MHA Today | June 9, 2017

June 9, 2017

MHA Today: News for Healthcare Leaders

twitter linkedin MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Herb Kuhn, MHA President & CEO

In the summer of 2014, Los Angeles physician, Rishi Manchanda, delivered a health-focused TED talk that was a catalyst to the expanding “upstreamist” movement in health care — the central tenet of public health. It is predicated on a simple idea: most elements of health occur “where we live, and where we work, where we eat, sleep, learn and play — where we spend the majority of our lives.” Physicians’ offices and hospital emergency departments are downstream of these places. I’d like to use his thinking to share thoughts on the problem of violence in hospitals and communities.

The American Hospital Association has designated today as a National Day of Awareness to focus attention on progress toward ending all forms of violence. However, rather than recruit you at this late hour, let me share what Missouri hospitals are doing.

Violence is often a downstream consequence. It occurs too often in hospitals when patients and families are placed in high-stress situations, or individuals with behavioral health conditions or substance abuse issues react against caregivers and others, often forcefully. It happens more frequently than most realize. And, it happens in communities for more reasons than could be listed in this space.

The consequences of violence in hospitals often involves law enforcement and legal and regulatory conundrums. First and foremost, providers want to deliver safe and appropriate care to patients while protecting family and co-workers.

Ending violence is aspirational. Reducing violence and mitigating the harm are actionable.

Similar to the upstreamist approach to care, reducing violence doesn’t start at the bedside — although hospitals are preparing for it to manifest there. It begins by focusing on better health and more resilient communities.

Last year, MHA collaborated with the Kansas Hospital Association in the release of a new system for evaluating the likelihood of adverse childhood experiences’ influence on health downstream. Since many of the components of the methodology are built around violence-related ACEs, the solutions must be focused on violence reduction. Last week, the study’s author, Mat Reidhead, was part of a panel discussion where he presented the research, which has drawn attention locally and nationally.

Better data, including ACEs’ research, can help us predict and mitigate poor health. And, strong community-based partnerships to address the downstream problems associated with upstream family- and community-based violence should be included in hospitals’ community health needs assessments.

Hospitals should be a safe haven. Too often, they are not.

Keeping hospital employees, patients and visitors safe has been an important part of efforts to establish community resiliency. Since 2010, 2,371 Missouri hospital employees have participated in training programs through MHA, designed to react to, and reduce, violence. These include programs from responding to armed violent intruders to de-escalating situations that could lead to violence. MHA’s S.A.F.E.R. initiative provides a structural framework for hospitals to address violence when it enters the facility, with tools, education and resources to assist staff in making deliberate and appropriate decisions in high-stress situations. Yet, there is more to be done, and MHA and Missouri hospitals continue to develop new strategies to safeguard patients, families and the workforce. Hospital preparedness for violence is an upstreamist intervention.

The toll of violence is high. According to the Centers for Disease Control and Prevention, more than 2.3 million Americans are treated in U.S. emergency departments annually for injuries from violence. Violence has an annual cost of $85 billion in medical expenses and lost productivity. The downstream cost of those who never present at an ED for violence, yet suffer poorer health as a result of violence in families and communities, is far higher.

Hospitals can’t do it alone.

The parable that Manchada uses is common in public health. It relates the story of three visitors at a river. The beautiful scene is shattered by the cries of a child. As they begin to work to save the children they find floating downstream, one by one they devise strategies to save them before they fall over the waterfall — each more effective in saving more children. They are successful at saving some, but not all. Eventually, they notice that one of their group is missing. She’s swimming upstream and saving kids as she goes. When they yell out to find out where she’s going, she says, “I’m going to find out who is throwing these kids in upstream.”

