In
this issue
MHA
selected to continue improvements in patient safety
Hospital Improvement Innovation Networks to continue patient
safety improvement efforts started under the Partnership for Patients
initiative
The Minnesota Hospital Association (MHA) has been selected as one of 16
national, regional, or state hospital associations, Quality Improvement
Organizations, and health system organizations to continue efforts in reducing
preventable hospital-acquired conditions and readmissions. The Hospital
Improvement Innovation Network (HIIN) contracts awarded build upon the
collective momentum of the Hospital Engagement Networks (HEN) and Quality
Improvement Organizations to reduce patient harm and readmissions. This
announcement is part of a broader effort to transform our health care system
into one that works better for the American people and for the Medicare
program.
“We are very honored to be selected from applicants nationwide to continue our
work on improving health care quality and safety for all Minnesotans,” said Dr.
Rahul Koranne, MHA’s chief medical officer. “Building on more than 15 years of
quality improvement work at MHA, and through our past participation in the
Hospital Engagement Network, hospitals and health systems across the state were
able to make significant progress toward reducing hospital-acquired conditions
and readmissions, as well as reducing harm across the board. We are excited to
continue our journey of relentless quality improvement in service of patients
and families as members of the new Hospital Improvement Innovation Network.”
MHA will receive $4.25 million for each of the next two years to continue the
statewide quality improvement work begun in 2011 with the Partnership for
Patients Hospital Engagement Network. The HEN sought to
reduce patient harm from hospital-acquired conditions in 10 focus areas. As
part of the HIIN, MHA will continue work in the 10 focus areas plus additional
areas, including the following:
- Increasing from 69 to 100
percent the number of hospitals having Patient and Family Engagement Councils;
- Reducing catheter-associated urinary tract infections
by building on the current “bundle,” that is, 4- 5 evidence-based steps
that providers follow for culturing every patient every time;
- Building on an 81 percent
reduction in sepsis mortality rates;
- Reducing readmissions beyond the 30 percent
reduction under HEN by helping hospitals partner with their
communities to work on mental health, medication safety and transitions
between settings of care;
- Creating a streamlined
improvement tool for hospitals called SAFER Care that addresses all harms in
one roadmap. MHA was recognized by CMS for a SAFER Care roadmap for
critical access hospitals as part of HEN.
“Minnesota’s hospitals and health systems work to provide every
patient with the highest quality care,” said Dr. Jeffrey Lyon of Essentia
Health, who chairs MHA’s Quality and Patient Safety Committee, comprised of
hospital and health system leaders from across Minnesota. “Participating in HEN
from 2011 through 2016, our hospitals and care teams served as national leaders
in expanding quality and patient safety improvement efforts. Our selection for
HIIN provides us with additional opportunities and resources to fuel statewide
collaboration that will benefit patients, families and communities.”
Through 2019, these Hospital Improvement Innovation Networks will work to
achieve a 20 percent decrease in overall patient harm and a 12 percent
reduction in 30-day hospital readmissions as a population-based measure
(readmissions per 1,000 people) from the 2014 baseline.
To learn more about MHA's participation in HIIN, visit the MHA website. return to top
St.
Cloud Hospital CAUTI Quality Leadership Academy earns inaugural CHAIN Award
St. Cloud Hospital’s catheter-associated urinary tract infection (CAUTI)
Quality Leadership Academy (QLA) on Sept. 28 earned the inaugural CHAIN Award
for Excellence in Infection Prevention, presented by the Collaborative
Healthcare-Associated Infection Network (CHAIN).
Formed in 2011, CHAIN represents a partnership led by the Minnesota Chapter of
the Association for Professionals in Infection Control and Epidemiology
(APIC-Minnesota), MDH, MHA and Stratis Health. CHAIN develops and helps
implement effective approaches for eliminating healthcare-associated infections
(HAIs) in Minnesota. This year, CHAIN is specifically focused on reducing and
preventing catheter-associated urinary tract infections (CAUTI) and the spread
of Clostridium difficile infection
(CDI).
The CHAIN Award for Excellence in Infection Prevention recognizes the HAI
prevention initiatives of individual health care professionals or teams in
hospital settings who are working to build a safer overall health care
environment through the reduction of CAUTI and the spread of CDI.
Although St. Cloud Hospital had previously worked to reduce CAUTI through steps
like staff education and new policies, sustainable results were not achieved.
The hospital formed a CAUTI QLA collaborative to identify opportunities for
improvement related to hospital CAUTI rates.
“QLA members are a collaborative, multidisciplinary team comprised of leaders,
physicians, nursing, patient safety experts, and affected department
stakeholders,” said Ellen Simonson, St. Cloud Hospital’s director of infection
prevention and control. “The group incorporates principles of adaptive
leadership to create an environment of improvement directed toward achievement
of the Triple Aim.”
The CAUTI QLA reviewed occurrences of CAUTI; identified opportunities for
improvement, specifically in neurosurgical patients who had urinary catheters
inserted for fewer than six days; and developed a five-part process to address
the areas of need. The process focused on reducing primary UC insertion,
identifying points at which UCs should be removed post-surgery and ensuring
care team competency on two-person UC insertion technique.
The hospital implemented interventions including:
- Providing care team training
and competency validation on two-person UC insertion technique
- Revising surgeon procedure
cards to eliminate automatic pre-procedure UC placement
- Individually assessing each
patient for UC need immediately prior to the procedure
- Communicating to support the
need for catheter placement or demonstrate why UC insertion was not
necessary
“During these interventions, we recognized the need to exercise
leadership, such as acknowledging staff feelings of ‘blame’ for CAUTIs;
ensuring product availability for incontinence management; and managing the
practice change of automatically placing catheters as directed by the procedure
cards,” said Simonson.
