Montana Flex Grant & Performance Improvement Network
2625 Winne Ave | Helena, MT 59601
Phone: 406-442-1911
www.mtpin.org
 Website                              Email                               Facebook
Important Dates

March 1 
Final deadline for Q4 2015 PIN Benchmarking

March 16-17
MHA Health Summit
Bozeman, MT

March 12 
Lean Internship 
Application Deadline

Mid-March
Data collection open for:
Q4 MBQIP (CART)
Q4 EDTC

April 6 
Q3 HCAHPS Due
(submitted by vendor)

April 27-28 
MHA Leadership Institute
Billings, MT
April 30
Q1 EDTC due 

May 1
Q4 MBQIP Outpatient Measures due to QualityNet

May 15
Q4 Imm-2 due to QualityNet

Q4 2015 & Q1 2016 Healthcare Worker Immunization due to NHSN
Quick Links
February 2016
Flex Grant/PIN Newsletter
Welcome to the Flex Grant and Performance Improvement Network (PIN) Newsletter!   This periodic newsletter is designed to be a summary of the latest activities of the MT Flex Grant and the work of the PIN; as well as a look at what is coming up.

Please contact us anytime with questions, suggestions, and content!
Lean Internship Program Applications Open

The 2016 Flex/MSU Lean Rapid Improvement Event Internship application is available HERE.  

All MT CAHs are eligible to participate in this innovative, successful project where MSU Industrial Engineering student interns conduct two-week rapid improvement events in your facility over the summer months.  MT Flex has offered this popular program for six years and students conducted almost 60 rapid improvement events in many CAHs across the state.  

Sample projects include improving ER flow, central supply inventory control, assessing radiology productivity, improving OR turnaround times, improving dietary work flow, pharmacy inventory control.....just to name a few.  This can be a nice compliment to current Lean projects you may already have underway. 
 
The application is simple but careful thought should be given to the project you select.  These are 2-week rapid improvement events so projects must be to scale.  Existing data is very important.  The application provides a complete description of the project.  Application deadline is March 11.  The application requires an Administrator's signature for consideration.
 
Jamie Schultz, MT Flex Improvement Coordinator and Dr. Sobek, MSU IE&MS Engineering Program Director, will help scope your project and determine necessary data if need be.  You can reach Jamie at 406.457.8016 or jamie.schultz@mtha.org
 
MT Flex Grant Support for CAH Attendance at the MHA Health Summit


The MT Flex grant will financially support attendance for up to two staff members from a Montana CAH that work in quality, nursing director positions, or as CEO.   MT Flex will cover the early bird conference registration fee, one night's lodging, and a travel stipend.   To receive financial assistance, attendees must attend the Flex Update and a minimum of three other Flex aligned sessions. Flex aligned sessions will be denoted on registration.
 
Education sessions designated as "Flex-aligned" include the Flex Update and Roundtables, QI Showcases, and topics touching on project management, workflow, and QI and IT alignment.  We are very excited about our topics and speaker caliber!  There will be some time for fun at the CAH Staff Dinner Wednesday night - food, fun, and networking with your peers!
 
HOW TO REGISTER WITH FLEX SUPPORT
 
To register for this year's event, please go to www.mtha.org or click on the following link:  Register Today!
  • Choose MHA Member
  • Enter your details and select your hospital from the list.
  • Choose your job code: (CEO, DON or Quality)
  • Register for Sessions.   The Flex Update and three other Flex aligned sessions are required to receive reimbursement.
  • You pay nothing now. Conference fees will be adjusted following the conference if attendees meet the above guidelines. 
  • CAH Staff will receive a reimbursement form at the Flex Update session.
  • Flex staff will communicate with MHA Education staff to ensure appropriate financial assistance for CAH Staff.
MBQIP Minute

ZERO CASES
Please complete the zero cases survey for Q3 2015 cases.  If you know your Q4 zero cases you may complete the survey for that time period also.

OUTPATIENT REPORTING
CART Entry for Quarter 4 2015 Cases: 
CART Q4 2015 data entry has been delayed until at least Mid-March 2016 due to ICD-10 conversion.   New paper tools will also be available at this time.

