Leadership in Action: The Michigan Spine Surgery Improvement Collaborative’s program director, Muwaffak Abdulhak, MD, FRCS(C)
Dr. Abdulhak joined Henry Ford Hospital in July 2001 as director of the Neurosurgery Spine Program. He was board-certified in internal medicine before training in neurosurgery. After completing his neurosurgery training at the University of Western Ontario in London, Ontario, he became a fellow of the Royal College of Surgeons of Canada. In addition, he completed a complex spine fellowship program at the Medical College of Wisconsin. Dr. Abdulhak is certified by the American
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Board of Neurological Surgery. He leads the spine and neuro trauma program at Henry Ford Hospital; this is a multi-disciplinary effort with a strong collaboration with the orthopedic department. Dr. Abdulhak has very extensive experience focusing on minimally invasive approach as well as complex and reconstructive and deformity correction spine surgery for degenerative and traumatic, as well as metastatic spine disease.
What motivates you?
Collaborating with teams of talented surgeons, gives me great opportunity to learn from, and be inspired by, masters in the field. We realize when we engage in the quality improvement work, we learn from each other and we usually walk away with more value than what we put in. I call this the practice of “catch ball,” where any team member can offer an idea for process improvement. It is then “passed” back and forth among all stakeholders from surgeons and quality improvement officers to others invested in the outputs from the process. Moving the idea around without a strict hierarchy of decision-makers increases engagement. This results in an environment where wisdom is seen as a universal virtue where everyone’s ideas are seen as valuable. As we practice this decentralized structure, we see more collaboration, a stronger sense of ownership and more creative solutions, as everyone has the freedom to contribute. This is the great motivator to create change day after day.
What is your goal for spinal surgery outcomes in Michigan?
The goal for spine surgery outcomes in Michigan is simple! We want to make Michigan the best place to have spine surgery in the country, and we are well on our way. At the heart of MSSIC is data-driven improvement. We collect and analyze detailed patient data from hospitals and ambulatory surgery centers statewide, giving surgeons access to real-world insights that empower them to refine their practices.
MSSIC has successfully implemented several quality improvement initiatives that have positively impacted patient care. Current and past initiatives include:
- Reduction of urinary retention, surgical site infections, emergency department utilization and readmissions
- More patients ambulated within eight hours of surgery
- Reduction of opioid prescribing at discharge
- Implementation of comprehensive, Enhanced Recovery After Surgery programs at all MSSIC sites
- Efforts to reduce racial, ethnic or economic disparities in patient outcomes within current initiatives
Several different calculations have suggested cost savings to Blue Cross Blue Shield of Michigan and other payers of $50 million to $70 million so far, not counting the “indirect cost savings” related to fewer complications in the form of being able to return to work more quickly and having less caregiver burden. There is still more work to be done, but I can say without doubt, having been on multiple national platforms, MSSIC is paving the way. We’re viewed as the team to look up to when it comes to setting the national standards of care for spine surgery, through multiple landmark papers including early ambulation after surgery, the Enhanced Recovery After Surgery program, the opioid prescribing guideline initiatives and many more.
What quality improvement result that you have been able to put in place through the Value Partnerships platform are you most proud of?
I am most proud of our ERAS initiative. This is a perfect fit with spine surgery and is accomplished through a multidisciplinary approach and standardized protocols and interventions. ERAS has been shown to reduce surgical stress, complications, length of stay and overall costs. It’s patient-centric and increases satisfaction. Making ERAS a standard of care at every MSSIC site is consistent with the CQI model, and we have experienced implementation across the state at a speed that has outpaced what a single institution could do.