Minnesota Hospital Association


December 08, 2014

MHA Newsline: Dec. 8, 2014

In this issue 

Encourage the flu vaccine during National Influenza Vaccination Week

Influenza activity is on the rise in Minnesota but it’s not too late to get vaccinated. MHA is joining the Centers for Disease Control and Prevention (CDC), the American Hospital Association and others to be United Against the Flu – a campaign to amplify the importance of getting vaccinated. Dec. 7-13 is National Influenza Vaccination Week – the perfect time to encourage staff and your community to get their flu vaccine. People 65 and older, young children and those with chronic conditions such as asthma or heart disease are especially susceptible to the flu, making it all the more important that health care workers who care for these populations get vaccinated. return to top   

Budget forecast positive, legislators express caution

Last week, the Office of Management and Budget (MMB) reported good economic news. Highlights include: 

  • Minnesota has a $556 million projected surplus for the current biennium. State law requires MMB to direct 33 percent of this forecast balance to the budget reserve. As such, $183 million of the surplus will be transferred to the budget reserve, leaving a $373 million balance. 
  • The projected surplus for state fiscal years 2016-17 is $664 million, bringing the total projected surplus to $1.037 billion. 

Gov. Dayton will use this forecast to finalize his budget recommendations, which will be released on Jan. 27, 2015. The next forecast will be released at the end of February and will be used by both the governor and the legislature to set the 2016-17 budget, beginning July 1, 2015.   

While the small budget surplus is welcome news to policymakers, the economic forecast also included reasons to proceed with caution. The U.S. economic outlook has weakened since the last report and as a result Minnesota’s economists have modified the GDP projections. Senate Majority Leader Tom Bakk (DFL-Cook) cautioned that the surplus might not be large enough to cover the inflationary increases on ongoing spending obligations and that lawmakers might have to cut some spending.    

Of particular concern to the health care community is the 13.9 percent projected increase in spending for health and human services. MHA is in the process of analyzing the budget forecast and the projected health care expenditures; recognizing that most Medical Assistance provider payments are flat, so cost increases are driven by enrollment and/or utilization experience.   

For questions, contact Mary Krinkie, vice president of government relations, 651-659-1465 or Kristin Loncorich, director of government relations, 651-603-3526. return to top   

Minnesota hospitals make progress in preventing patient harm

Minnesota hospitals and health systems have prevented more than 12,000 patients from being harmed and saved more than $93 million as a result of a reduction in hospital-acquired conditions from 2010-13. Nationwide, hospitals experienced a 17 percent reduction in harm, preventing 1.3 million patient harms and saving more than $12 billion in health spending, according to a report issued by the U.S. Department of Health and Human Services.  In Minnesota, the largest improvements were in the number of hospital readmissions prevented; reduction in elective deliveries prior to 39 weeks gestation; fewer patient falls; fewer adverse drug events; fewer infections; and fewer patients experiencing a pressure ulcer. The efforts were part of the federal Partnership for Patients initiative in which 115 Minnesota hospitals participated over the past three years.   

MHA is proud of the work of member hospitals and your commitment to improving patient care and outcomes. Each participating hospital has been sent a Minnesota plaque to recognize your participation.   

Last week, the Centers for Medicare and Medicaid Services (CMS) presented the MHA Hospital Engagement Network an award for its participation and performance in the Partnership for Patients initiative and the Leading Edge Advanced Practice Topics with a plaque and certificate. Nationwide, more than 3,700 hospitals participated in this important three-year initiative to improve patient safety. The Partnership for Patients had the ambitious goals of reducing hospital-acquired conditions by 40 percent and readmissions by 20 percent by the end of 2014.  return to top   

Minnesota hospitals recognized for excellence in medication-use safety

The Minnesota Hospital Association (MHA) was named a finalist for the 2014 Award for Excellence in Medication-Use Safety from the American Society of Health-System Pharmacists (ASHP) Research and Education Foundation. The award recognizes innovative initiatives to improve medication safety. 

MHA and its member hospitals were recognized for the “Road Map to a Medication Safety Program,” which provides evidence-based recommendations/standards for Minnesota hospitals in the development of a comprehensive medication safety program. The Road Map is a tool to focus a hospital’s attention and resources on adverse drug events, specifically related to anticoagulants, diabetes medications and opioids. In the first two years, the Road Map helped Minnesota hospitals make significant progress in reducing adverse drug events. It is estimated that 1,977 fewer events have occurred since the Road Map inception. This is equivalent to 77 fewer events per month or 1.6 fewer events per day.   