CARE TRANSITIONS (ED TRANSFERS)
Q1-2015 cases due to MT Flex/PIN by April 30th.  You may enter concurrently by using the tools here.

PATIENT SATISFACTION
If you don't have a vendor, please visit our website here.

PATIENT SAFETY REPORTING
IMM-2 (Flu Immunizations for Eligible Patients)
Q4 2015 cases are the first cases for data collection for this MBQIP measure.  This measure is reported to CART Inpatient for Quarters 4 and 1 (October - March) that cover the designated flu season.

NHSN Enrollment and Healthcare Provider (HCP) Flu Immunizations
Healthcare Provider (HCP) flu immunization is a newly required MBQIP measure.  This measure is submitted to the National Healthcare Safety Network (NHSN).   You may be familiar already with NHSN as HAI and other patient safety measures are submitted here as well.

HCP immunization is an annual data submission.   Hospitals are to report for the flu season (defined as October 1 - March 31).  Data is due by May 15th.

Meeting the requirement of submitting this measure does include enrollment in NHSN.  The MT HAI Prevention Initiative, Mountain-Pacific Quality Health, Hospital Engagement Network and MT Flex grant have pooled efforts and resources to aid MT CAHs in completing NHSN enrollment and to provide assistance in reporting and surveillance.

For NHSN Assistance please contact:
Christine Mulgrew, PhD MPH
Epidemiologist
MT DPHHS, Communicable Disease Epidemiology Section
406-444-0274
cmulgrew@mt.gov

 
Click here for the NHSN paper abstraction tool for HCP immunizations.
Click here for the Montana HCP Immunization Consensus Statement.
What's Trending on the PIN List Serve

Respite Care
When a patient is placed in a Respite care setting do the providers need to have a History and Physical, Discharge Summary and how often do they round on the patient.  Respite care is a Private pay situation.
  • At our facility, we do not have a "respite care" status and I do not believe there is a status of "respite care" in a critical access hospital.  Every patient who is admitted to a non-skilled swing bed at MCH is treated the same regardless of their pay source.  I am not sure how the "respite" status got started here at our facility but we had our medical staff convinced that they did not need to do any of the items you discuss below.  We have since educated our medical staff that the patients who come here are swing bed patients and need to be treated that way.  I am convinced that the survey folks would have a problem with us if we did not complete the items listed below.
  • If you are not billing for professional services then no, unless you want the documentation for risk management purposes.
  • It has been the practice at several facilities I worked in both North Dakota and Montana that once a patient is deemed comfort care only or the code status changes then the nurse plan of care changes. As far as an H&P and discharge summary goes then the same rules apply as the rest of the patients.  

KCL IV/Outdated Medications
Our KCl additive outdated 02/01 and our pharmacist has been unable to get any.  It is "back-ordered."  He has asked me to query you on the list-serve and see if anyone knows of a methodology for using an outdated medication when you are unable to obtain new stock or an equivalent alternative. Does anyone have a policy or procedure and/or know of an option available?

  • Good question, this happens to us also.
    We try and get it in small quantity from Benefis, but never thought about emergency expired use!
  • Our pharmacist gives me a letter that states that the drug is on back order and or unavailable. I keep the med on hand then for emergency. I also will go to our Sister Hospital and try to buy from them. I have also gone to places like Dubin Medical, Golf Coast Pharmaceuticals, etc... and paid outrageous prices for the med. 
  • Here is a great link - that can tell you about current and resolved shortages - why, when they will be resolved and suggested alternatives. http://ashp.org/menu/DrugShortages
     
    The second is the specific report on potassium
     
    You could also try the FDA licensed compounding pharmacies - But be sure they are registered with the FDA 
     
