 3). At the third cycle, the conservative and optimal estimates of cumulative live-birth rates were, respectively, 42.7% and 65.3% for transfer of cleavage embryos and 52.4% and 80.7% for transfer of blastocyst embryos when fresh autologous oocytes were used. CONCLUSIONS: Our results indicate that live-birth rates approaching natural fecundity can be achieved by means of assisted reproductive technology when there are favorable patient and embryo characteristics. Live-birth rates among older women are lower than those among younger women when autologous oocytes are used but are similar to the rates among young women when donor oocytes are used. (Funded by the National Institutes of Health and the Society for Assisted Reproductive Technology). Copyright © 2012 Massachusetts Medical Society.

Chen Y.,Michigan State University | Wang K.,Michigan State University | Leach R.,Michigan State University | Leach R.,Spectrum Health Medical Group
Biochemical and Biophysical Research Communications | Year: 2013

Placental trophoblast invasion involves a cellular transition from epithelial to mesenchymal phenotype. Cytotrophoblasts undergo epithelial to mesenchymal transition (EMT) when differentiating into extravillous trophoblasts and gaining the capacity of invasion. In this research, we investigated the role of DNA methylation in trophoblasts during this EMT. First, using BeWo and HTR8/SVneo cell lines as models of cytotrophoblasts and extravillous trophoblasts, respectively, we analyzed the gene expression and DNA methylation status of the known epithelial marker genes, E-Cadherin and Cytokeratin7. We found that, in HTR8/SVneo cells, both genes were silenced and their promoters hypermethylated, as compared with the high-level gene expression and promoter hypomethylation observed in BeWo cells. This result suggests that dynamic DNA methylation of epithelial marker genes plays a critical role in the trophoblast EMT process. To verify these results, we treated HTR8/SVneo cells with 5-aza-dC, a known inhibitor of DNA methyltransferase, for three days. Five-Aza-dC treatment significantly increased the expression of epithelial marker genes and slightly decreased the expression of mesenchymal genes, as detected by qRT-PCR, immunocytochemistry and Western blot. Furthermore, 5-aza-dC treated HTR8/SVneo cells changed their morphology from mesenchymal into epithelial phenotype, indicating that 5-aza-dC induced mesenchymal to epithelial transition. Lastly, we examined the effect of 5-aza-dC on trophoblast migration and invasion capacity. We applied 5-aza-dC to HTR8/SVneo cells in trans-well cell migration and invasion assays and found that 5-aza-dC treatment decreased trophoblast migration and invasion capacity. In conclusion, DNA methylation of epithelial marker genes represents a molecular mechanism for the process of trophoblast EMT. © 2013 Elsevier Inc..

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