Minnesota Hospital Association


October 03, 2016

MHA Newsline: Oct. 3, 2016

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 websitereturn 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) websitereturn 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 onlinereturn to top