Safety Officer
We have recently lost our safety officer due to retirement who was the plant manager. Who do your facilities have as the safety officer besides the plant manager. Our new Plant manager is somewhat reluctant to take this role. Any thoughts would be appreciated.
  • I (Director of QI) am the Safety Officer here along with my other roles.  I run the Safety Meetings, do minutes, do policies, etc.  Of course our facilities manager is part of the Safety Committee so we have his expertise.  One reason I have kept this role is that our facilities guys were not comfortable managing a committee and the duties that entails.
  • Our safety officer used to be our Facilities Manager - it is now me (
     Quality/Discharge planning).  I had it when I was the DON and it followed me to my present position as Clinical Care Coordinator.  It doesn't have to be the facilities person.
  • HR Director
 
facility spotlight   
Facility Spotlight

 
  
CMMC Outpatient Cardiac Rehab Program Recognized for Outstanding Performance 
Submitted by Julie Reiman, QIC
 
The staff of Central Montana Medical Center's Outpatient Cardiac Rehab Program was recently recognized for their outstanding work. The Cardiac Rehab program at CMMC continues to be involved in the Regional Cardiac Rehabilitation Outcomes Project that is sponsored by the Montana Association of Cardiovascular and Pulmonary... Rehabilitation (MACVPR) and the Cardiovascular Health Program within the Montana Department of Public Health & Human Services. The program is entering the 10th year of the project, and there are over 110 cardiac rehab programs from 17 states tracking and reporting on a uniform set of evidence-based cardiac rehab quality indicators.

CMMC's cardiac rehab program had the highest rating of all small hospitals from Montana and Wyoming who participated in the project. Of the 13 quality indicators evaluated, CMMC's cardiac rehab program exceeded the regional benchmark in 9.5 of the 13 indicators.

Debby Lee, RN; Paxton Mitchel and Margaret Smith received the award at MACVPR's annual conference in Billings. According to Michael McNamara, Montana Department of Public Health & Human Services, the staff were recognized in front of their peers "for the excellent job they are doing and for the excellent care they are providing the cardiac patients in Lewistown."
 



State Employee Health Center Coming to Anaconda

Submitted by Jamie Johnson, DON
The State of Montana and CareHere, along with Community Hospital of Anaconda, are excited to announce the opening of a Montana Health Center in Anaconda.  The Montana Health Centers offer primary care services, chronic disease management, and health coaching at no cost to State of Montana Benefit Plan (State Plan) members, their dependents over 2-years-old, retirees who have the State Plan as their primary coverage.    The state contracts with CareHere to operate all its health centers.

The Anaconda Health Center location is a little different from ones in Helena, Butte, Missoula, Billings, or Miles City.  The facilities in those locations are leased by the state. CareHere employs the providers and manages the everyday clinic operations. In Anaconda, CareHere is contracting with Community Hospital to hire the staff and providers at the Pintler Family Medicine East practice to see eligible State of Montana Benefit Plan (State Plan) members on Wednesdays.

Montana was the first state government in the nation to open employee health centers as a means of improving the health of its employees and reducing the costs of health care.  Preliminary data shows that the Helena health center provided State Plan members more than 25,000 primary care appointments in 2013 and saved the State and State Plan members almost $3 million.
Lt. Governor Angela McLean joined Department of Administration Director Sheila Hogan for the grand opening of the Montana Health Center in Anaconda.    

 "The Anaconda Health Center represents a new model of partnering with a local hospital in a way the will benefit both State employees and main street Montana." McLean says. "This center will give our hard working correctional officers and other state employees in the Anaconda area access to important primary care services so they can take good care of themselves and their families."

Community Hospital CEO Steve McNeece says, "The hospital is pleased to collaborate with the State of Montana and CareHere to offer a state health clinic in Anaconda.  CHA is excited for this opportunity and we are committed to providing personalized, quality health care to the members of the State of Montana Benefit Plan."

Submit your facility spotlight to Jennifer Wagner (jennifer@mtha.org) to meet the sharing requirement for a PIN Quality Award!
 

 

This publication was made possible by Grant #H54RH00046 (MT Medicare Rural Hospital Flexibility Grant) from the Health Resources and Services Administration (HRSA), Office of Rural Health Policy (ORHP) to the MT Department of Public Health and Human Services (DPHHS).  Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA, ORHP or MT DPHHS. 

 
MHA logo with link

  

 

dphhslogo2013

 

Copyright © 2012. All Rights Reserved.