Minnesota Hospital Association

Quality & Patient Safety

Working together to improve patient safety and quality

The Minnesota Hospital Association partners with a number of other health care organizations, state agencies and member hospitals across the state to advance patient safety and quality in the state. Minnesota is a national leader in patient safety and quality, and it is through the collaborative efforts of these organizations that this achievement is possible. By working together to implement evidence-based practices, hospitals and health care providers ensure patients receive top-notch care and are working to keep costs down. Expand the boxes below to learn more. 

Collaborative Healthcare-Associated Infection Network

Healthcare-associated infections (HAI) are a serious patient safety issue, and reducing HAIs is a national priority. In 2009, the U.S. Department of Health and Human Services developed an action plan with national goals for reducing HAIs, and provided funds through the American Recovery and Reinvestment Act (ARRA) for each state to develop and implement its own HAI Action Plan.

In 2011, Stratis Health, Associated Professionals in Infection Control – Minnesota (APIC-MN), the Minnesota Department of Health (MDH) and MHA formed the Collaborative Healthcare-Associated Infection Network (CHAIN). The partnership was formed to develop and carry out effective approaches for reducing healthcare-associated infections in Minnesota. HAI prevention goals will be achieved through interventions focused on hand hygiene, transmission precautions, injection practices, antimicrobial stewardship and environmental cleaning. The comprehensive unit-based safety program (CUSP) contributes to the foundation for all HAI prevention efforts.

CHAIN focuses on the prevention of:

  • Catheter associated urinary tract infections (CAUTI)
  • Clostridium difficile infections (CDI, C. diff)
  • Central line associated bloodstream infections (CLABSI)
  • Multidrug resistant organisms (MDRO), including MRSA, VRE and MDR
  • Surgical site infections (SSI)
  • Ventilator associated pneumonia (VAP)

Drug Diversion Prevention

Hospitals, health care providers, state government and law enforcement have joined together to create a set of best practices that hospitals and health care facilities can use to enhance security for controlled substances, including narcotics and other powerful prescription medications.

The Controlled Substance Diversion Coalition, convened by the Minnesota Department of Health and the Minnesota Hospital Association, came together in May 2011 to prevent theft of prescription drugs by health care workers, patients, families, and visitors, and to raise awareness about the issue within health care settings. The coalition is an effort of a broad-based stakeholder group, including hospitals, long-term care facilities, home care and hospice.

The Drug Enforcement Agency requires hospitals and other health care facilities to report the theft or loss of controlled substances. In Minnesota from 2005 to 2011, there were 250 reports of theft or loss of controlled substances. Reports increased from 16 in 2006 to 52 in 2010, a 325 percent increase. (Retail pharmacy thefts are not included in these numbers.)

Overall the prescription drug problem is the fastest growing drug problem in the nation, according to the Office of National Drug Control Policy. The public has more access to these drugs today than in previous times. The number of opiate prescriptions dispensed by U.S. retail pharmacies increased from 76 million in 1991 to 210 million in 2010 – triple the number. The number of prescriptions for stimulants increased from 5 million in 1991 to 45 million in 2010.

Drug Diversion Prevention Resources

The coalition has created a road map and tool kit that will improve health care providers’ controlled substance storage and security, procurement, prescribing, preparation and dispensing. The road map includes training materials, sample policies and procedures, and a flow chart of reporting guidelines and requirements that providers can use when they suspect a drug diversion has occurred.

The road map is a collection of about 100 best practices for preventing and responding to controlled substance diversions. Some examples include camera surveillance in high risk areas, keeping prescription pads in locked locations, implementing a clearly defined process for controlling and accounting for keys, rules against sharing pass codes, utilizing bar codes for tracking, deploying secure and locked delivery carts, and using tamper resistant packaging.

Access the road map, tool kit and final report.

Minnesota Alliance for Patient Safety (MAPS)

The Minnesota Alliance for Patient Safety (MAPS) is a statewide patient safety coalition founded in 2000. MAPS members include more than 50 public-private health care organizations, including strategic partners such as the Minnesota Hospital Association, Minnesota Medical Association, Minnesota Department of Health, Stratis Health and Minnesota Medical Insurance Exchange (MMIC) Group. 

MAPS actively provides support to stakeholders to enable them to provide care that is:

  • safe from avoidable harm;
  • coordinated across transitions/settings; 
  • an environment where patients are knowledgeable and active participants in their care; and 
  • care in a transparent and safe culture.

MAPS offers two DVDs on patient safety to orient clinicians and leaders to the field of patient safety.

  • Patient Safety 101 topics include: the epidemiology of harm, definitions, measures, human factors, and the design of safe systems.  
  • Patient Safety 102 includes the cultural elements of a successful patient safety program. Topics include patient safety culture, Just Culture, patient engagement, health literacy and the role of leadership.  

Order the Patient Safety 101 and 102 DVDs.

