The MHA Keystone Center Patient Safety Organization (PSO) Annual Meeting brings together national safety and clinical experts each year to discuss hot topics in healthcare. It will be held virtually from 9 a.m. to 3:10 p.m. March 9.
During the past several years, there has been an increasing prevalence of workplace violence in healthcare, and COVID-19 has contributed to violent behavior. That is why a key focus for the 2022 meeting is workplace violence and well-being.
Ken Smith, CHSP, CIE, CHCM, vice president at Healthcare Safety Services, will assist hospitals and health systems in complying with The Joint Commission’s new standards on workplace violence that took effect in January. Additionally, he will identify prevention strategies and action plans to assist health systems and hospitals with increasing workplace violence due to the COVID-19 pandemic.
Bryan Sexton, PhD, director of the Duke Center for Healthcare Safety and Quality, will outline the WELL-B webinar series that will begin March 29, demonstrating the efficacy of bite-sized interventions to sustain improvements in healthcare worker well-being.
Additional presentations will focus on anticoagulation-related adverse medication events and the intersection of health equity and safety.
Registration is free and available to MHA Keystone Center PSO members. Continuing education opportunities will be offered. Members with questions may contact the MHA Keystone Center PSO.
The Centers for Medicare & Medicaid Services (CMS) recently included proposals related to the quality reporting programs for long-term care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs) in its proposed rule to update the Medicare fee-for-service prospective payment system for home health agencies (see related article). LTCHs and IRFs were initially scheduled to begin reporting two new quality measures Oct. 1, 2020, including Transfer of Health Information to the Provider and Transfer of Health Information to the Patient, as well as several standardized patient assessment data elements (SPADES).
Due to the COVID-19 public health emergency (PHE), the CMS declined to release updated versions of the patient assessment tools necessary for reporting this information and delayed the compliance date for reporting these items until Oct. 1 of the year that is at least one full fiscal year after the end of the COVID-19 PHE. The CMS proposes to require reporting of these measures and SPADES beginning Oct. 1, 2022, since COVID-19 cases and deaths have declined. The MHA encourages LTCHs and IRFs to submit comments to the CMS regarding this provision by Aug. 27. Members with questions should contact Vickie Kunz at the MHA.
The MHA and the MHA Keystone Center have long been committed to addressing health disparities, a foundational concept that shapes the organizations’ quality improvement and safety efforts.
One effort in ensuring equitable outcomes for all has been supporting hospitals to address health disparities through consistent collection of accurate demographic data, such as race, ethnicity and language, in addition to disability and veteran status. By creating a standardized process for collecting this information, health systems can take strides to ensure all patients can reach optimal treatment outcomes.
A simple, yet critical, action healthcare organizations can take to improve patient demographic collection is implementing a screening question to identify service members and veterans. This ensures they get connected with appropriate and important resources available to them.
The most effective way to accurately identify patients’ military service is to ask the question, "have you or a member of your household served in the military?" It is part of the “Ask the Question: Did They Serve” initiative championed by the Michigan Veterans Affairs Agency (MVAA) in collaboration with the Veterans Health Administration and the Substance Abuse and Mental Health Services Administration to prevent suicide among service members, veterans and their families.
Using "have you served?" instead of "are you a veteran?" allows those who may not consider themselves a veteran or are uncomfortable identifying as such to answer yes, ensuring they receive access to services and support they earned.
The MVAA will connect service members, veterans and their families to critical benefits and programs including healthcare and mental health, education and employment, legal aid and other resources. All services are free and confidential and can be accessed by calling (800) 642-4838 (1-800-MICH-VET).
This simple question is a critical screening tool for the medical community and may provide an opportunity for a referral to be made to benefits veterans have earned. Flyers are available that healthcare providers can distribute to these patients.
Twenty MHA Keystone Center Patient Safety Organization members participated in a virtual Rural Health and Opioids Safe Table Nov. 17. Safe tables encourage peer-to-peer guidance by offering legally protected, confidential environments for discussion around sensitive topics.
In addition to the ongoing challenges presented by the COVID-19 pandemic, an increasing number of reports from national, state and local media suggest increases in opioid and other drug-related mortality. The pandemic has exacerbated the nation’s opioid epidemic, which has grown even more complicated and deadly. Participants engaged in conversations about how the pandemic has highlighted socioeconomic factors that negatively impact patient populations, such as patients who do not have access to transportation for their appointments.
The Northern Michigan Opioid Response Consortium (NMORC) and the MHA Keystone Center also presented current efforts to address opioid misuse. NMORC is focusing on improving poor economic factors, prescribing patterns and expanding statewide distribution of naloxone, a medication approved by the U.S. Food and Drug Administration designed to rapidly reverse opioid overdose.
