Quality Initiatives

Launched in 2014, MHA’s Strategic Quality Initiatives department’s mission is to support hospital members in achieving the Triple Aim of better health and better care at lower costs. Technical and adaptive support is provided through active engagement in state and national grants and contracts, and includes in-person and virtual educational events, publications and resources to drive improvement and implementation across a variety of preparedness, quality improvement and population health-related topics. Member-specific projects and trainings are available through the business services line.

  • Publications
  • Resources
  • Resource Library

The Health Research & Educational Trust of the American Hospital Association, with funding from the Centers for Disease Control and Prevention, is bringing together multiple organizations at the state level to improve coordination of infection prevention efforts and foster strong working relationships through the “States Targeting Reductions in Infections via Engagement” program. MHA was awarded a subcontract for the scope of work that began Nov. 1, 2016.

Program Specifics

  • 12-month program for short-stay and long-term acute care hospitals
  • Education:
    • Three webinars to orient teams to the program
    • On-demand videos that facilities can access as needed; topics include: foundations of infection prevention and control and HAI-specific education
    • In-person meeting in the state
  • Technical assistance:
    • On-going support from your state lead
    • Monthly coaching calls
    • HAI-specific office hours with expert faculty

MHA is supporting 14 members through this program. For questions and requests for information, please contact Jessica Rowden.


Trajectories is a quarterly publication from MHA's Strategic Quality Division focusing on progress in quality and population health efforts.

  • The March 2017 issue highlights integrated infection control strategies.

  • The November 2016 issue highlights Missouri hospital successes in achieving the Triple Aim of better health and better care at lower costs.
  • The September 2016 issue discusses how to spot, treat and survive sepsis.
  • The July 2016 issue highlights the importance of diabetes management.
  • The May 2016 issue highlights the importance of hospital preparedness.
  • The March 2016 issue discusses how opioids are a population health dilemma.
  • The January 2016 issue highlights the importance of enhancing quality of care through care coordination.

  • The November-December 2015 issue spotlights disparities in health care quality.
  • The September-October 2015 issue discusses the importance of preventing health care-associated infections.
  • The July-August 2015 issue of Trajectories outlines a four-step approach to harness the power of hospital data to drive quality improvement.
  • The May-June 2015 issue provides an overview of population health, specifically emergency preparedness and community resiliency.
  • The March-April 2015 issue provides an overview of patient harm in Missouri, specifically prevention and safety.
  • The February 2015 issue spotlights women's health, specifically heart health and readmissions.
  • The January 2015 issue spotlights women’s health, specifically obstetrics harm, in Missouri.

  • The December 2014 issue reviews population health management through care coordination and population health improvement through community health.
  • The November 2014 issue highlights the economic contribution and quality of care provided by CAHs to rural communities, and the implementation of the Triple Aim Principles.
  • The October 2014 issue provides an introduction to the MHA quality strategy, building from the foundation established by the Hospital Engagement Network and moving forward to implementing the Triple Aim Principles of better health, better care and lower costs.

Quality News




Case Studies

Critical Opportunity Lost
After presenting to the emergency department, a woman with chest pain was given nitroglycerine and a so-called GI cocktail. Her electrocardiogram was unremarkable, and she was scheduled for a stress test the next morning. A few minutes into the stress test, the patient collapsed and went into cardiac arrest. Case review revealed that providers failed to notice the patient had an elevated troponin level prior to discharge. In the accompanying commentary, Jonathan R. Genzen, MD, PHD, and Heather N. Signorelli, DO, both of the University of Utah School of Medicine, discuss critical values and the importance of prompt communication as well as policies and procedures to ensure appropriate care is initiated.

Medication Mix-Up: From Bad to Worse
Admitted to the hospital with chest pain, headache, and accelerated hypertension, an older man with a history of chronic kidney disease and essential hypertension who had missed several days of his regular medications was to be started back on them gradually. One of his antihypertensive medications (minoxidil) was ordered via the EHR, but a vasopressor/antihypotensive medication with a similar name (midodrine) was dispensed. Fortunately, a nurse noticed the discrepancy before administration. Amanda Wollitz, PharmD, of Florida Hospital Orlando, and Michael O'Connor, PharmD, MS, of Intermountain Healthcare Pharmacy Services, review errors with look-alike, sound-alike medications and offer strategies to prevent them.

Precision Medicine: Health Care Tailored To You

The President's new Precision Medicine Initiative is a bold new enterprise to revolutionize medicine and generate the scientific evidence needed to move the concept of precision medicine into every day clinical practice.

What is Precision Medicine? It's an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.

Aren't we already using Precision Medicine? Yes, significant advances in precision medicine have already been made for select cancers, but the practice is not currently in use for most diseases. Many efforts are underway to help make precision medicine the norm rather than the exception.

