In this issue
Hospital
spotlight: Abbott Northwestern again earns Magnet® status
Abbott Northwestern Hospital in Minneapolis has again attained
Magnet® recognition as part of the American Nurses Credentialing Center’s
Magnet Recognition Program®. This voluntary credentialing program for hospitals
recognizes excellence in nursing and is the highest honor an organization can
receive for professional nursing practice. The Magnet program promotes high
standards based on 14 Forces of Magnetism, including:
- Quality of nursing leadership
(strong, visionary leaders)
- Organizational structure
(decentralized with care decisions made at the unit level)
- Management style (staff members
are involved at all levels)
- Personnel policies and programs
(competitive salaries and benefits)
- Professional models of care
(number and type of staff needed to care for patients)
- Quality of care (always
striving for better patient outcomes)
- Quality improvement (always
learning and a non-punitive environment)
- Consultation and resources
(staff have access to experts and evidence)
- Autonomy (staff practice at the
highest level allowed by their education and licensure)
- Community and the hospital
(staff members make a positive impact on the community)
- Nurses as teachers (teaching is
an important nursing role)
- Image of nursing (viewed as
integral to the hospital mission)
- Collegial interdisciplinary
relationships (team members work together for the patients)
- Professional development
(personal growth and development are valued and are a part of the
mission).
Congratulations to staff and leadership at Abbott Northwestern
on this prestigious honor. Learn more about the Magnet Recognition
Program® or find a Magnet hospital. return to top
28
more hospitals recognized for reducing early elective deliveries
MHA and the March of Dimes have recognized 28 additional
Minnesota hospitals for reducing the number of elective inductions and Cesarean
deliveries performed before 39 completed weeks of pregnancy. Babies delivered
before full term are at increased risk of serious health problems and death in
their first year of life. Each hospital will receive a banner to display that
spreads the message that “Healthy Babies are Worth the Wait.”
Banner recipients were determined by reviewing the MHA Perinatal Safety Roadmap
and early elective delivery outcome data submitted to the Patient Safety
Registry. All recipients had less than a 5 percent early elective delivery rate
for four quarters, a hard stop policy with clearly defined medical indications
for deliveries less than 39 weeks, and a process to monitor the scheduling of
Cesarean sections and inductions of labor prior to 39 weeks gestational age.
The 28 hospitals join 35 others that were recognized in late 2013. For a
complete list of banner recipients, visit the MHA website. For questions, contact Kattie Bear-Pfaffendorf, MHA patient safety and quality specialist,
651-659-1404. return to top
Rebasing
legislation affecting future Medicaid payments
The Minnesota Department of Human Services (DHS) is proposing an
overhaul of the fee-for-service (FFS) payment system for inpatient hospital
services provided to Medical Assistance (Medicaid) beneficiaries. This is an
important and complex proposal that is moving quickly at the Legislature.
Following are the Minnesota Hospital Association's (MHA) key messages for its
members to convey to legislators:
-
Ending the most recent 10
percent cut to hospital payments on Sept. 1, 2014 is the most significant
thing the legislature can do to mitigate the potentially destabilizing
changes in hospital payments. Current law calls for this rate cut to end on July 1,
2015, but MHA is urging legislators to go beyond the DHS proposal by
accelerating the end of this cut to align with the other required payment
system changes in Sept. to help ensure that no hospital sustains dramatic
losses.
- It is critical that the
legislature enact some protections and safeguards for hospitals as the state makes multiple,
complex changes to the Medical Assistance program's payment system. While
hospitals recognize that these changes are necessary when federal ICD-10
requirements are enforced,
they present tremendous uncertainty for hospitals because no one knows how
much more or less hospitals will be paid for the same services after the
changes are implemented.
- Minnesota needs to move forward
with updating hospital payment rates because our current system is
based on hospitals’ costs in 2002. By updating payment rates and the
grouper software used by the state, hospital payments would better reflect
the services MHA members provide to Medical Assistance beneficiaries.
At this time, it is impossible for MHA or DHS to predict how
these interconnected changes will impact individual hospitals. MHA hopes to
have the ability to model some of the changes when DHS has developed a rebasing
formula. Understandably, this legislation is accompanied by a high degree of
apprehension.
Adding to the uncertainty are developments at the federal level. This evening
the U.S. Senate will vote on a bill to delay implementation of the Sustainable
Growth Rate for physician payments. Among the bill's provisions is a one-year
delay in the requirement to convert to ICD-10, thereby creating greater
ambiguity around the timing and sequencing of the interrelated changes proposed
by DHS.