The MHA Keystone Center discussed its partnership with the Michigan Center for Rural Health to offer providers training on opioid-related academic detailing, which is peer-to-peer educational outreach focused on delivering evidence-based information in a dynamic, engaging and clinician-centric way. Members with questions may contact the MHA Keystone Center.
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule for the Medicare fee-for-service physician fee schedule (PFS) payments, effective Jan. 1, 2021. The proposed rule would update the PFS rates and implement year five of the quality payment program created by the Medicare Access and CHIP Reauthorization Act of 2015. The CMS proposes to:
Reduce the conversion factor to $32.26, with the budget neutrality adjustment to account for changes in relative value units, as required by law. This would be a decrease of $3.83, or 10.6%, from calendar year 2020.
Add services to the Medicare telehealth list of services and make other changes to retain certain COVID-19 telehealth flexibilities.
Increase payment rates for office/outpatient evaluation and management visits.
Expand supervision of diagnostic tests by certain nonphysician practitioners.
Delay the next Clinical Laboratory Fee Schedule (CLFS) data reporting period by one year so that hospital outreach laboratories would not need to report private payer data before the Jan. 1 through March 31, 2022, time period.
Eliminate the phase-in of CLFS payment cuts through calendar year 2024.
Align the Medicare Shared Savings Program reporting requirements with Meaningful Measures to reduce reporting burden and focus on patient outcomes. Automatic full credit for Consumer Assessment of Healthcare Providers and Systems patient experience of care surveys will be provided for performance year 2020. More information is available on the Quality Payment Program fact sheet, which can be downloaded from the Quality Program Resource Library on the CMS website.
Implement provisions of the Substance Use disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, including Medicare coverage for opioid treatment programs, screening for substance use disorder in Medicare physicals and electronic prescribing of controlled substances.
The CMS will accept comments on the proposed rule through Oct. 5. The agency has waived its typical timeline for releasing the final rule, which may result in release of the final rule as late as Dec. 2 for the Jan. 1, 2021, effective date. Members with questions should contact Renée Smiddy at the MHA.
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As healthcare facilities encourage their patients and staff to feel comfortable coming back to their facilities, doing so as safely as possible is a primary objective. This will require long-term planning, comprehensive solutions, and consultations with experts from both the science and industry communities. The months – perhaps years – ahead will probably remain volatile and dynamic, but there are reasons to remain optimistic. The two-part webinar series Continuing with Confidence in Healthcare Facilitieswill be offered from 11 a.m. to noon EDT Aug. 11 and 18.
The Aug. 11 session will describe several approaches to consider when evaluating a comprehensive strategy. Participants will learn about important programs and solutions that can help to eliminate harmful pathogens, both in the air and on surrounding surfaces. They will also explore how to identify people with elevated skin temperatures and be able to track high-risk situations through contact tracing.
The Aug. 18 webinar will give participants a deeper understanding of important programs and solutions that can help to create and maintain a healthy Indoor Air Quality program. Some of these strategies are cloud-based analytics; creative heating, ventilation and air conditioning strategies; and various sophisticated and sustainable energy management programs.
The webinars are offered free of charge, but members must register to receive dial-in instructions. Questions about the webinars should to be directed to Kristen Hammock at the MHA.
The Infection Prevention Boot Camp webinar series gives healthcare staff a thorough understanding of how to create and lead a comprehensive infection prevention and control plan across units and disciplines. Credentialed, expert faculty will detail critical quality and safety processes and measures through six webinar sessions, held from 2 to 4 p.m. EDT each Thursday from Aug. 13 through Sept. 17.
Each two-hour webinar focuses on specific content that infection preventionists must know to prevent and control infections. Topics include the role and core competencies of the infection preventionist, the infection prevention and control requirements of various regulatory bodies, how to develop an infection control risk assessment and infection prevention plan, how to evaluate an infection prevention program, the elements of an effective surveillance program, and the prevention and treatment of specific infections.
The registration fee for the six-session boot camp is $600 per line for MHA members and $700 per line for non-MHA members. Register online or contact Erica Leyko at the MHA for more information.
The Leadership Corner features updates from the MHA leadership team. The updates will provide new insights to safety and quality, as well as updates on MHA Keystone Center activities and initiatives.
Ewa Panetta, BA, CPPS, manager of safety and quality, MHA Keystone Center, discusses the MHA Keystone Center Age-Friendly Health Systems Action Community and the importance of equipping hospitals to provide age-friendly care during a pandemic.