What is the President's plan? The President's 2016 Budget invests $215 million in the Precision Medicine Initiative, including key investments to the National Institutes of Health and Food and Drug Administration to support research, development and innovation of this effort.

Trajectories - a monthly publication focusing on progress in quality and population health efforts.

MHA Today - a daily publication provided as a service to members of MHA.

Archived Case Studies

Archived Articles

Recordings and Presentations

What's Up Wednesday Webinars



Immersion Project Overview Webinars

Clinical Quality Webinars

Patient Family Engagement

  • MHA Clinical Quality Quarterly Webinar - Making Patients and Families the Center of Medical Rounding (November 2016) - Recording | PowerPoint
  • MHA Clinical Quality Quarterly Webinar - Patient Family Advisors in Policy Design Strategies (August 2016) - Recording | PowerPoint
  • MHA Clinical Quality Quarterly Webinar - Recruiting Patient Family Advisors (May 2016) - Recording | PowerPoint
  • MHA Clinical Quality Quarterly Webinar - Medication Safety (February 2016) - Recording | PowerPoint

SQI Regional Meetings - Spring

  • Readmissions and Care Coordination: Aim Towards Outcomes (April 24, Springfield) - PowerPoint
  • Readmissions and Care Coordination: Aim Towards Outcomes (April 22, Independence) - PowerPoint
  • Readmissions and Care Coordination: Aim Towards Outcomes (April 15, Cape Girardeau) - PowerPoint
  • Readmissions and Care Coordination: Aim Towards Outcomes (April 14, St. Louis) - PowerPoint

SQI Regional Meetings - Fall

  • Reducing Patient Harm and Infection (September 16, St. Louis) - PowerPoint
  • Reducing Patient Harm and Infection (September 17, Ste. Genevieve) - PowerPoint
  • Reducing Patient Harm and Infection (September 22, Blue Springs ) - PowerPoint
  • Reducing Patient Harm and Infection (September 24, Springfield) - PowerPoint

Electronic Clinical Quality Measure Resources

Confused about the eCQM Program? The CMS Quality Reporting Center has documents to assist. Available in the eCQM Resources section of the website are an overview of the calendar year 2016 eCQM Program, a preparation checklist and FAQs.

Another resource is the CMS eCQM Library where viewers will find eCQM reporting standards documentation and QRDA file specifications.

In addition, The Joint Commission Pioneers in Quality Program offers resources to assist hospitals on their eCQM journey. Webinar recordings also are available.

MHA Resources

Orientation Resources

Orientation resources, including the QAPI Guide, MHA Survey Manual and Quality Regulatory Orientation Guide can be found on the Regulatory Web page. Reporting guides are located above, under MHA Resources.

OB Resources

Antimicrobial Stewardship Program

Click here for additional resources.

Strategic Quality Initiatives Resource Library

The following books and guides are available for check out by MHA member hospitals. These resources will help your hospital continue to identify and improve gaps in quality improvement. Topics include patient and family engagement, health care data, quality improvement, lean six sigma, overcoming change and work/life balance, etc.

Upon request, books will be mailed and can be checked out for a three-week period. Check out is free. For book requests and questions, contact Kristy Strope at kstrope@mhanet.com or 573-893-3700, ext. 1307.

Quality Improvement

  • Common Knowledge: How Companies Thrive By Sharing What They Know. Nancy M. Dixon. ISBN 978-0875849041. 188 pages.
  • From Good To Great, Why Some Companies Make the Leap and Others Don’t. Jim Collins. ISBN 978-0066620992. 300 pages.
  • The Healthcare Quality Handbook: A Professional Resource and Study Guide, 27th Edition. Janet Brown. Hardwiring Excellence- Purpose, Worthwhile Work, Making a Difference. Quint Studer.2003. ISBN 978-0-97449986-0-2. 277 pages.
  • A Culture Of High Performance- Achieving Higher Quality at a Lower Cost. Quint Studer. 2013. ISBN 978-1-622-18003-5. 283 pages.
  • 10 Powerful Ideas For Improving Patient Care Book 3. Maureen Bisognano and Robert Lloyd with Dan Schummers. ISBN- 978-1-56793-266-9. 78 pages.
  • 10 Powerful Ideas For Improving Patient Care Book 4: Maureen Bisognano and Robert Lloyd with Dan Schummers. ISBN-978-1-56793-287-4. 70 pages.
  • 10 Powerful Ideas For Improving Patient Care: James L. Reinertsen and Wim Schellekens with Dan Schummers. ISBN-978-156793248-5. 74 pages.
  • 10 More Powerful Ideas For Improving Patient Care: Maureen Bisognano and Robert Lloyd with Dan Schummers. ISBN-1-56793-236-3. 78 pages.
  • Value By Design – Developing Clinical Microsystems to Achieve Organizational Excellence: Eugene C. Nelson, Paul B. Batalden, Marjorie M. Godfrey and Joel S. Lazar. 2014. ISBN-678-0-470-38534-0. 346 pages.
  • The Value of Close Calls in Improving Patient Safety – Learning How to Avoid and Mitigate Patient Harm: Joint Commission Resources. ISBN-678-1-59940-415-8. 2011. 182 pages.
  • Return on Process (ROP) – Getting Real Performance Results from Process Improvement: Michael West. 2013. ISBN-678-1-4398-8639-7.352 pages.
  • The Healthcare Quality Book – Vision, Strategy, and Tools: Scott B. Ransom, Maulik S. Joshi and David B. Nash. ISBN-1-56793-224-X. 2005. 495 pages.

