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October 2018
In This Issue
Annual Conference
Safety & Preparedness Updates
HIIN Updates
MoAQH Update
Quality Reporting News
Upcoming Events
Join us on Oct. 18 and 19 for our 2018 Annual Emergency Preparedness and Safety Conference: Creating Safe Environments to Give and Receive Quality Care. 

This conference will feature national experts who will share strategies and lessons learned related to natural disasters and safety incidents. Attendees will have the opportunity to gather approaches to enhance established emergency management programs, as well as integrate preparedness initiatives into daily hospital operations.

Late breaking: We are pleased to announce that we are adding a closing session on Friday, Oct. 19, for Cox Health Emergency Management staff to present on the July 19 Duck Boat Incident in Branson. Staff will highlight the critical impacts to the health care community following a large scale, multi-jurisdictional incident, to include the key players, best practices and opportunities for improvement.

Visit for additional details, including the conference agenda. Register by Thursday, Oct. 4. Limited space remains!

BJH Operation Viral Vacation by Nick McLaren, BJH Public Relations Manager
In 2016, Missouri designated Barnes-Jewish Hospital as the state’s assessment hospital for patients under investigation for Ebola virus disease. The University of Kansas Hospital System in Kansas City, Kan., was authorized in 2018 to support Missouri’s western hospitals for Ebola activity with multiple patients.

Ebola Exercise For more than two years, team members from BJH have been training and fine-tuning the process of caring for a patient suspected of having the virus. If a patient’s test results confirm the presence of Ebola, the patient would be transferred to the regional Ebola treatment center at the University of Nebraska Medical Center. On July 11, BJH, along with several coordinating agencies, put the transfer process to the test.

“Operation: Viral Vacation” was a five-hour, full-scale exercise involving BJH incident management teams, emerging infectious disease task force members, Abbott EMS personnel, City of St. Louis Emergency Management Agency and Department of Public Health, State of Missouri Department of Health and Senior Services, St. Louis Lambert International Airport, and the University of Nebraska Medical Center.

“Viral Vacation was conducted to evaluate our region’s ability to safely transport a confirmed EVD (Ebola) patient from Barnes-Jewish to St. Louis Lambert International Airport,” said Jason Campbell, BJH emergency preparedness manager. “The exercise demanded effective incident command practices, information sharing and resource management among several organizations.”

Ebola Exercise PatientThe exercise began with notification of a confirmed diagnosis at BJH. The emergency operations center (EOC) was activated, and the team in the medical intensive care unit began their preparations for transport.

“The EOC plays a vital role in this type of activity. There are several agencies involved, and the EOC allowed for more effective incident command operations and collaboration with those other response agencies,” said Campbell.

Aside from the EOC and the MICU staff, the team had to call on a specially trained team from Abbott EMS to move the mock patient from the hospital to the airport. To make the 13-mile journey, the incident management team also sought assistance from the City of St. Louis, the state, the Missouri Highway Patrol and the airport.

“Operation: Viral Vacation demonstrated our proficiency in Ebola patient handling,” stated Emma Hooks, BJH director of environmental health and safety and regulatory compliance. “Our trained team members successfully placed the mock patient into isopod containment and transported him to the awaiting ambulance for transfer.”

“As one evaluator reported, exercise clinical and patient transport operations were ‘flawless,’” Hooks said.

Ebola Exercise EMSMichele Gatzert is the patient care manager for the 8300 MICU. Her team was responsible for preparing and moving the patient to the custody of Abbott EMS. “Overall, the exercise was very successful. The observers commented that we demonstrated many successes, such as strong communication among team members and checking in with one another, in addition to strong site management and a consistent focus on safety,” Gatzert said.

With an escort from the Missouri Highway Patrol, the Abbott team transported the mock patient to the airport and loaded him onto an awaiting aircraft.

Viral Vacation, and the resulting after-action report and improvement plan, will help identify gaps to be addressed in future training and exercises across all participating agencies.

“For the future, we will review our levels of personal protective equipment and the timing of patient preparation,” Gatzert said. “The MICU moved so smoothly that, as a result, we were early in preparing for transport.”

This exercise was intended to provide a learning environment with a realistic scenario requiring coordination among multiple agencies. By all accounts, it achieved its desired effect. “The observers said that few teams take exercises as seriously as we do, and they feel confident in our ability to perform in real world events,” said Gatzert.

“Operation: Viral Vacation emphasized the value of the partnerships we’ve forged with key community stakeholders,” said Hooks. “It also verified the St. Louis regional capabilities to safely and efficiently handle suspected or confirmed Ebola patients.”

