MHA Today | October 11, 2019

October 11, 2019
MHA Today: News for Healthcare Leaders

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October 11, 2019

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 Next week is Healthcare Security and Safety Week. Unfortunately, with the growing incidence of violence in hospitals, security and safety have become an everyday concern. In fact, nearly half of hospitals surveyed by MHA about preparedness and safety indicated that violence ranked in the top three internal risks in 2019.

Violence in hospitals is an organizational and cultural challenge. Hospitals are required to safeguard staff, patients and visitors. This responsibility can leave hospital administrators and staff caught between regulatory agencies. In addition, most violence that occurs in the hospital comes from outside the organization. Early data from MHA’s surveillance indicate that the majority of reported incidents are directed at employees by patients or visitors, with approximately two-thirds involving an individual with a mental health diagnosis. Emergency departments report the highest number of incidents followed closely by other patient care settings.

Late this week, 125 emergency preparedness leaders from throughout the state met at MHA’s Annual Emergency Preparedness and Safety Conference. Planning and preparedness leaders were educated on the components of safe care environments and workforce resiliency to help them integrate worker safety into their all-hazards planning.

Hospitals cannot address the problem of violence alone. MHA is growing our partnerships with the Missouri Departments of Health and Senior Services, Mental Health, and Public Safety to mitigate violence, including expanding opportunities to work with the Missouri Crisis Intervention Team Council. When community stakeholders work together to understand the triggers that can lead to violence, hospitals benefit. These include systems to mitigate the risk within the community, and training in de-escalation of community members as they interact with first responders.

Some of the effort will require change within the hospital. The September edition of Trajectories — which recently was highlighted in the International Association for Healthcare Security and Safety newsletter — provides an update on security and safety practices, and strategies for engagement. The recommendations include strategies hospitals can adopt to foster safe care environments.
Healing Happens Here Campaign
We’re also working to address the cultural issues. The Healing Happens Here campaign sets expectations for behavior in hospitals. The resources are a reminder that hospitals are a place of healing and that physical and verbal abuse aren’t welcome.

All of these efforts are components of the S.A.F.E.R. Initiative, which provides multifaceted resources for hospital safety and security.

The integrity of the hospital workforce is at stake. Caregivers at the front line have a difficult job. However, no hospital employee should consider verbal or physical abuse “just part of the job.” Hospitals’ ability to recruit and retain employees will, in part, be determined by our ability as hospital leaders to protect them in the workplace.

Hospitals need clarity in determining the guardrails as administrators try to balance conflicting guidance between patient and workforce safety. MHA has been working with Sen. Roy Blunt to engage the Department of Health and Human Services and Occupational Health and Safety Administration to work together to reconcile rules that conflict when accounting for patient and worker safety. So far, the agencies have been slow to address the issue.

As health care moves into the “Quadruple Aim,” workforce resiliency efforts will grow in scope. Addressing violence is a core element to that resiliency.

There’s much work to be done to improve safety. The progress we’re making — toward understanding the drivers of violence, strategic partnerships to mitigate it, and better regulations to safeguard workers and patients — is important. As the data emerge on violence in hospitals, we’ll continue to deliver tools to improve hospitals’ policies.

We’ll be working to communicate our efforts next week. Look for materials in MHA Today and on social media that you can share internally and with the community you serve.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Missouri Makes Progress In Mitigating Opioid Use Disorder
MLN Connects Provider eNews Available

Quality and Population Health

Missouri Makes Progress In Mitigating Opioid Use Disorder

Staff Contact: Shawn Billings or Tiffany Bowman

In the U.S., 19.3% of adults with mental illness also experienced a substance use disorder in 2018. In particular, opioid misuse and the use of synthetic opioids — namely, fentanyl — have had a profound impact on Missouri’s communities. Individuals routinely present to emergency departments seeking help with opioid withdrawal, poisoning and — all too often — due to opioid overdose.
Mitigating OUD in Missouri
Missouri hospitals, community-based agencies and statewide partners have rallied behind this public health emergency and are making significant progress. This collaborative work centers on workforce and infrastructure development, naloxone distribution, overdose prevention education, increased access to evidence-based opioid use disorder treatments, including pharmacotherapy, and decoding the role of social determinants of health outcomes. Working together is the best way to combat this epidemic and heal our patients, families and communities.

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Regulatory News
the latest actions of agencies monitoring health care

MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

Updates to MLN Connects Provider eNews were issued by the Centers for Medicare & Medicaid Services. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • New Medicare card: 80% of claims submitted with Medicare Beneficiary Identifiers
  • Quality Payment Program: Merit-based Incentive Payment dates and deadlines
  • Proper use of the KX modifier for Part B immunosuppressive drug claims
  • Fiscal year 2020 Inpatient Prospective Payment System and Long-Term Care Hospital PPS claims hold
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Did You Miss An Issue Of MHA Today?

October 7, 2019
Trump Administration, CMS Enhance Nursing Home Transparency
This Week Is Mental Illness Awareness Week
CMS Announces OQR Education Session

October 9, 2019
ED Mental Health Dashboard Available To Member Hospitals
HHS Proposes Stark And Anti-Kickback Revisions
CMS Issues FY 2020 Inpatient PPS Correction Notice
Missouri AIM Collaborative Launches November 1
St. Louis Area School District Sues Vaping Company

Consider This ...

Next week is Healthcare Security and Safety Week. Nationally, hospitals and health care providers are four times more likely to be victims of violence in the workplace compared to all other industries.

Source: Missouri Hospital Association