Data and Analytics

  • The Health Care Data Guide: Learning from Data for Improvement. Lloyd P. Provost and Sandra K. Murray. ISBN 978-0470902585. 480 pages.
  • Healthcare Analytics for Quality and Performance Improvement: Trevor L. Strome. ISBN978-1-118-51969-1. 2013. 226 pages.

Patient and Family Engagement

  • The HCAHPS Handbook 2- Tactics to Improve Quality and the Patient Experience. Lyn Ketelsen, Karen Cook, Bekki Kennedy- Studer Group. 2014. ISBN 978-1-622-18009-7. 425 pages.
  • The Putting Patients First Field Guide- Global Lessons in Designing and Implementing Patient-Centered Care. Margaret Gerteis, Susan Edgman-Levitan, Jennifer Daley, Thomas L. Delbanco. 1993. ISBN 978-1-118-444494-8. 269 pages.
  • Putting Patients First- Designing and Practicing Patient-Centered Care. Susan B. Frampton, Laura Gilpin and Patrick A. Charmel. 2003. ISBN 0-7879-6412-3. 313 pages.
  • Putting Patients First- Best Practices in Patient-Centered Care. Second Edition. Susan B. Frampton and Patrick A. Charmel. 2009. ISBN 978-0-470-37702-4. 304 pages.
  • Through the Patient’s Eyes-Understanding and Promoting Patient-Centered Care. Margaret Gerteis, Susan Edgman-Levitan, Jennifer Daley, Thomas L. Delbanco. 1993. ISBN 1-55542-544-5. 296 pages.
  • Let Patients Help! “e-patient Dave” de Bronkart and Danny Sands. 2013. ISBN 978-1-466306493. 78 pages.
  • A Roadmap for Patient and Family Engagement in Healthcare. Gordon and Betty Moore Foundation. 2014. 67 pages.
  • Patient-Centered Care Improvement Guide. Picker Institute. 2008. 215 pages.
  • Questioning Protocol: Randi Redmond Oster. ISBN-978-0-9899120-0-6. 2014. 288 pages.

Hospital Leadership

  • The Healthcare Imperative – Lowering Costs and Improving Outcome: The Institute of Medicine Of The National Academes. 2010. ISBN-978-0-309-14433-9. 631 pages.

Lean Six Sigma

  • The Lean Six Sigma Pocket Toolbook: A Quick Reference Guide to 100 Tools for Improving Quality, Speed, and Complexity. Michael L. George, David Rowlands, Mark Price and John Maxey. ISBN 978-0071441193. 225 pages.

Change Management

  • How the Way We Talk Can Change the Way We Work: Seven Languages for Transformation. Robert Kegan and Lisa Laskow Lahey. ISBN 978-0787963781. 256 pages.
  • Made to Stick. Why Some Ideas Survive and Others Die. Chip Health and Dan Heath. ISBN 978-1400064281. 291 pages.

Work/Life Balance

  • Decisive: How to Make Better Choices In Life and Work. Chip Heath and Dan Heath. ISBN 978-0307956392. 336 pages.

Emergency Preparedness

  • Crisis Standards of Care. A Toolkit for Indicators and Triggers. Institute of Medicine of The National Academies. Board of Health Science Policy. Dan Hanfling, John L. Hick, and Clare Stroud. 2013. ISBN 978-0-309-28552-0. 183 pages.
  • Crisis Standards of Care. A Systems Framework for Catastrophic Disaster Response. Institute of Medicine of The National Academies. Board of Health Science Policy. Dan Hanfling, Bruce M. Altevogt, Kristin Viswanathan, Lawrence O. Gostin. 2012. ISBN 9778-0-309-25346-8. (Set of seven small books.)
  • The 9/11 Commission Report. Final Report of the National Commission On Terrorist Attacks Upon The United States. Thomas H. Kean, et al. 2004. ISBN 978-0-393-06041-6. 428 pages.