March 4, 2016
Unsatisfactory/Needs Improvement
Yesterday, the Centers for Disease Control and Prevention released its annual Healthcare Associated Infections Progress Report for acute care hospitals and the data are alarming: 
  • On four of the six measures (MRSA, C. difficile, catheter-associated urinary tract infections, and abdominal hysterectomy surgical site infections), Maryland ranks 48th or worse nationally
  • On the other two measures - central line-associated bloodstream infections and colon surgical site infections - Maryland ranked 32nd and 24th, respectively
  • On half of the six measures, Maryland saw a significant increase in rates compared to the national baseline
  • Maryland showed statistically significant improvement on just one measure: CLABSI 
These data are surprising when in contrast, under the auspices of the Medicare waiver, hospitals have made notable and impressive progress on reducing readmissions and potentially preventable complications.
They are alarming - not because these data are uniformly measured across the nation, and not because they represent metrics outlined in the U.S. Department of Health and Human Services' national action plan to prevent HAIs (though those facts are concerning) - but because they indicate that patients at Maryland's hospitals are at risk.
While it's easy to understand hospitals' frustration with multiple quality measures and the challenge of improving in several areas simultaneously, Maryland's performance on this report suggests that a rapid and meaningful course correction is needed. For your consideration: 
  • Conduct a deeper analysis into your hospital's performance on these metrics to better understand opportunities for improvement
  • Convene an executive-level discussion around how to course-correct based on your findings
  • Consider the array of resources now available to help improve these metrics, like the Maryland Patient Safety Center's Clean Collaborative (designed to reduce C. difficile and MRSA rates), and offerings from our Quality Improvement Organization, VHQC
  • Continue to examine your hospital's data on these metrics on a monthly basis, consistent with mandated CDC reporting requirements 
This is a bitter pill for Maryland's hospitals to swallow - especially given the monumental change that you've undergone and tremendous success you've achieved in the past couple of years. But facts are facts and these data, limited as they may be, are a call for Maryland's hospitals to collectively rise to this challenge.

At Work in Annapolis
Taking a very brief break from the General Assembly action is MHA's government relations team in our Annapolis offices, from left: Legislative Aide Jane Krienke and government relations directors Pete Baron, Brian Frazee, and Jennifer Witten.
Past the halfway point in the 2016 session, the team continues to advocate for our top priorities: reducing and eliminating Maryland's Medicaid tax on hospital care, restraining out-of-control liability costs, and improving care for people suffering from mental health and substance abuse problems. Numerous other issues have demanded attention as well and work groups on various issues are meeting to finalize legislation.  MHA participated in several legislative and budgetary hearings; the Medicaid and Behavioral Health Administration budget hearings were held, along with legislative hearings on telemedicine, extrapolation, network adequacy, and mental health parity. MHA also participated in several medical liability bill hearings including the cap on noneconomic damages, civil liability, and health courts. Keep up with the latest on these important bills in today's Advocacy Dashboard.
Resources Available to Help Reduce HAIs
The Centers for Disease Control and Prevention on Thursday released its annual Vital Signs Report focusing on the progress hospitals are making on health care-associated infections (HAIs). The report noted that the field needs to be vigilant against antibiotic-resistant organisms (or "superbugs") such as some strains of C.diff and MRSA and advocates that strong Antibiotic Stewardship Programs are one way to do this and continue the fight against HAIs. The CDC also released its annual update to its National and State HAI Progress Report, and MHA shared talking points with hospital public relations and quality leads. In addition, the CDC launched its Antibiotic Resistance HAI Patient Safety Atlas, which provides interactive data about HAIs caused by antibiotic-resistant bacteria. This data is designed to be used by health departments and facilities to help prioritize infection control priorities as well as for academic researchers, drug and device manufacturers and other interested parties. Other resources include the Maryland Patient Safety Center's Clean Collaborative (designed to reduce C. difficile and MRSA rates), and the infection prevention tools provided on VHQC's website (hospital staff will have to create a login).
Armstrong Institute Offers DVT Webinar
The Johns Hopkins University Armstrong Institute for Patient Safety and Quality will mark the start of Deep Vein Thrombosis Awareness Month by offering a free webinar March 8 at 2 p.m. Participants will learn about strategies at the provider, nurse and patient levels for ensuring that all hospitalized patients receive risk-appropriate prophylaxis. The presentation will cover not only prescribing, but the often-overlooked issues surrounding whether ordered doses are actually administered. Hear how Johns Hopkins blood-clot prevention experts are seeking to improve administration using analytics, nurse training, patient education and other interventions. Click here for details and to register.
Webinar Addresses Transfers from OR to ICU
The Agency for Healthcare Research and Quality is hosting a free webinar on the implementation of TeamSTEPPS as part of a collaborative effort to improve the triaging of patients from the operating room to the intensive care unit. The webinar, March 9 at 1 p.m., is called "Five hours in the PACU?  MetroHealth Uses TeamSTEPPS to Improve Patient Transfer from the OR to ICU." It will feature two TeamSTEPPS champions from the MetroHealth System in Cleveland: Joseph F. Golob Jr., M.D., medical director of patient safety and the surgical ICU, and Robert L. Smith, Ph.D., director of medical staff assistance and TeamSTEPPS programs. Their presentation will discuss how the need for the TeamSTEPPS intervention was identified, the role of electronic health records in the implementation effort, and the results of this cross-unit effort. Click here to register.
Using Education to Re-recruit Your Managers
It is no secret that finding and keeping talented managers is more difficult today than ever before. Maintaining an appropriate pay structure has proven difficult. 

Looking for a Cutting-Edge Provider for Blood and Associated Services?
For more than 60 years, Blood Bank of Delmarva (BBD) has provided blood and blood components to hospitals throughout the Delmarva region, helping avoid blood shortages and saving thousands of lives with assistance from more than 150,000 current donors.

CDC: Hospitals Preventing Infections; Antibiotic Resistance Ongoing Challenge

Acute-care hospitals reduced central-line associated bloodstream infections by 50 percent and surgical site infections by 17 percent between 2008 and 2014, according to a Vital Signs report released Thursday by the Centers for Disease Control and Prevention.

Tuesday, March 8
MHA Executive Committee meeting

Wednesday, March 9
Health Services Cost Review Commission meeting

Thursday, March 10
MHA Financial Technical Work Group meeting
The Baltimore Sun, By Meredith Cohn, March 3
Modern Healthcare, By Steven Ross Johnson, March 3
The Baltimore Sun, By David Anderson, March 3
NPR, By Andrea Hsu, March 2
The Baltimore Sun, By Pamela Wood and Michael Dresser, March 2
Baltimore Business Journal, By Sarah Gantz, March 1
Capital Gazette, By Ben Weathers, February 29
Modern Healthcare, By Shannon Muchmore, February 29