Participating hospitals have been able to make tangible, concrete changes based on the Road Map, which resulted in clinical improvements. Examples include decreasing Naloxone use by redesigning order sets to address opioid tolerant and opioid naïve patients; and improving communication between the hospital electronic medical record and the outpatient anticoagulation clinic that decreased inpatient elevated INRs, a measure of the time it takes blood to clot.  return to top   

MDH issues Ebola-related Health Advisory

The Minnesota Department of Health issued a Health Advisory on Nov. 26 providing guidance for where Persons Under Investigation (PUI) for Ebola—patients with symptoms consistent with Ebola AND epidemiologic risk factors for exposure to Ebola—will be treated in Minnesota. As was reported last week, four hospitals in Minnesota have been designated an Ebola treatment center. These four hospitals have agreed to accept: 

  • PUI who is part of MDH’s active monitoring program 
  • PUI from another health facility in transfer or through pre-hospital EMS, once MDH has determined that the patient is a Person Under Investigation 

In addition, on Dec. 2 the Centers for Disease Control and Prevention (CDC) issued Interim Guidance for Preparing Frontline Healthcare Facilities for Patients with Possible Ebola Virus Disease. The guidance reiterates the message that all acute care hospitals and other emergency care settings including urgent care clinics, and critical access hospitals, need to be able to identify, isolate, evaluate and immediately notify MDH about potential Ebola patients. The guidance is available here.   

MHA members determined that going forward the all-hospital preparedness calls will take place every other week as opposed to weekly. The next call is scheduled for Thursday, Dec. 18 at 3 p.m. The schedule will be evaluated and adjusted as necessary. return to top   

APRNs must act now to be licensed by Jan. 1

As MHA previously reported, Minnesota state law now requires a separate license for Advance Practice Registered Nurses (APRNs). All Minnesota APRNs must be licensed by Jan. 1, 2015.      

The Minnesota Board of Nursing reports a very heavy work load and is urging all APRNs to complete their applications and submit payment to the Board immediately to allow the Board time to process and to be in compliance with the law. The four roles impacted by this law are Clinical Nurse Specialist (CNS); Certified Registered Nurse Anesthetist (CRNA); Certified Nurse Midwife (CNM); and Certified Nurse Practitioner (CNP).   

To become licensed, APRNs are required to hold a current Registered Nurse license and submit documentation of successful completion of an acceptable graduate APRN program and current certification as an APRN in a role and population focus.   

In addition to requiring APRN licensure, the law removes the requirement for a collaborative management plan and written prescribing agreement for APRNs. CNS and CNPs will be required to practice for 2,080 hours within the context of a collaborative agreement with a licensed CNS, CNP or physician who has experience in providing care to patients with similar medical problems.   

The Minnesota Board of Nursing is posting a list of APRN licensure that is complete. This will help nurses verify when the process is complete.  

More information can be found, including frequently asked questions, on the Minnesota Board of Nursing’s website. return to top   

12 Minnesota communities selected for accountable health awards

The Minnesota Departments of Health and Human Services selected 12 Minnesota Accountable Communities for Health (ACH) to receive grants as part of the state’s State Innovation Model (SIM) grant from the federal government.   

Researchers estimate that health care accounts for only about 20 percent of a population’s health, while modifiable community, social and economic factors contribute 80 percent. Keeping a person healthy takes a collaborative approach from clinical and community providers. The SIM grants will help the 12 ACHs’ efforts to promote health and improve health care by strengthening clinical and community partnerships. The participating ACH sites, including several MHA members, are: 

  • UCare/Federally Qualified Health Center Urban Health Network (FUHN), Minneapolis 
  • Vail Place/North Memorial, Hopkins 
  • Hennepin County/Hennepin Health, Minneapolis 
  • Generations Health Care Initiatives, Duluth 
  • New Ulm Medical Center, New Ulm 
  • Otter Tail County Public Health, Fergus Falls 
  • Allina Health Systems/Northwest Metro Alliance, Minneapolis 
  • CentraCare Health Foundation, St. Cloud 
  • Southern Prairie Community Care, Marshall 
  • Lutheran Social Service of Minnesota/Bluestone Physician Services, St. Paul 
  • Unity Family Health Care, Little Falls 
  • North Country Community Health Services, Bagley 

MHA was a supporter of the state’s SIM grant proposal to improve health in communities, provide better care and lower health care costs. return to top   

Updating governance practices and board composition on tap at Winter Trustee Conference

Frequent MHA speaker, Larry Walker, president of The Walker Company, will present sessions on updating governance practices and board composition at the Winter Trustee Conference Jan. 9-11 at the Marriott Minneapolis Northwest in Brooklyn Park.   

“Rethinking Governance: Getting in Shape for What’s Next,” will explore why rethinking and redefining the role of governance is vital and practical. Walker will cover ways to examine your governance practices, structure and processes to determine where and how you may need to right-size to meet the challenges of tomorrow.   

In his second session, “Raising the Leadership Bar: Building and Sustaining a Competent Board,” Walker will explore the leading skills and competencies trustees will need to guide their organizations successfully.   

Click here for more information.   

Continuing education for nursing home administrators 

The content of this conference has been approved by the Minnesota Board of Examiners for Nursing Home Administrators for up to 9.25 contact hours. return to top