Newborn Screening Education

Since 1965, the Minnesota Department of Health (MDH) has screened Minnesota newborns soon after birth to see if they are at risk for rare, hidden disorders. By identifying these disorders, interventions, medications or changes in diet can help prevent most health problems caused by disorders on the newborn screening panel.

Minnesota is a national leader in newborn screening. The Newborn Screening Program, together with hospitals, laboratories, and medical professionals across the state, screens newborns for more than 50 disorders that affect metabolism, hormones, the immune system, blood, breathing, digestion, hearing, or the heart.  

View the links below for important information on the Newborn Screening Program, and for more information and resources, visit the MDH website

Webinar: Educating Parents about Newborn Screening and Parental Options
This recording introduces an educational infographic for providers to use when discussing newborn screening with parents and guardians. 

Newborn Screening Materials and Resources: Education Materials and Forms

Newborn Screening educational infographic (downloadable pdf)

Information courtesy of the Minnesota Department of Health


Reducing Avoidable Readmissions Effectively Campaign (RARE)

The Reducing Avoidable Readmissions Effectively (RARE) Campaign is engaging hospitals and care providers across the continuum of care to prevent 6,000 avoidable hospital readmissions within 30 days of discharge across Minnesota between July 1, 2011 and Dec. 31, 2013. The original goal of collectively reducing 4,000 readmissions by Dec. 31, 2012 was exceeded. Reducing readmissions will alleviate the burden placed on patients and their families and will allow them the comfort and well being of staying in their own beds. The fourth quarter 2013 data is in, and RARE Campaign participants have helped prevent 7,975 readmissions and allowed Minnesotans to spend 31,900 nights of sleep in their own beds instead of in the hospital. In the last quarter of 2013, Minnesota hospitals reached a collective reduction in readmissions of 19 percent.

Participating hospitals are working to reduce their own readmission rates by 20%, from the 2009 baseline, as measured by the MHA's Potentially Preventable Readmissions (PPR) data. According to the Health Research and Education Trust, unplanned readmissions cost Medicare $17.5 billion.

Currently, 85 hospitals and 93 community partners are participating in RARE. The RARE Campaign builds upon and expands work that has been going on for several years by many hospitals, medical groups, health plans and the campaign’s operating, supporting and community partners. The campaign focuses on five key areas that, if not managed well, are known to be main contributors to avoidable hospital readmissions:

  1. Comprehensive discharge planning
  2. Medication management
  3. Patient and family engagement
  4. Transition care support
  5. Transition communications

Learn more about the RARE Campaign

Transforming Care at the Bedside (TCAB)

Transforming Care at the Bedside (TCAB) is a national program of the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI), two national quality improvement organizations. Its goal is to engage front-line hospital nurses and leaders at all levels of the organization to:

  • improve the quality and safety of patient care;
  • increase the vitality and retention of nurses;
  • engage and improve the patient's and family members' experience of care;
  • improve the effectiveness of the entire care team.

TCAB is different from traditional quality improvement efforts in that it does not come out of the executive office, but is a bottom-up approach that empowers nurses and other bedside caregivers to suggest, test and implement potential solutions to problems and find new ways to improve patient care.

The goals of TCAB are to increase the time nurses spend in direct patient care; to improve quality, reliability and safety of patient care; to create patient-centered care; and to improve nurse retention by improving workforce vitality. By achieving these goals, hospitals hope to reduce errors and adverse events and the results in Minnesota have been impressive. One or more participants have reported:

  • half as many falls;
  • increasing the number of patients triaged upon arrival to the emergency room from 58 percent in August 2010 to 98 percent in March 2011;
  • increased patient satisfaction scores; and
  • after putting TCAB in place, some teams have been able to raise the amount of time spent at the bedside to 60 percent.

A total of 50 Minnesota hospital units have participated in TCAB training — the most of any state in the country.

More time at the bedside

According to an article in the Rochester Post Bulletin, Olmsted Medical Center (OMC) is working to change the fact that, nationally, nurses only spend an average of 31 percent of their work time in direct patient care. Through TCAB, OMC aims to increase the amount of time spent at the bedside. Before TCAB, OMC identified that nurses spent 42 minutes per day hunting and gathering patient supplies, dealing with equipment that didn’t work and handling prescription problems. As of May 2011, OMC nurses had increased their bedside time to 57 percent on the day shift, 54 percent in the evenings and 37 percent during the overnight shift.

One example of a simple change that has made a big impact was described to the Rochester Post Bulletin:

“To send a specimen to the lab, you must use a plastic bag. The bags were kept in the nurses’ station. Now they’re kept in the patient rooms, eliminating the extra trip to and from the nurses’ station each time a specimen gets sent.”

 Another example of how TCAB has improved patient care is that in the past, nurses would leave a tape recorded message at the end of their shift describing how their patients were doing. Now, nurses introduce each other at shift changes and give reports together at the bedside.