For questions, contact Joe Schindler, MHA vice president of finance
or Matt Anderson, MHA vice president of regulatory and strategic affairs. If
you talk with legislators about this issue, please provide a brief summary of
your conversation and the legislators' reactions to Mary Krinkie,
MHA vice president of government relations or Kristin Loncorich, MHA director of government relations. return to top
CDC
report shows improvements in hospital-acquired infections, more work to be done
A report from the Centers for Disease Control and Prevention
(CDC) details the nation’s progress toward eliminating healthcare-associated
infections (HAIs). The National and State Healthcare-Associated Infections Progress Report finds that nationally significant reductions were
reported in 2012 for nearly all infections, with decreases in central
line-associated bloodstream infections (CLABSI) and surgical site infections
(SSI) leading the way. Hospital-onset C. difficile and MRSA bloodstream
infections saw minimal decreases while catheter-associated urinary tract
infections (CAUTI) increased by 3 percent nationally.
In Minnesota, infection rates are below the national standardized infection
ratio (SIR) for CLABSI and SSI, colon surgery, while CAUTI and SSI, abdominal
hysterectomy continue to present challenges for hospitals. Minnesota hospitals
are involved in a number of efforts to reduce healthcare-associated infections.
-
Minnesota is one of 10 state
health departments participating in CDC’s Emerging Infections Program,
which allows for extra surveillance and research of HAIs.
- Through the Collaborative
Healthcare-Associated Infections Network (CHAIN), hospitals across the
state are implementing a road map of best practices for effective HAI
prevention focused on hand hygiene, transmission precautions, injection
practices, antimicrobial stewardship and environmental cleaning. A gap
analysis for CAUTI, CLABSI, SSI, ventilator-associated events and C.
difficile accompany the HAI road map.
- As a Hospital Engagement
Network, MHA keeps hospitals appraised of state level HAI data and
provides resources on HAI specific prevention best practices.
- Hospitals are engaged in the
national On the Cusp: Stop CAUTI project.
- Hospitals in the Leading Edge
Advanced Practice Topics (LEAPT) project are targeting hand hygiene
compliance and environmental services best practices in order to reduce
the spread of C. difficile infection.
While there is still much work to be done, the efforts appear to
be paying off. Data available through the MHA Hospital Engagement Network show
an 11 percent reduction in CAUTI and a 61 percent reduction in CLABSI. return to top
Rep.
Paulsen supports legislation to establish equity in the Medicare Hospital
Readmissions Reduction Program
MHA appreciates Rep. Erik Paulsen’s (R) recent co-sponsorship of
H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmission
Program Act of 2014.
This legislation would adjust the Medicare Hospital Readmissions Reduction
Program to account for certain socioeconomic and health factors that can
increase the risk of a patient’s readmission.
Some of the specific requirements of the bill include requiring an analysis
(effective in Fiscal Year 2015) of each hospital’s dual-eligible population to
ensure that hospitals are not unfairly penalized for treating the most
vulnerable patients; and exclude from the program certain readmissions that are
classified as transplant, end-stage renal disease, burns, trauma, psychosis or
substance abuse. The legislation would also require the Medicare Payment
Advisory Commission to study whether the program’s 30-day readmission threshold
is appropriate.
MHA has requests pending with the remaining House offices of the Minnesota
congressional delegation to sign onto the bill. A Senate counterpart for this
legislation has not been introduced at this time.
For more information, contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
Sens.
Klobuchar and Franken sign onto legislation supporting a fix to the
two-midnight requirement
Minnesota Sens. Amy Klobuchar (D) and Al Franken (D) recently
signed on as cosponsors to S. 2082, the Two-Midnight Rule Coordination and
Improvement Act of 2014. This legislation would support delaying enforcement of
the two-midnight policy and direct the Centers for Medicare and Medicaid
Services to take a more thoughtful approach by developing a new standard that
will provide clarity on whether a patient should be billed as an inpatient or
outpatient.
Under the current requirement, Medicare beneficiaries must stay at least two
midnights in a hospital to be presumed to be appropriately paid for by Medicare
as an inpatient admission. There are some exceptions to hospital stays of a
shorter duration with proper physician documentation, but MHA is concerned
about the precarious position this puts physicians in at the time of admission.
The requirement is administratively burdensome and gets in the way of the best
medical judgment.
Minnesota Reps. Bachmann (R) and Peterson (D) have signed onto the House
version of this legislation, H.R. 3698, the Two Midnight Rule Delay Act. The
Senate and House bill are supported by MHA and the American Hospital
Association.
For more information, contact Ann Gibson, MHA vice president of federal
relations and workforce, 651-603-3527. return to top
U.S.