Safety & Preparedness Updates
Missouri’s 2018-2019 Seasonal Influenza Monitoring Strategy
In response to the high number of hospitalizations due to seasonal influenza during the 2017-2018 season requiring increased staffing, additional supplies and reconfigured space, MHA revised its monitoring strategy for this year. Late last month, a memo and guidance were distributed to Missouri hospital emergency preparedness and infection control directors outlining this process. The revised strategy proactively establishes a set of standardized questions, providing staff with advance notice of the information to be collected. MHA will utilize EMResource to conduct weekly queries of Missouri hospitals, which began Thursday, Sept. 27, in hopes of establishing a baseline dataset before increased influenza activity. The data collected is critical in identifying early warning signs of increased flu activity that may have a direct impact on hospital resources, bed availability and staffing levels.
Missouri Earthquake Planning
Southeastern Missouri is part of the New Madrid Seismic Zone, an active seismic zone with the capability of producing a large, devastating earthquake. Thus, earthquake preparedness and planning are important parts of our emergency preparedness efforts. Continue reading to learn ways in which MHA and our partners are preparing and how you can be involved.

The Great ShakeoutThe Great Shakeout: At 10:18 a.m. Thursday, Oct. 18, people worldwide will participate in an annual earthquake drill. Individuals and many types of organizations, including hospitals, will “drop, cover and hold on” to practice how to protect themselves in the event of an earthquake. This also is a good time to review your facility’s emergency plan, share information about earthquake and general preparedness with staff, or plan a more extensive exercise. To register to participate, or for more information and resources, visit The Great Shakeout website.

Joint State of Missouri and FEMA Region VII New Madrid Seismic Zone Earthquake Interagency Operations Plan: The Federal Emergency Management Agency and Missouri State Emergency Management Agency recently finished a collaborative planning process to revise the Joint State and Federal NMSZ Earthquake Plan. Although the plan is signed, NMSZ planning will continue to refine and operationalize the plan. The plan includes an Emergency Support Function 8: Public Health and Medical Services annex and a Recovery Support Function: Health and Social Services annex. The recently finalized plan is available for review in the EMResource document library.

New Madrid Seismic Zone ExerciseSave the Date: New Madrid Seismic Zone Exercise: Shake and Fury, a multistate exercise, will be held June 3-7, 2019, to test the response capabilities in a New Madrid Seismic Zone event. In conjunction with this exercise, MHA will hold a statewide mobile communications asset exercise with hospitals and other health care coalition members. For more information, or to be part of the exercise planning process, contact Kara Amann-Kale at

National Biodefense Strategy
The following is courtesy of the Office of the President of the United States.

President Trump released the National Biodefense Strategy. The strategy sets the course for the U.S. to combat the serious biothreats our country faces, whether they arise from natural outbreaks of disease, accidents involving high consequence pathogens, or the actions of terrorists or state actors. The strategy enables risk awareness to inform decision-making across the biodefense enterprise; ensures biodefense enterprise capabilities to prevent bio-incidents; strives for biodefense enterprise preparedness to reduce the impacts of bio-incidents; enables rapid response to limit the impacts of bio-incidents; and facilitates recovery to restore the community, the economy and the environment after a bio-incident. The strategy establishes a strong leadership structure and a dedicated mechanism to improve coordination of federal biodefense activities.

Implementation of the National Biodefense Strategy is a priority for the Trump Administration. A National Security Presidential Memorandum, “Support for National Biodefense,” directs implementation of the strategy. Through the strategy, the U.S. will use all appropriate means to assess, understand, prevent, prepare for, respond to and recover from biological incidents—whatever their origin. Strengthening our biodefense will help better protect the American people, our homeland and the welfare of our citizens.

National Biodefense StrategyThe Department of Health and Human Services and the Office of the Assistant Secretary for Preparedness and Response will play a leading role in implementing the strategy. To learn more, please visit

HIIN Updates
Hospitals Meet Milestone Criteria
Thank you for your hard work in submitting data and improving care in your organizations! The HIIN team has reviewed data submission and improvements for the two-year HIIN project and is ecstatic to announce that 53 hospitals met the milestone criteria. MHA HIIN will distribute $80,825 back to those hospitals to continue their work on quality improvement and creating safe care environments. These stipend checks will be sent to the hospitals around mid-October.
AHRQ ICU Project
In August, MHA welcomed 14 ICUs from nine different hospital organizations into the AHRQ Comprehensive Unit-based Safety Program. During this project, units work to improve infection prevention practices, prevent CLABSI and CAUTI, and improve outcomes for their patients. The past month, these ICUs have been busy getting their baseline assessments submitted, conferring their data rights and setting up their teams.
Regional meetings are coming up! Throughout the month of October, regional meetings will take place in three locations from 9:30 a.m. to 2 p.m. These are free for FLEX participating hospitals. Registration is required for each location.
Dates: Locations:
Thursday, Oct. 4 Clinton, Mo.
Wednesday, Oct. 10 Chillicothe, Mo.
Wednesday, Oct. 17 Festus, Mo.
2018 Perinatal Nursing Conference: Improving Outcomes for Mother and Baby
MU Sinclair School of Nursing and the Missouri Section of the Association of Women’s Health, Obstetric and Neonatal Nurses is hosting a conference on Thursday, Oct. 25.

