Bits 'N Pieces Newsletter


March 2020 Print

President's Message

   President’s Message

Rachel D. Grant, CSSC

2019-2020 MSHRM President

Having successfully navigated the holidays, I must admit to a state of surprise that the first two months of 2020 have already come and gone! Which brings us to a flurry of activity for MSHRM in the coming months!

I’m happy to report that the Education Committee received positive reviews on the MSHRM Winter Webinar and that we are making technical changes to resolve the issues some participants experienced. Thanks to the Committee’s continuing efforts, the agendas for our upcoming Spring and Annual Meetings are again riveting!

MSHRM’S Communications Committee has received several submissions for our new logo, but there’s still time to send in your design ideas! And be prepared to be pleasantly surprised at the Annual Meeting when the Committee introduces MSHRM’s newly designed website -

The Awards and Venzke Committees are actively taking nominations for our organization’s various awards. Please don’t forget to recognize those in our organization who have impressed you with their efforts in Michigan’s healthcare risk management.

THANK YOU to our committed corporate partners! The Sponsorship Committee is finalizing our 2019-20 contributions, so if your organization intends to (but hasn’t yet) partner with MSHRM, please feel free to reach out to the Committee – or to me directly – to discuss sponsorship options. As you know, the continued generosity of our partners allows MSHRM to provide the outstanding education opportunities for our membership year after year!

Interesting changes in Michigan Court Rules and ANOTHER comprehensive update from our Government Issues Committee (see below). 

Our Secretary will soon be taking nominations for office and board positions for our 2020-21 membership year. Please consider volunteering your time and talents to the future growth of MSHRM!

Our new Chapter Administration Team is working hard behind the scenes with all of our committees and officers to ensure that all of the above goes off without a hitch. As a Board, we are very thankful for their efforts this year.

Finally, I was reminded this week just how precocious Michigan’s “spring” weather is (as my plane was de-iced TWICE before take-off), and it reminded me that MSHRM’s Spring Meeting is right around the corner. Fingers crossed that we’ll have the “luck o’ the Irish” with the weather that day!

I’ll look forward to seeing you on the 17th!

Rachel D. Grant, CSSC

2019-20 MSHRM President



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MSHRM Spring Program

Register Now for the MSHRM Spring Program! The seminar will take place on Tuesday, March 17, 2020 from 9 a.m. to 4 p.m. at the Henry Center for Executive Development in Lansing. The MSHRM Education Committee is working hard to create an educational, meaningful and relevant agenda. More information and registration  will be available on the MSHRM website in the coming weeks.


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Vendor Sponsorship & Exhibition Opportunities

MSHRM’s Vendor Sponsorship and Exhibition Program offers the ideal opportunity to connect with over 250 healthcare leaders from across Michigan including healthcare risk managers, patient safety officers, quality assurance professionals, attorneys, insurance professionals, risk management consultants, and others involved in healthcare risk management and patient safety.


Through sponsorship, your organization will benefit from networking opportunities, key visibility, and be honored for enabling MSHRM to provide valuable educational resources and programs at an affordable cost for our members and guests. Your contribution will help provide safer healthcare across Michigan!


Visit for complete details of our suggested sponsor levels and opportunities. Contact MSHRM at [email protected] or 616.755.8488 with any questions.


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MSHRM Annual Conference

Save the Date for the MSHRM Annual Conference!  The conference will take place Wednesday, May 22 thru Friday May rom 9 a.m. to 4 p.m. at the Amway Grand Plaza in Grand Rapids.  The MSHRM Education Committee is working hard to create an educational, meaningful and relevant agenda. More information and registration  will be available on the MSHRM website in the coming weeks.


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Michigan Court Rule Changes

Important Update to Michigan Court Rules by Nancy  Chinonis


On January 1, 2020, significant changes went into effect regarding the Michigan Court Rules.  Several of the most important changes are outlined below.


Initial Disclosures


One of the most important changes, the requirement of Initial Disclosures, will significantly impact what needs to be completed during the 182 day stay period between when the NOI is served and the filing of Plaintiff’s Complaint.   


The Initial Disclosures are extensive and require a great deal of information to be provided within, at most, 28 days from the filing of an Answer to the Complaint.  As such, it is imperative that preparation begin immediately upon receipt of a NOI.


For defendants, initial disclosures are due fourteen (14) days after plaintiff’s initial disclosures or 28 days after they filed their Answer, whichever is later.  (MCR 2.302(A)(5)(ii)).  A defendant’s initial disclosures are due regardless of whether plaintiff filed their initial disclosures timely or not. 


