Hospital honored with MHA Innovation of the Year in Patient Care Award
Regions Hospital in St. Paul received the Minnesota Hospital Association (MHA) 2016
Innovation of the Year in Patient Care Award in the large hospital category,
which recognizes hospitals for developing innovative ways to meet the needs of
patients and ensure that they are delivering safe and high-quality care.
Regions Hospital earned this award for its street-to-treat initiative, which is
designed to get patients with stroke-like symptoms an accurate diagnosis as
soon as possible, starting with the first responders who respond to the 911
call. If stroke seems likely, they give the Emergency Center at Regions
Hospital a heads-up by calling a Code CVA. The code activates a team of stroke
experts that meets the patient and first responders at the ambulance bay. Once
the patient arrives, the EMS team gives its report and the patient and stroke
team move into a nearby imaging room.
American Stroke Association guidelines indicate that a CT scan should be
initiated within 25 minutes of the patient's arrival. By partnering with more
than 60 local EMS agencies to call the Code CVA ahead of time, Regions Hospital
has reduced this time to less than six minutes. After implementing
street-to-treat, Regions Hospital increased the percentage of stroke patients
treated in less than 60 minutes from 33.6 to 62 percent of patients - compared
to 14.4 percent of patients in a CDC study of 98 hospitals.
Additional award winners will be profiled in upcoming issues of Newsline. To
learn more about the award winners, visit the MHA website. return to top
new state regulations impact hospitals
Two new regulations that will impact hospitals go into effect
Aug. 1, 2016.
The first new law can be found in Chapter 120. Authored by Sen. Ron Latz
(DFL-St. Louis Park) and Rep. Nick Zerwas (R-Elk River), this legislation
clarifies current law regarding the notification of local law enforcement
before releasing a patient from an emergency hold or admission if law
enforcement brought the patient to the hospital and if the patient is being
released before the 72-hour hold has expired. If a patient leaves the facility
against medical advice, this legislation expands current law to require
hospitals notify the officer who brought the patient to the hospital.
MHA was able to amend this legislation to specifically include language
clarifying that this new provision of law will not be in conflict with the
Minnesota Health Records Act (notwithstanding Section 144.292, Release or
Disclosure of Health Records) for the release of a patient’s name under these
The legislation also bans a patient from being allowed to or required to
consent to participation in a clinical drug trial during an emergency admission
or hold. A patient may continue participation in a clinical drug trial if the
patient was participating in a drug trial prior to the emergency admission or
The second new law can be found in Chapter 150. Authored by Sen. Alice Johnson
(DFL-Blaine) and Rep. Brian Daniels (Faribault), this law requires all
televisions in a hospital public waiting area to have the closed caption
feature activated if the television includes the closed caption feature. The
hospital is to make reasonable effort to ensure that members of the public do
not disable the closed caption feature. If the closed caption feature if turned
off, the hospitals must, as soon as practicable, turn on the closed caption
MHA was able to amend this legislation so that this new regulation is in
Statute 144.611 and not in the section of law dealing with the Americans with
Disabilities Act as was called for in the original bill. MHA encourages
hospitals to make every effort to keep their closed captioning feature activated
on all televisions in public areas of the hospital.
For more complete information on all legislation impacting hospitals from the
2016 session, the annual MHA Legislative Report will be released soon. For more
information, please contact Mary Krinkie, vice president of government
relations, MHA, or Kristin Loncorich, director of state
government relations, MHA. return to top
1 is first deadline for violence prevention training
For over a year, MHA members have been engaged in implementing
the provisions of 2015 legislation regarding workplace violence
prevention and making Minnesota’s hospitals a safer environment for patients,
employees and visitors. One of the final components of first-year
implementation specifies that by Aug. 1, all Minnesota hospitals are to have
provided safety training to all health care workers and other individuals who
have direct contact with hospital patients. This training is to be conducted
for all health care workers upon hire and going forward provided on an annual
MHA members have been actively implementing the 2015 legislation by involving
direct care workers in the formation of their workplace violence prevention
plans, providing violence prevention training for direct care staff and
reviewing incidences of violence. MHA members are reminded to review their
violence prevention plans with their designated committee at least annually and
to include a review of the plan’s effectiveness, which should include the most
recent gap analysis as prepared by the Minnesota Department of Health, as well
as the number of acts of violence and injuries by unit that occurred at the
hospital during the previous year.
Resources for implementing the workplace violence prevention law are available
on the MHA website. return to top
accepting comments to proposed communicable disease reporting rule updates
The Minnesota Department of Health (MDH) has formally proposed
updates to the communicable disease reporting rules through the rulemaking
process and published the Notice of Intent to Adopt on July 18, 2016, in the
“State Register.” MDH will be accepting comments on the proposed changes until
Aug. 22, at 4:30 p.m. Comments and requests for a free copy of the rules should
be sent to the agency contact person, Patricia Segal Freeman, by mail at P.O.
Box 64975, St. Paul, MN 55164-00975; by fax at 651-201-5501; or by email at email@example.com. All
interested persons are encouraged to comment. If MDH receives 25 or more
written requests for an administrative hearing, a hearing will be held on Sept.
19 at 9:30 a.m. in B144, Orville L Freeman Building, 625 N. Robert St., St.
