HFH ER Makes Big Gains With MEDIC

The Michigan Emergency Department Improvement Collaborative (MEDIC) is dedicated to improving the quality of emergency department (ED) care across the state of Michigan. Participating EDs maintain a clinical data registry to analyze information, identify best practices, and improve performance. Henry Ford Hospital was one of the initial sites within MEDIC which began in 2015 and are led by physician champions Drs. Seth Krupp and Michelle Slezak (HFH EM ’08). Over the past 5 years, using continuous quality improvement, HFH ED has gone from being one of lowest performers to the highest in the realm of appropriate CT utilization in both minor head injuries and pulmonary embolism.

Within MEDIC, CT utilization for head injury is measured against the standard of the Canadian CT Head Rule. The Canadian CT Head rule has consistently performed well in multiple settings and contexts. At the HFH ED, adult head CT appropriateness after injury increased appropriateness from 32% in July 2016 to 76% in September 2021 (Figure 1). HFH ED started one of the lowest performing Hospitals in MEDIC now we are currently ranked #2 out of 32 Michigan based Hospitals (Figure 2). The only other group above us is a small private group, so the fact that we have accomplished this in a busy academic setting is truly amazing.

Further, while doing a better job documenting and thoughtfully selecting patients needing head CTs, we have significantly decreased the number of CTs performed in traumatically injured patients.

For more information, visit MEDIC’s main page at https:medicqi.org