The impact of the 2019 Novel Coronavirus (COVID-19) pandemic on healthcare systems has been profound as organizations adjust to a continually evolving environment. Nevertheless, healthcare employees continue to perform remarkable work in the face of many unknowns.
One key lesson has surfaced during this pandemic – the urgent need for age-friendly healthcare. Older adults and individuals with underlying, serious medical conditions are at higher risk for morbidity and mortality related to COVID-19. Addressing this issue has been a priority for the MHA Keystone Center Age-Friendly Health Systems Action Community, which focuses on reliably implementing geriatric care consistent with evidence-based best practices.
Funded by the Michigan Health Endowment Fund, the MHA Keystone Center Age-Friendly Health Systems Action Community models the successful Age-Friendly Health Systems movement launched by the John A. Harford Foundation and Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association and Catholic Health Association of the United States in 2017. The initiative focuses on adults 65 years and older by concentrating on the 4Ms Framework for creating age-friendly environments.
What Matters to the patient/family.
Medication – using age-friendly medications that don’t interfere with Mobility, Mentation or What Matters.
Mentation – preventing, identifying and treating conditions like dementia, depression and delirium appropriately.
Mobility – ensuring older adults move safely every day to maintain and improve function.
These essential elements ensure that older adults receive optimal care across healthcare settings, experience no healthcare-related harms and that the care they receive aligns with What Matters the most to them and their caregivers. The initiative is designed for hospital-based teams (emergency departments, ICUs, general wards and medical-surgical units) and ambulatory care teams (primary care and specialty care).
The MHA Keystone Center launched its first cohort of the Age-Friendly Health Systems Action Community in October 2019. During the seven-month Action Community, teams focus on assessing and implementing the 4Ms elements. Participating organizations are eligible to receive two levels of recognition by the IHI:
Age-Friendly Health System Participants are recognized for being on the journey to becoming an Age-Friendly Health System and have submitted a description of how they are putting the 4Ms into practice.
Committed to Care Excellence as an Age-Friendly Health System is recognition for exemplars in the movement. Organizations that receive this recognition demonstrate profound alignment with the elements of the 4Ms Framework.
Of the 20 participating sites, three organizations – Sparrow Ionia Hospital, TONE Home Health, and Bronson LakeView Hospital – have been recognized by the IHI as Age-Friendly Health Systems
The MHA Keystone Center acknowledges these efforts and encourages the sustainability of age-friendly care.
The MHA Keystone Center Age-Friendly Health Systems Action Community has adjusted its timeline, needs and priorities during the COVID-19 pandemic to better serve participating sites. Despite these circumstances, participants continue to reach the Age-Friendly Health Systems recognition levels.
Lessons Learned During the COVID-19 Pandemic
The COVID-19 pandemic has increased awareness and the need for Age-Friendly Health Systems. By becoming an Age-Friendly Health System, hospitals and healthcare practices are well-equipped to support older patients at a higher risk of severe illness.
What Matters: To provide high-quality and safe care, clinicians should understand and actively support What Matters to the patient. Conversations about advance care plans and goals of care are the essential first steps in care planning. Healthcare clinicians are encouraged to use telehealth channels to ask patients their goals, preferences and priorities. They can work together to build a care plan focusing on physical distancing and ensuring they have all their basic needs met, such as access to food or medication.
Medication: The 4Ms Framework enhances facilities’ focus on reviewing and deprescribing high-risk medications. If medication is necessary, the use of age-friendly medication that does not interfere with What Matters to the older adult, Mobility, or Mentation is encouraged. The COVID-19 pandemic presents medication management challenges for older adults. Older adults may experience barriers to managing their medication at home or receiving medication, as many stay home per federal and state guidelines.
Mentation: While isolating at home, older adults are at a higher risk for developing mentation issues like depression and delirium. The 4Ms Framework assists healthcare clinicians in prioritizing and putting key strategies in place to help prevent, identify, treat and manage depression, dementia and delirium across the care continuum.
Mobility: With limited opportunities to move around, older adults may experience a decline in function leading to a negative long-term impact. The Age-Friendly Health Systems movement addresses this element by providing support for clinicians to ensure they work with older adults to find safe alternatives to moving around safely every day.
The MHA Keystone Center Age-Friendly Action Community continues to serve as a supportive community for healthcare teams working to provide evidence-based care to older adults while lowering care costs. The MHA Keystone Center is exploring opportunities to continue the Age-Friendly Health System movement in the future.
Please view the MHA website for additional MHA Keystone Center quality improvement projects and future cohorts of the Age-Friendly Health Systems Action Community.