Michigan Health and Hospital Association Keystone Center

In 2003, the Michigan Health and Hospital Association (MHA) Keystone Center, with funding from the Agency for Healthcare Research and Quality (AHRQ), organized a large-scale collaboration effort among Michigan's health and health care stakeholders, including hospitals, State government, payers, and employers. With these partners, the MHA Keystone Center forged evidence-based solutions that improve the quality of care offered to Michigan's residents. Many of the patient safety interventions developed by the MHA Keystone Center are now being used throughout the nation and around the world.

Summary of Activities:

This group of stakeholders developed clinical interventions that Michigan hospitals implement to improve quality and patient safety in a variety of care settings and treatment scenarios. These include care transitions, emergency rooms, organ donations, hospital-associated infections, intensive care units, obstetrics, safe care, and surgery. One such example is the Comprehensive Unit-Based Safety Program (CUSP), which provides each hospital with a framework for intervention and integrates communication, teamwork, and leadership improvements to help create a culture free of patient harm. The MHA Keystone Center supports hospitals' transition into the CUSP by offering more than 3,000 annual learning opportunities including workshops, webinars, conference calls, and individual meetings.

The first broad-scale application of CUSP was in Michigan, under the leadership of the Michigan Health and Hospital Association, where it was used to significantly reduce central line-associated bloodstream infections (CLABSIs) in that State. Following that success, CUSP was expanded to 10 States and then nationally through an AHRQ contract with the Health Research and Educational Trust, the research arm of the American Hospital Association. This project is the largest national effort to combat CLABSIs to date, and involved hospital teams at more than 1,100 adult intensive care units in 44 States over a 4-year period. Hospitals participating in this initiative used CUSP to prevent more than 2,000 CLABSIs, a 40-percent reduction in the rate of CLABSIs. This reduction saved more than 500 lives and avoided more than $34 million in health care costs, according to results released in 2012.

Alignment to the National Quality Strategy (NQS):

NQS priorities of the Michigan Health and Hospital Association (MHA) Keystone Center: Make care safer by reducing the harm caused in the delivery of care.

Efforts such as these:

  • Make care safer by reducing the harm caused in the delivery of care.

The MHA Keystone Center's interventions improve the safety of patients, as demonstrated with their success in reducing central line-associated bloodstream infections by nearly 58 percent and ventilator-associated pneumonia by 62 percent since 2004.


The MHA Keystone Center is supported by Blue Cross Blue Shield of Michigan, the Centers for Medicare and Medicaid Services Partnership for Patients Hospital Engagement Network, the Michigan Department of Public Health, and Michigan hospitals. Find more about the MHA Keystone Center at http://www.mhakeystonecenter.org/.

Page last reviewed March 2017
Page originally created November 2016
Internet Citation: Michigan Health and Hospital Association Keystone Center. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/workingforquality/priorities-in-action/michigan-health-and-hospital-association-keystone-center.html
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