The purpose of this one-day conference is to update the knowledge and enhance the skills of maternal-infant health care providers related to the clinical management and care of high-risk pregnant women and their newborn babies. The day features the latest evidence-based practices and tools applicable to both inpatient and ambulatory perinatal practice settings. Plenary sessions on topics of general interest are supplemented by breakout sessions on more specialized topics.

For additional details or to register, visit the conference web page.

MoAHQ Update by Missy Sutton, MoAHQ President
Missy Sutton, MoAQH PresidentAt MHA’s 96th Annual Convention & Trade Show, MoAHQ will be hosting a full membership luncheon at 11 a.m. on Thursday, Nov. 8. All MoAHQ members are invited and encouraged to attend this complimentary luncheon. The MoAHQ membership luncheon will feature best practices and pearls of success from the Distinguished Quality Award winner and nominees. Alison Williams, MHA Vice President of Clinical Quality Improvement, will provide a Missouri quality update. The district representatives will provide district activity updates, and the president will provide a board update to membership with an open forum for questions. This is a great opportunity to network with other quality professionals and peers.

Quality professionals are managing patient satisfaction, patient safety, emergency preparedness, and risk management, and often are responsible for the outcomes of all clinical areas in the hospital. MoAHQ is aware that these important roles are ever-changing in the health care world of quality. Take time to refresh yourself and meet a few new colleagues with whom you can talk “quality” and who understand your daily challenges. Hope to see you in November!

Visit our updated website at to learn more, or directly contact me at To join MoAHQ, visit our website.
MHA Publications
Sepsis SME Spotlight
Sepsis SME Spotlight September was Sepsis Awareness Month, and MHA shared a Sepsis SME Spotlight article. The subject matter expert shares sepsis bundle updates, a HIINovating practice and helpful resources.
NAS Quality Resource Brief
MHA’s Strategic Quality Initiatives division will periodically release tips and tools to assist hospitals in achieving the Triple Aim – better health, better care, lower costs. MHA recently published a resource entitled, Neonatal Abstinence Syndrome: Guidance to Improve Clinical Documentation and Data Capture.
September Trajectories
Opioid use disorder, a form of substance use disorder, is classified as a chronic, relapsing brain disease. OUD is associated with increased morbidity and death, and it is linked to a decrease in the nation’s average life expectancy. Recently, MHA released a publication on this topic entitled, Trajectories: Integrating Evidence-Based OUD Treatment: A Medication First Model.
September Policy Brief
Good health outcomes rest not only on quality clinical care, but also on nonclinical factors that influence a patient’s health. These factors, known as “social determinants of health,” are a frame around the conditions a clinician identifies as the picture of a patient’s health. MHA recently published a policy brief entitled, Decoding Social Determinants of Health.

Quality Works® Expands Services
Quality Works® expanded its services to include expertise in facilitating and leading clinical quality, population health, safety collaborations and performance improvement education. These offerings include the following.
To learn how our experts may assist your facility, contact Sherry Buschjost at
CMS Issues Addendum to IQR Specifications Manual
Read more.
CMS Releases OQR Specifications Manual
Read more.
CMS Now Accepting CY 2018 eCQM Data
Read more.
TJC Releases Specifications Manual Addendum 2018A1
Read more.
CMS Selects Hospitals for OQR CY 2020 Validation
Read more.

More news can be found in MHA Today.

Upcoming Events

2018 Infection Prevention Week and
Health Care Safety and Security Week


2018 Annual Emergency Preparedness & Safety Conference:
Creating Safe Environments to Give and Receive Quality Care
Tan-Tar-A Resort
Osage Beach, Mo.


FLEX MBQIP Regional Meetings
Free for FLEX participating hospitals.
Hampton Inn
Clinton, Mo.


FLEX MBQIP Regional Meetings
Free for FLEX participating hospitals.
Chillicothe, Mo.


FLEX MBQIP Regional Meetings
Free for FLEX participating hospitals.
Holiday Inn Express & Suites
Festus, Mo.

Upcoming Virtual Events

Health Equity Webinar
11 a.m. - Noon


Safe Sleep Webinar
10 - 11 a.m.


Quality Works Medical Group Leadership Series:
Population Health & Quality Payment
Noon - 1 p.m.


Fourth Quarter Emergency Preparedness
Program Update Webinar
11 a.m. - Noon

For additional MHA events, visit the MHA calendar.

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