House passes legislation to hold off scheduled cuts to Medicare physician
payment cuts
On Thursday, March 27, the U.S. House passed by voice vote
legislation that would hold off scheduled cuts to Medicare physician payments
through April 1, 2015. Medicare physician payments are scheduled to be cut by
24 percent on April 1 without final congressional action. The Senate will still
need to take up this measure. Some of the other hospital-related provisions in
the bill include:
- Two-midnight requirement - extends the delay in
enforcement of the two-midnight requirement through March 31, 2015.
- ICD-10 - delays implementation of the
ICD-10 coding system until Oct. 1, 2015.
- Medicare extenders - extends the
Medicare-Dependent Hospital Program, low-volume adjustment and ambulance
add-on payments through April 1, 2015.
- Sequester - doubles the Medicare
sequester cuts (4 percent) for the first six months of 2024, but
eliminates the sequester cuts for the last six months of 2024.
- DSH - delays the start of Medicaid
disproportionate share hospital payments cuts for one year, until 2017,
but extends cuts for an additional year through 2024.
For more information, contact Ann Gibson,
MHA vice president of federal relations and workforce, 651-603-3527. return to top
DHS
requesting proposals for children’s mental health grant contracts
The Minnesota Department of Human Services (DHS) is requesting
proposals to enter into grant contracts with children’s mental health providers
enrolled in Minnesota Health Care Programs (MHCP) to develop clinical capacity
to provide evidence-based treatment to children and adolescents, specifically
Trauma-Focused Cognitive Behavioral Therapy. The objective is to strengthen the
clinical infrastructure by providing training and consultation to practicing
mental health professionals, particularly across the central region of the
state. The training and consultation will be provided in collaboration with the
Ambit Network. Proposals are due by 4 p.m., Friday, April 28; work is proposed
to start June 1, 2014. The full RFP is available online. For more
information contact Patricia Nygaard at DHS. return to top
April
is National Donate Life Month
Currently, nearly 120,000 men, women and children are awaiting
organ transplants in the U.S. Each year more than 28,000 of them begin new
lives after receiving their transplant. Sadly, an average of 18 people die a
day before getting their second chance due to a lack of organs.
During the month of April, individuals, organizations and communities are
encouraged to support National Donate Life Month and
consider the need for organ, tissue and eye donations. MHA has worked closely
with LifeSource, a federally-designated organization that manages organ and
tissue donation in the Upper Midwest, to increase the number of registered
donors in the state and to strengthen the culture of donation in Minnesota. As
a result, more than 3 million people have registered to be an organ and tissue
donor in Minnesota, North Dakota and South Dakota. In addition, hospitals have
had great success partnering with LifeSource to honor patients’ end-of-life
decisions to donate.
To learn more about how your hospital can get involved with organ and tissue
donation, visit the Life Source website. return to top
More
opportunities to attend mental health workforce community forums
Community forums focused on gathering input on the state of
Minnesota’s mental health workforce continue to be held around the state.
HealthForce Minnesota, in conjunction with Minnesota State Colleges and
Universities (MnSCU), is holding these forums to gather information ahead of a
statewide mental health workforce summit, scheduled for May 28 at Hennepin
Technical College.
Many MHA members have attended their local forums and taken the opportunity to
outline their concerns and ideas about Minnesota’s mental health workforce. MHA
members are encouraged to attend upcoming local forums and provide input.
HealthForce is seeking specific examples of what barriers exist to recruiting
and retaining mental and behavioral health staff, as well as possible solutions
to these barriers.
The scheduled community forums are as follows:
Visit the HealthForce Minnesota website for more
information, or contact Jen McNertney, MHA policy analyst,
651-659-1405. return to top
Honoring
Choices Minnesota sponsoring advanced care planning facilitator certification
course
This “must have” advanced care planning (ACP) facilitator
training course is offered to interdisciplinary healthcare providers,
caregivers, community members, interdisciplinary healthcare students, and other
interested individuals. The course is designed for individuals who want to
learn how to lead effective in-depth ACP conversations. It utilizes the
Respecting Choices® curriculum and certification process to provide
the needed skills to lead conversations on future health care wishes and
preferences.
Course objectives:
- Describe interview skills for
basic ACP, planning for adults with chronic, progressive illness and those
living in long-term care
- Demonstrate beginning
competency in facilitating basic ACP discussions
- Demonstrate competency in
completing a health care directive
- List a variety of educational
materials and tools available for promoting and assisting with ACP
- Identify key strategies for
community engagement
- Identify key principles and
strategies to develop an effective ACP program
The training takes place Friday, May 9 from 8
a.m. – 4:30 p.m. at the Broadway Ridge Building in Minneapolis. Registration
and additional details are available online. CEUs available for nursing and social
work. Space is limited so early registration is recommended. return to top