Initial disclosures require the following information to be disclosed:


  1. The factual basis of a party’s claims and defenses;
  2. The legal theories on which a party’s claims and defenses are based, including, if necessary, citation to legal authorities;
  3. Witnesses, including names, addresses, and telephone numbers of individuals with discoverable information;
  4. A copy and description, including location, of any electronically stored information that a party may have in its possession and may use to support its claims or defenses;
  5. A copy and description of any electronically stored information that is being held by a third party;
  6. A calculation of damages;
  7. A copy of any pertinent portions of an insurance policy, indemnity agreement/clause, security agreement, etc.; and
  8. The anticipated subject areas of expert testimony.


As referenced above, “electronically stored information” includes text messages, photographs, emails, social media posts, a patient’s electronic medical record, safety reports, incident reports, audit trail of the electronic medical record, and other similar such data.  The Initial Disclosure rule requires the existence of all electronically stored information that pertains to the case be disclosed to opposing counsel at the very beginning of litigation. 

The rules are clear that any evasive or incomplete initial disclosure or supplemental disclosure will be treated by courts as a failure to respond.  Harsh punishments are possible should there be a failure to comply with the initial or supplemental disclosures, including heavy sanctions, inability to use concealed evidence to prove the case, inability to call a witness or expert witness, and limiting discovery that can be performed during the discovery phase of the case. 


Disclosures must be based upon information which is reasonably available to the party at the time the disclosure is made.  The courts will not accept the argument that the initial disclosure was not timely due to a failure to investigation or due to the opposing party’s failure to provide sufficient disclosures. 


Importantly, the Initial Disclosures are a continuous document.  As such, they are required to be supplemented throughout the course of discovery as new information is learned. Should a party become aware that their Initial Disclosure was incomplete or incorrect in any way, the party must supplement or correct that disclosure in a timely manner.  As a rule of thumb, initial disclosures should be supplemented once a month, or more often as necessary. 



Each party to a lawsuit is limited to 20 interrogatories in total.  A discrete subpart of an interrogatory counts as a separate interrogatory.  The following is an example of what will likely be acceptable and not acceptable under the new rules:


Not Acceptable:

  1. State your full name.
  2. State your date of birth.
  3. What is your social security number?
  4. What is your driver’s license number?



  1. Did you meet with Dr. Smith following the incident outlined in the Complaint?
  2. When did that meeting occur?
  3. What was discussed at that meeting?
  4. How long did the meeting last?


There are no limitations to requests for admission. 

Given the significant limitations in the ability to serve written discovery questions, a significant shift in the way written discovery is currently utilized will be required. 

Furthermore, under this new rule, interrogatories must be served at least 28 days prior to discovery cut off. 



There is a seven-hour, one day time limit per deposition.  MCR 2.306(A)(3). While this may not present a problem in the majority of cases, it is something to keep in mind for more complex medical malpractices cases in which there are numerous defendants. 



While these new court rules went into effect until January 1, 2020, it is unclear at this time whether they will apply retroactively.  The court rules are silent, leaving it up to each judge to decide on a case by case. Thus, it is likely that there will be some variation between judges regarding whether these new rules will apply to cases filed before January 1, 2020.   For each case filed after January 1, 2020, the above will apply. 


Given that a significant amount of information will need to be disclosed no later than 28 days after the filing of a defendant’s Answer to a Complaint, an intensive pre-suit investigation will need to occur in order to ensure the necessary information is identified, gathered to the extent it can be gathered, and disclosed at the appropriate time. Moreover, given the short amount of time to disclose witnesses and anticipated expert testimony, expert review should commence with regards to causation, standard of care, and damages during the NOI period.


The full rule can be found at


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Sponsorship Committee Update

February 2020

The generosity of our sponsors has been immense last year and so far during our campaign this year.  As a small show of gratitude above and beyond the delineated benefits of sponsorship, the committee would like to thank and recognize those who have contributed so far this year:


Grant Settlements, LLC

MPIE & ERC Risk Solutions

Duggan & Krueger, LLC

Kitch Attorneys & Counselors

MHA Keystone Center

Smith Haughey Rice & Roegge





Eaton Rapids Medical Center


Tanoury Nauts McKinney & Garbarino, LLC

Ringler & Associates


The committee is not just about raising money to enhance our educational goals.  We are diligently working on developing new and enhanced value and benefits for our sponsors.   We understand and discuss at each meeting how we can help our sponsors to really make it worth their while to support us. 


We are always in need of fresh and new ideas, and very much welcome comments and feedback from our sponsors and members, so feel free to reach out to myself if it is a good comment and Bill Krueger if negative. ;).  All kidding aside, our sponsors are the lifeblood of MSHRM.  The committee strives to provide the best value to every contributor no matter what level they are able to assist at. 