The interventions yielded measurable results for patients. In the two years
preceding the CAUTI QLA, there were 15 CAUTIs in the Intensive Care Unit
neurosurgical patient population. Post-intervention, zero CAUTIs have been
attributed. The post-surgery removal of UCs where appropriate decreased
opportunities for a patient to acquire a CAUTI by 35 percent.
St. Cloud Hospital plans to expand these successful interventions to
appropriate patients in the general surgery population and Emergency Trauma
Center. return to top
Mental
Illness Awareness Week is Oct. 2-8
Mental Illness Awareness Week (#MIAW) was established by
Congress in 1990 to take place the first full week in October. This year, the
26th annual Mental Illness Awareness Week is Oct. 2-8. The week’s
theme revolves around building a movement of replacing stigma with hope by
taking the #StigmaFree pledge.
One in five adults experiences mental illness problems every year; however, 50
percent of chronic mental illness begins by age 14 and three-quarters by age
24. Although many people today understand that mental illness is a medical
condition, individuals and families affected by mental illness are still often
subjected to stigma and discrimination.
Being stigma-free means learning about and educating others on mental illness;
focusing on connecting with people to see each other as individuals and not a
diagnosis; and, most importantly, taking action on mental health issues and
taking the StigmaFree pledge.
For more information, visit the National Alliance on Mental Illness (NAMI) website. return to top
Minnesota
Hospital Price Check website updated with 2015 data
The Minnesota Hospital Price Check website has
been updated to include calendar year 2015 data. Based on the claims data that
Minnesota hospitals provide to MHA, the site includes charge information on all
inpatient Diagnosis Related Groups (DRGs) and the top 25 outpatient procedures
for each hospital.
MHA has maintained the Minnesota Hospital Price Check website as a public
resource since 2007. While the state of Minnesota requires that only the top 50
most frequently utilized DRGs are publicized, MHA publishes data on all
inpatient DRGs to provide the public with the most complete information
available. The website is updated annually by Oct. 1 with data from the
previous year.
Individuals visiting the Minnesota Hospital Price Check website should note
that the data can be used to help compare overall charges among regional health
care providers but should not be used as an estimate for what a patient can
expect to pay. The charges posted are an average of what the hospital charges
all payers – commercial insurers, Medicare and Medicaid. The data does not
include charges for the physician or other professional fees, such as pharmacy,
diagnostic imaging or lab work.
When comparing recent data released by the Centers for Medicare and Medicaid Services for the top100 DRGs, Minnesota’s charges are 6 percent below the national
average. That means our charges are relatively low compared to other states. In
addition, when looking at the variation of average charges from high to low
charges, Minnesota’s inpatient hospital charges show considerably low variation
among hospitals.
With questions, contact Mark Sonneborn, vice president of health
information and analytics, MHA, 61-659-1423. return to top
MHA
submits comment letters to CMS
Each year, the Centers for Medicare and Medicaid Services (CMS)
proposes new rules for various payment activities. This year has yielded
numerous proposed rules with further implementation of the Affordable Care Act
(ACA). MHA recently commented on the proposed 2017 outpatient prospective payment system (OPPS) rule
and a new Medicaid Disproportionate Share (DSH) rule.
The main concern cited by MHA in its OPPS comments is the proposed elimination
of payments for Hospital Outpatient Departments (HOPDs). MHA, along with the
American Hospital Association, argue that while the Bipartisan Budget Act of
2015 called for site-neutral provisions, CMS has certain flexibility for
transitioning to a new system. CMS’ proposal is extremely restrictive and could
impact access to care. Fortunately, the proposal does not impact provider-based
clinics operated by Critical Access Hospitals.
In the Medicaid DSH rule, CMS proposes to include individuals covered by
commercial insurance who would otherwise be Medicaid-eligible either due to
condition or financial status in the Medicaid DSH calculation of costs versus
payments. This proposal negatively impacts hospitals’ ability to recoup
Medicaid losses through the DSH program, as is the intent of the program.
Children’s and safety net hospitals are particularly impacted.
For more information, contact Joe Schindler, vice president of finance, MHA,
651-659-1415. return to top
CentraCare
Health’s Dennis Miley retires
Dennis Miley retired as administrator of CentraCare Health –
Paynesville effective Oct. 1. CentraCare Health will be announcing his
successor in the near future.
Miley was an active member of MHA during his career as a health care leader. He
served on numerous MHA committees, most recently the Healthcare Leadership
Institute Task Force and the Small, Rural Hospital Committee. He also served as
the Region 3 chair in 1999.
Miley was honored in 2008 with the American Hospital Association Grassroots
Champion Award recognizing his exceptional leadership in generating grassroots
and community activity in support of his hospital and its patients. return to top
Randy
Shaver Cancer Research and Community Fund seeks grant applicants
The Randy Shaver Cancer Research and Community Fund raises funds
for cancer-related research and community projects in Minnesota. Its mission is
to support research, prevention, treatment and other needs of the cancer
community throughout the state.
As a statewide resource, the Randy Shaver Research and Community Fund is
seeking applications for the current grant funding cycle. The organization
will grant over $500,000 through a Request for Proposals process. Funds may be
used for:
- Technology or tools that would
enhance early detection of cancer
- Costs for promising new
programs that promote research that would help prevent cancer relapses
- Projects that demonstrate
research in the area of cancer
- Programs that enhance the lives
of Minnesota’s Cancer Community by providing aid or assistance
- Program expansion or special
projects of a time limited nature
Applications are due by Oct. 31. Learn more and
download the grant application online. return to top