Paul, Minnesota 55155.
Access more information on the proposed changes, such as the proposed rules, a
summary of the changes, the Notice of Intent to Adopt (which outlines the
comment and hearing process) and the Statement of Need and Reasonableness
(SONAR), at the MDH Communicable Disease Reporting rulemaking website. return to top
proposes updates to hospital and CAH conditions of participation
The Centers for Medicare and Medicaid Services (CMS) on June 16
issued a proposed rule to update select Conditions of
Participation (CoPs) that hospitals and Critical Access Hospitals (CAHs) must
meet to participate in Medicare and Medicaid. The changes are intended to align
Medicare requirements with current standards of practice, support improvements
to quality of care and reduce barriers to care.
Comments on this topic are due to CMS by Aug. 15. MHA will be submitting
comments and MHA members can choose to include their comments with MHA’s
letter. To participate in MHA’s submission, send comments by July 28 to Tania Daniels, vice president of quality and safety, MHA. return to top
proposes no payment for new or modified provider-based clinics
The Centers for Medicare and Medicaid Services (CMS) on July 6
published its proposed rule for the Outpatient Prospective Payment System
(OPPS). One proposal would permanently end paying the hospital outpatient
facility fee for designated provider-based clinics that came into existence,
moved their physical address, changed their service delivery outside a family
of services or changed ownership on or after Nov. 2, 2015. The payment to physicians
would revert to the full physician payment rate as if they were an independent
provider, including facility overhead.
This proposal would negatively impact a number of hospital-based clinics, since
the financial incentive to operate these clinics under the hospital’s
outpatient department would be eliminated. MHA will be developing a
comment letter to address the stresses this could place on the system,
including the impact to access, ability to modernize facilities and services,
and overall finances of already low- to negative-margin services.
Comments on this topic and other aspects of the OPPS proposed rule are due to
CMS by Sept. 6. With questions, contact Joe Schindler, vice president of finance, MHA. return to top
comments on proposed rules for inpatient Medicare payments
MHA submitted comments in response to the Centers for Medicare
and Medicaid Services’ (CMS) fiscal year 2017 proposed rule for hospital
inpatient prospective payment systems and quality reporting. Some of the
issues specifically addressed by the MHA letter were concerns about the
unusually high documentation and coding negative adjustment, Disproportionate
Share Hospital (DSH) payment methodology changes and proposed procedures for
notifying outpatient observation patients of their status. A positive item for
hospitals is the reversal and payback by CMS of the two-midnight adjustment
(0.2 percent) that has been in place for the last three years.
Prospective Payment System (PPS) hospitals can expect a net positive 0.81
percent increase to the federal operating rate after taking into account
various mandated adjustments. The portion of payment related to capital costs
is expected to increase a net 1.73 percent.
Comments were submitted June 17 and the final rule from CMS is expected by the
first week of August. The full comment letter is available on the MHA website. With questions, contact Joe Schindler, vice president of finance, MHA. return to top
to offer sexual assault examination training webinars for MHA members
With support from MHA, the Minnesota Coalition Against Sexual
Assault (MNCASA) is offering webinars on providing medical forensic exams for
sexual assault patients. MHA encourages participation in these member-exclusive
training opportunities to improve practices related to medical forensic exams
for sexual assault victims.
A three-part webinar series will provide sexual assault nurse examiner (SANE)
training using medical forensic exam curriculum that was developed for
emergency department nurses. The series is intended for nurses who will be
performing the exams. Participants who complete this series will be better
equipped to perform medical forensic exams. Sessions include:
- July 21, 2-3 p.m.: SANE
Training 101: Part 1 – What is Sexual Assault?
- Part one of this series will teach context around sexual
assault, best practices around hospital responses to sexual assault patients
and how to document the patient’s account of the assault. Participants will
have a deeper understanding of what the crime of sexual assault encompasses,
the impact on victims, the importance of engaging with community partners,
health care providers’ best reactions to patients who have been assaulted and
how to facilitate and document the patient’s account of incident.
- July 28, 2-3 p.m.: SANE
Training 101: Part 2 – The Exam
- Part two of this series will describe the aspects of a medical
forensic exam and explain how to complete each component. Participants will
have a better understanding of evidence collection, injury identification and
the physical exam.
- Aug. 10, 2-3 p.m.: SANE
Training 101: Part 3 – Discharge and Follow-Up
- Part three of this series will cover sexual
assault patient discharge, follow-up and reporting to law enforcement. Topics
such as sexually transmitted infection (including HIV) prophylaxis and
pregnancy prevention will be discussed.
Participants can earn one nursing contact hour CEU for each of the webinars on
July 21, July 28 and Aug. 10. Instructions for requesting CEUs will be provided
after each webinar.
Webinars will be facilitated by Linda Walther, a SANE practicing in the Twin
Cities and the clinical coordinator for the Statewide Medical Forensic Policy
Program, and Kari Ogrodowski, the policy coordinator of the Statewide Medical
Forensic Policy Program.
With questions about webinar content, please contact Linda Walther
or Kari Ogrodowski.
To RSVP for a webinar, email Sarah Bohnet, visual communications
specialist, MHA. return to top