Minnesota Hospital Association


November 26, 2012

MHA Newsline

In this issue:

Hospitals focused on preventing adverse drug events

Road map guides hospitals in developing robust medication safety program

On Thursday, Nov. 29 MHA will host an adverse drug event educational kick-off that brings together pharmacists, nurses, providers, quality professionals, patient safety professionals, and others interested in implementing, evaluating or augmenting a medication safety program.

The kick-off is the culmination of the work of the adverse drug event advisory group, made up of hospitals and other key stakeholders, as well as medication-specific subgroups comprised of subject matter experts. Since early 2012, the teams have been working on development of a road map and tool kit founded on evidence-based best practices focusing on anti-coagulants, hypoglycemic agents and opioids. These medication classes were selected based on evidence that adverse drug events involving these medications account for up to 67 percent of emergency hospital admissions for older Americans. The advisory group also developed the road map noting areas ADEs intersect with other hospital-acquired conditions, such as readmissions, falls, and VTE, to further improve outcomes.

If you have questions, contact Karen Olson, MHA patient safety/quality coordinator, 651-603-3521. ^top of page

HHS releases three ACA-related insurance rules

The Department of Health and Human Services last week released three proposed rules and additional guidance related to many of the insurance provisions contained in the Patient Protection and Affordable Care Act. The three proposed rules deal with Essential Health Benefits, which are the administration’s proposed core set of mandatory covered health benefits; codifying health insurance market provisions that prohibit discrimination based on pre-existing conditions or gender; and implementing and expanding employer use of incentives under their wellness programs while protecting consumers from unfair underwriting practices that could reduce benefits based on health status (rule). Finally, a letter was released to states providing guidance on the interaction of Medicaid coverage with the so-called “benchmark” plans that serve as the minimum coverage option in each state.

Some changes have been made since earlier guidance was released. One change allows insurance plans to charge higher deductibles for small group plans than originally set in the legislation if doing so helps keep premiums and out-of-pocket costs more affordable. Another change will increase the number of prescription drugs that must be covered in a plan’s drug formulary. Finally, tobacco users will be able to keep their premiums lower if they participate in tobacco cessation programs.

Still to be released are rules related to premium and medical device taxes, the Basic Health Plan option, and federally-facilitated exchanges, among others.

MHA staff will continue examining the proposed rules. For more information contact Jen McNertney, MHA policy analyst, 651-659-1405 or Matt Anderson, MHA vice president of regulatory and strategic affairs, 651-659-1421. ^top of page

CDC warns of other fungal infections associated with contaminated steroids

Centers for Disease Control and Prevention (CDC) issued a health advisory explaining that although new cases of fungal meningitis continue to be reported, CDC has recently observed an increase in the number of patients presenting with other infections in a peripheral joint, such as a knee, shoulder or ankle. Patients who received injections in peripheral joints only are not believed to be at risk for meningitis, but they could be at risk for joint and other infections, including epidural abscess, phlegmon, discitis, vertebral osteomyelitis, or arachnoiditis at or near the site of injection. These complications have occurred in patients with and without evidence of fungal meningitis.

Please let your patient safety leaders know that CDC is expected to host a clinical conference call on Tuesday, Nov. 27 from 2-3 p.m. ET. Check here for details. For the most current information about this outbreak, including clinician guidance on treatment of affected patients, visit the CDC website. ^top of page

Attendees at MHA January Trustee Conference will learn how two Minnesota hospitals handled challenging situations

The Winter Trustee Conference will feature 16 breakout sessions on various topics of interest to hospital board members including physician relationship, community health needs assessments, advocacy and finance and patient safety issues. Breakout sessions highlighting how two Minnesota hospitals faced an adverse patient safety event and a dispute between the hospital board and medical staff are featured below.

Bradley Beard, president of Fairview Southdale Hospital in Edina, will take a look at an event that could have ended very differently — and how keeping open and honest communication is always the right choice. He will also discuss the Adverse Health Event Reporting Law, which just celebrated its ninth anniversary, and where Minnesota hospitals are with this important transparency initiative.

Sara A. Noel, a shareholder at Minneapolis law firm Leonard Street and Deinard, and Ben Peltier, MHA’s vice president of legal services, will discuss a recent court decision involving a dispute between the medical staff at Avera Marshall Regional Medical Center and the hospital’s board of directors. The court decision provides extensive insight into how Minnesota law governs the relationship between a hospital’s board and medical staff.

The two experienced attorneys will discuss the court case and other guidance available to hospital boards. They will also discuss strategies to promote good relations between the staff and the board. The January Trustee Conference will be held Jan. 11-13, 2013 at a new location, the Minneapolis Marriott Northwest in Brooklyn Park, a move made necessary by growth in the number of conference attendees. For more information or to register, conference brochure. ^top of page

NAMI Minnesota to hold holiday drive

National Alliance on Mental Illness (NAMI) Minnesota is holding its annual holiday presents drive for children and adults with mental illnesses who will be hospitalized over the holiday season. According to NAMI, many people are far from home and few receive card or wishes for recovery.

If your hospital would like to participate, please contact Sue Abderholden. NAMI will be delivering gifts on Dec. 22. Gifts must be unwrapped and be safe (nothing sharp, no ribbons) and can be dropped off Monday through Friday between 9 a.m. and 5 p.m. at the NAMI office until Dec. 21. Arrangements can be made for evening or weekend drop-offs. Gifts can include art materials, games, puzzles, sudoku, air dry clay, DVDs, origami paper, journals (nonspiral), scrapbooking supplies, crossword puzzles, word finds, cards, toiletries, etc. ^top of page