We may not be able to stop violence, but being aware of it — in our communities and hospitals — is essential to reducing it. Each individual we reach upstream means better downstream health and greater safety. It means stronger, healthier and more resilient communities throughout our state.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Seeks Comments About Reducing Regulatory Burden Caused By ACA
MHA Launches Readmission Immersion Project
ASPR TRACIE Hosts EMS And Infectious Diseases Webinar
HRSA Announces Faculty Loan Repayment Program

Regulatory News
the latest actions of agencies monitoring health care

CMS Seeks Comments About Reducing Regulatory Burden Caused By ACA

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a request for information to seek input on ways to eliminate or change regulations that are outdated, unnecessary or ineffective. This RFI is a direct result of President Trump’s executive order “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal,” in which the secretary of the U.S. Department of Health & Human Services was directed to “afford the states more flexibility and control to create a more free and open health market; provide relief from any provision or requirement of the [Patient Protection and Affordable Care Act] that would impose a fiscal burden on any state or a cost, fee, tax, penalty, or regulatory burden on individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products, or medications; provide greater flexibility to states and cooperate with them in implementing health care programs; and encourage the development of a free and open market in interstate commerce for the offering of health care services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.” Comments must be submitted within 30 days after publication in the Federal Register.

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Quality and Population Health

MHA Launches Readmission Immersion Project

Staff Contact: Toi Wilde

MHA is launching the Readmissions Reduction/Care Transitions Immersion Project – Cohort 2 Tuesday, Aug. 15. The project focuses on decreasing readmissions and improving care transitions for hospital-based patients. The project timeline starts Aug. 15 and ends Sept. 7, 2018. Registration will open at 9 a.m. Monday, June 12, and close at 5 p.m. Friday, July 14. Registration is limited to 20 Missouri hospital participants. Complimentary registration is available for Hospital Improvement Innovation Network participating hospitals through contract funds. Non-HIIN participating hospitals can contract through Quality Works to participate according to the fee schedule. For more information, a project flyer and intent to participate are available.

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ASPR TRACIE Hosts EMS And Infectious Diseases Webinar

Staff Contact: Stacie Hollis

ASPR’s Technical Resources, Assistance Center, and Information Exchange, is hosting a webinar at 1 p.m. Thursday, June 22, that will introduce the Emergency Medical Services Infectious Disease Playbook. The playbook provides information on how to transport patients known to have, or suspected of having, an infectious disease. The webinar will explain why and how the playbook was developed, walk participants through the content, and share how best to use the playbook in daily practice. The webinar also will discuss current challenges that the EMS community faces related to infectious diseases. Register online.

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Workforce News

HRSA Announces Faculty Loan Repayment Program

Staff Contact: Jill Williams

The Health Resources and Services Administration’s Faculty Loan Repayment Program helps recruit and retain health professions faculty members by encouraging students to pursue faculty roles in their respective health care fields. Applications are being accepted through Thursday, June 29. HRSA encourages interested applicants to read the application and program guidance.

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Did You Miss An Issue Of MHA Today?

June 8, 2017
Governor Releases Special Session Details
MHA Launches Leadership And Quality Assessment Tool Survey Project
HCAHPS Announces Patient Perspectives On Care Survey Deadline
MLN Connects Provider eNews Available

June 7, 2017
Greitens Calls Special Session On Abortion Legislation
MHA Research Underscores Missouri And Nonexpansion States Inequity In AHCA
CMS Announces IPFQR Program Education Session
NCHWA Releases New Health Workforce Projections

June 6, 2017
CMS Reminds IPFs Of Program Requirements
April MUR Available On HIDI Analytic Advantage®
Violence Awareness Day Provides Opportunity To Discuss Efforts

June 5, 2017
MHA Distributes Analysis For FFY 2018 Proposed LTCH PPS
CMS Releases Interpretive Guidelines For EP Rule
CMS Announces Delay In Hospital Compare Update For Certain Measures
U.S. Supreme Court Rules For Hospitals In Church Plan Dispute

Consider This ...

Five percent of pregnant women with a confirmed Zika infection in the U.S. territories, including Puerto Rico, went on to have a baby with a related birth defect, according to the most comprehensive report to date from federal officials.

Source: The New York Times