This spring has proved difficult for Missouri with prolonged, widespread and catastrophic flooding through much of the state, as well as severe weather and tornadic activity impacting several communities – with the most damage reported the evening of May 22 in the communities of Eldon and Jefferson City. Statewide, hospitals have demonstrated strong capabilities to activate their response plans, communicate effectively, and serve their patients and communities.

Throughout the response and recovery, MHA staff have and will continue to facilitate communication and coordination through established incident management platforms to support the health and medical community.

Through these real-world impacts, health and medical partners across the state have maintained commitments to participate in several large scale exercises to test their response capabilities.

These include but are not limited to the following exercises.

Highly Infectious Disease Exercises
On May 28 and 29, staff from Texas County Memorial Hospital, CoxHealth, Mercy Hospital Springfield, Mercy Hospital St. Louis, Saint Francis Healthcare and Lee’s Summit Medical Center conducted full-scale exercises in response to a patient under investigation of Ebola virus disease presenting to the emergency department. Following Missouri’s Ebola Virus Disease Treatment and Transport Plan, hospital staff effectively isolated the patient, utilized personal protective equipment and prepared the patient for EMS transport. Statewide communication platforms were used for notification and coordination.

These exercises culminated on May 30 when Barnes-Jewish Hospital, Missouri’s designated Ebola Assessment Hospital, prepared and transported the notional patient to University of Iowa Hospitals and Clinics in Iowa City, a designated Ebola Treatment Center for U.S. Health and Human Services Region 7.              

Pediatric Evacuation and Surge Exercise
On May 31 in central Missouri, health and medical partners tested medical surge capacity, hospital evacuation and transportation coordination during a simulated evacuation of University of Missouri Health Care’s Women’s and Children’s Hospital. The exercise tested the hospital’s capability to respond to a no notice mass casualty incident and coordinate appropriately with local, regional and state networks to facilitate safe and appropriate patient care. Staff from St. Louis Children’s Hospital, MHA, the Missouri Department of Health and Senior Services, and the Missouri State Emergency Management Agency were on site in Columbia to support exercise objectives.

Thank you to all those who actively participated or played a role in the execution of these successful preparedness opportunities. After Action Reports are in process for each exercise and will be shared appropriately when finalized.

Questions pertaining to statewide preparedness plans or programs may be directed to Jackie Gatz, Vice President of Safety and Preparedness, at jgatz@mhanet.com or 573/893-3700.

SHIP Grant Increases Support for Small Rural Hospitals 
Through a new grant, MHA now is able to further support Missouri’s small rural hospitals. The Small Rural Hospital Improvement Program grant, awarded by the Missouri Department of Health and Senior Services, focuses on hospitals with 49 available beds or fewer, as reported on the hospital’s most recently filed Medicare Cost Report. The SHIP grant allows MHA to support these hospitals by providing the following.

• financial incentives to increase participation in value-based and alternative payment models
• networking opportunities
• quality and financial benchmarks
• educational opportunities
• technical support, including tools and resources

HIIN Updates 
The HIIN project is well into Option Year period one, and the MHA HIIN team currently is finishing the HRET HIIN eight week sprints with 30 member hospitals. These sprints assist participating hospitals in identifying opportunities for Plan-Do-Study-Act improvement cycles through use of the HRET HIIN Process Discovery Tools and Coaching Guides.

MHA HIIN hospitals also have the opportunity to earn stipends by meeting the criteria of milestone 10 during this first option year period.

Additionally, HRET HIIN recently released new resources. Encyclopedia of Measures (EOM) version 1.6 has been released, as well as resources for Adverse Drug Events, including the following.

• Hypoglycemia
• Opioid Discovery Tool
• Excessive Anticoagulation Discovery Tool

• June 20: Evaluating CKD Impact in Primary Care Practice/Population
• July 18: Developing Practice Strategies to Implement CKD Care
• Aug. 1: Diet and Nutrition
• Aug. 15: Medication Management
• Sept. 5: Cardiovascular Risk in CKD/CKD Risk in Cardiovascular Disease