For anyone who would like to sponsor, the flyer and forms are located at the following link on the MSHRM website:


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Education Committee Update

“Who’s on First?  Second?  Third?” 

This past January, MSHRM had the pleasure of sponsoring a webinar where Alan Card, PhD, MPH, CPHQ, CPHRM, described the various “victims” of an adverse event. Patients are not the only people who experience the unfavorable incident.  The direct caregiver involved can experience great emotional distress from being a part of the patient harm event that typically surrounds a system or process failure, not an individual one. These caregivers are referred to as “second victims”. The webinar content expounded on this concept and defined yet a “third victim” which pointed to the emotional experience of the person responsible for the investigation of the patient event, the Risk Manager.  Dr. Card described the response of a Risk Manager to that of burnout or loss of confidence that could lend to their leaving the profession.  Recognizing these feelings as and actions as detrimental, he spoke to potential actions that could reduce the burden.  Our Winter Webinar has become an annual learning benefit to this organization alongside our Spring, Annual and Fall Meetings.



Looking to jump start your 2020 education?  The MSHRM Education Committee has been diligently at work, behind the scenes, planning for our upcoming Spring Meeting which will be held on Tuesday, March 17th this year.  We will meet at the James B. Henry Center for Executive Development, in East Lansing.  At this event, you will hear from a few speakers on a variety of topics including how to prevent patient self-harm and sexual misconduct in the healthcare setting; how to use and disclose electronically stored information; and, how to create Expectations Management Programs in your organizations. Register for this event TODAY!


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Government Issues Committee Update

Government Issues  Meeting Minutes


Legislative Update – R. Joppich

New bill that will call for providing counseling information for assaultive crime victims that come into our facility. Referred to Health Policy Committee.  No changes to the other bills on the list from last month


Peer Review Committee – C. Lawrence

Disclosure of peer review

Team is meeting regularly via conference call to frame issue and identify scope of project. Objective is to develop a reference grid as it relates to peer review requests from various external entities and internal departments. Focus has been primarily on hospitals; need to consider differing regulations for other healthcare entities.

  1. Joppich informs that Greg Drutchas and Elise Arsenault will also take part in the next call later this month to offer their expertise. A draft grid will be shared for the committees review and input at a later date.


Other concerns related to the topic:

  1. Sieler - Concern with maintaining peer review privilege by respecting separate protections for peer review, including for incident reports, RCA, and credentialing files. With the new court rules, those items should not be produced and objections/protections as to peer review noted if required. Also, materials in risk investigation files should not be shared in one file with these other protected peer review materials, and the risk materials should be protected as a function of attorney client privilege and/or peer review depending upon your organizations handing of risk functions.


  1. Piccirilli – Advised of pending case where protection of credentialing materials may differ if the source is from an outpatient surgery center as opposed to a hospital. The statutory protections are worded differently. He will forward the appellate decision for consideration by the committee.


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Communications Committee Update

The Communication Committee is actively working on updating the new website and engaging participation in our logo contest. We have a couple of submissions so far and are excitedly awaiting more!


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2019-2020 MSHRM Board of Directors and Committee Chairs


Front Row (L to R): Phyllis Clark (Communication Committee Co-Chair), Jennifer Thorn (Education Committee Co-Chair), Mark Hakim (Director), Jenna Wright Greenman (Chair of Council of Past Presidents), Kathy Schaefer (President-Elect), Rachel Grant (President), Vanessa Mulnix (Treasurer), Michelle Tuckerman (Education Committee Co-Chair), Heather Schragg (Director)


Back Row (L to R): William Krueger (Sponsorship Committee Co-Chair), Joslyn Iafrate (Membership Committee Co-Chair), Karen Stein (Secretary), Saulius Polteraitis (Director/Membership Committee Co-Chair), Richard Joppich (Director/Sponsorship Committee Co-Chair), Kristen Rifenbark (Past President)


Not pictured: Jean Sieler (Government Issues Committee Co-Chair), Rebecca Luna-Rubante (Communication Committee Co-Chair), Jose Brown (Director/Government Issues Committee Chair)


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Upcoming Events

Spring Program

Tuesday, March 17, 2020

9 a.m. - 4 p.m.

Henry Center for Executive Development, Lansing

Annual Meeting

Wednesday, May 20 -

Friday, May 22, 2020

Amway Grand Hotel, Grand Rapids



Better Patient Care Through Awareness and Risk Reduction


PO Box 329, Lake Orion MI 48361-0329

Website: | Phone: 248.558.3884| Email:  [email protected]


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