A pathway for patients: Michigan Medicine expands hospital services in Chelsea

At Michigan Medicine, the goal is to provide world-class care to as many patients as possible. However, limited capacity at the main academic medical center sometimes makes such a goal challenging.

That’s where the organization’s partnerships, affiliations and joint ventures come in.

For instance, in 2018, U-M Health and St. Joseph Mercy Health entered into a joint venture, St. Joseph Mercy Chelsea Hospital, giving U-M a 49 percent ownership stake in the facility. The joint venture helps both systems expand the medical services available in the Chelsea community, and helps Michigan Medicine further deliver on its commitment to give patients the right care, at the right time through additional inpatient services beyond the walls of University Hospital.

“Over the first two years of the joint venture, we have debuted a number of Michigan Medicine services in Chelsea, including bariatric surgery, general surgery, minimally invasive surgery and urology, as a few examples,” said David Bozaan, M.D.

Now, there is a new service that will allow the organization to expand care for inpatients at St. Joe Chelsea. Internally, the program is called the Michigan Hospitalist Chelsea Service (MHC), and Bozaan serves as its medical director.

“This new service will allow Michigan Medicine hospitalists (general care physicians) to provide care in a different setting, often closer to some patients’ homes,” Bozaan said. “We’re thrilled to get this program off the ground – and we’re confident that it will only expand as we move forward.”

Taking advantage of historic trends

University Hospital and the Frankel Cardiovascular Center often function right at, or just below, full capacity. At the same time, historically, St. Joe Chelsea has operated at less-than-capacity.

“Often, we have more patients who need to be admitted than we have beds for at Michigan Medicine, while the opposite is true in Chelsea,” Bozaan said. “So that provided an opportunity for patients to be treated at a high quality facility while expediting their care.”

Additionally, such a program would allow the organization to take advantage of the excellent care already provided at St. Joe Chelsea, with the hospital recently named the No. 2 hospital in the state by Newsweek (only behind Michigan Medicine).

Teams on both sides began planning how some inpatient beds could be used by Michigan Medicine patients. And then who, and how many, faculty and staff would need to move over to Chelsea. The strategic work began a year or so ago, with an initial launch date planned for this fall. However, the COVID-19 pandemic moved those plans up.

“With the potential need for capacity to treat a surge in COVID-19 patients in Ann Arbor, we accelerated our development of the MHC,” Bozaan said. “And we admitted our first patient to the program in mid-June. It was an incredible display of teamwork, innovation and strategic thinking.”

Finding the right patients

To make the move happen, Bozaan and his team needed to identify which patients were the right fit for care at Chelsea.

“We wanted patients with the most acute and specialized needs to remain ‘on the hill,’” Bozaan said. “So we needed to find inpatients who were at low risk of developing complications or needing unplanned specialized procedures.”

Three groups quickly emerged as candidates: Low-acuity general medicine patients, those suffering from low-risk heart failure, and individuals with leukemia and lymphoma, who are admitted at regular scheduled intervals for specialized chemotherapy that they can get safely at Chelsea. 

A new way of thinking

While patients are overseen by hospitalists in Chelsea, specialized care is always available if and when it is necessary.

“If specialists need to be brought in, they can be reached immediately via virtual methods, such as video, if needed,” Bozaan said. “Nobody will receive a lower level of care because they are being seen in Chelsea as opposed to Ann Arbor.”

In fact, Bozaan sees the possibility of patient care being transformed due to the new partnership.

“We’re re-thinking everything, including patient education and transitions of care,” he said. “For instance, if we better prepare heart failure patients for discharge and let them know how they can best care for themselves at home, the likelihood of them having long-term issues will diminish.”

The first transfers

The first Michigan Medicine patient was transferred to Chelsea on June 9. That began a phased approach to launching the program.

“We’re starting with general medicine now, with heart failure patients coming on board later this summer and leukemia and lymphoma patients in the fall,” Bozaan said. That will give the program time to get staff and supply chains in place, such as specialized pharmacists for the chemotherapy treatment.

Once everything is ready, the transitions should begin in earnest, with up to 12 patients on average per day being cared for at Chelsea.

“At first, we’re focused on identifying patients who come through our Emergency Department who want to transfer,” Bozaan said. “But eventually, the goal is for some to be admitted there by their Michigan Medicine physician without ever coming to Ann Arbor. And they’ll do so with the knowledge that they will be getting treatment from the experts at Michigan Medicine.”

That’s the key to the entire venture.

“What patients and providers need to understand is that being treated in Chelsea is the same as being treated in the academic medical center,” Bozaan said. “It’s literally the same physicians who will be managing your care, but this time in a new, more convenient environment.”

David Bozaan, M.D., was a guest on this week’s episode of The Wrap! Learn even more about the new service at Chelsea by checking out the podcast via the YouTube video below.