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May 2019
In This Issue
New Publication
Quality Updates
Grants & Contracts Updates
Safety & Preparedness Updates
Quality Reporting News
Upcoming Events
SAFER Logo Support Available for Hospital Workplace Violence Prevention

In Missouri, hospitals are experiencing record high accounts of violence against their workforce. Aggressive behavior, verbal threats and physical assaults have become commonplace, leading to an increase in violence within hospitals, which is often directed at caregivers. The U.S. Bureau of Labor Statistics found that 52 percent of all workplace violence incidents recorded are in health care. MHA has developed resources to assist member hospitals mitigate workplace violence through advocacy, reducing regulatory burden, strengthening partnerships and implementing evidence-based strategies through policy development and staff skill building.

Of note, MHA has been working in the following ways.

  • MHA facilitated the review and adoption of a definition of workplace violence with the intent of providing clarity and scope, and establishing parameters for data collection.
  • MHA launched a statewide data collection initiative to capture the prevalence of workplace violence in Missouri hospitals. A recording and user guide are available.
  • Healing Happens HereTo help hospitals communicate appropriate and expected behavior in care settings, MHA released patient-facing resources using the theme Healing Happens Here. The new resources can be co-branded for use throughout the hospital. To co-brand the PDFs, download the file, and view in Adobe Acrobat (not in browser). Click in the bottom right corner to launch an image browsing window to select your desired logo for placement.
  • Join us this June for one of three complimentary one-day interactive workshops to develop, implement and evaluate effective workplace violence prevention programs for hospitals and outpatient clinics. Hospitals are encouraged to send small groups of staff who are, or who will be, responsible for developing and managing this type of program. This workshop is funded through a subcontract with the Department of Health and Senior Services using US HHS ASPR Hospital Preparedness Program funding, CFDA 93.889.
    • Monday, June 10 | Blue Springs, Mo. | Register
    • Wednesday, June 12 | Springfield, Mo. | Register
    • Friday, June 14 | Chesterfield, Mo. | Register
For more information, contact Jackie Gatz, Vice President of Safety and Preparedness, at

New MHA Publication

Neonatal Abstinence Syndrome:
A Conversation That Could Save Two Lives

Trajectories Cover: Neonatal Abstinence SyndromeThe issue of opioid use during pregnancy is tethered to medicine, behavioral health, child protection, civil rights and women’s issues — perhaps in a way that no other public health crisis affecting women has. The impact of maternal opioid use on both the mother and unborn fetus is a serious community concern. As individuals and professionals in our communities, all of us have a role in improving maternal and infant health.

Neonatal abstinence syndrome affects between six and 20 newborns per 1,000 live U.S. births, and infant withdrawal from licit or illicit opioids is increasing at an alarming rate throughout the nation. In Missouri, the incidence of NAS increased 270 percent between 2008 and 2017. In addition, novel surveillance techniques suggest substantial variability in how NAS is diagnosed and managed in Missouri.

The May 2019 issue of Trajectories explores how to support the mother-baby dyad through recovery-oriented systems of care, implementing universal OUD screenings of all patients and using a medication-assisted treatment approach for individuals with OUD.

Quality Updates

PFAC Vlog Series 
The MHA Patient Family Advisory Council released the first in its five-part vlog series, “Patient Family Engagement: Telling Our Stories.” The series will discuss the importance of patient and family engagement through shared learning, promotion of best practices, and sharing patient experience and family engagement stories while supporting a culture of patient-centered care.

PFAC Vlog: Li Ern ChenVlog 1:
Li Ern Chen, M.D., MSCS, discusses the unique consumer/patient aspect we have in the health care industry, and the importance of educating our consumers/patients and giving them a voice to achieve a better experience and outcome.

New PFAC Resources Available 
The MHA PFAC announces its newest resource, the MHA PFAC Toolkit and Getting Started Checklist. These resources provide guidance and tools to formalize a patient family advisory council to assist your facility in delivering patient and family-centered care. Patient- and family-centered care leads to better health outcomes, improved patient and family experience of care, better clinician and staff satisfaction, and efficient allocation of resources. This guidance resource has been developed by MHA PFAC members and hospitals with active PFACs. They have generously shared their experiences and useful tools in a format intended to be tailored to fit your organization. For more resources and information on the MHA Patient Family Advisory Council, please visit our website.

Grants & Contracts Updates

HIIN Updates 
The Centers for Medicare & Medicaid Services and the Health Research and Educational Trust have formally issued a contract extension for Option Period 1 to continue the HIIN work through June 27, 2019. A longer extension, Option Period 2, also is expected to be funded following contract negotiations would cover the HIIN work through March 27, 2020. The HIIN team will keep you apprised of plans for Option Period 2 and any deliverables required from your teams. Also, be on the lookout for milestone criteria as the MHA HIIN team works to finalize this piece of the project.

Improvement Sprints 
To assist hospitals, the HIIN team is offering several sprints in VAE, VTE, falls and HAPI for to help drive improvement. Sprints offer the opportunity to join a topic-specific quality improvement collaborative and have a demonstrated history of harm reduction and achieving 20/12 goals. Hospitals joining sprints will participate in the following.

  • three to four virtual events designed to assist hospitals in assessing and acting on root causes of specific harms
  • completing a Mini-Root Cause Analysis Process Improvement Discovery Tool
  • guidance from subject matter experts and peer advisors to address challenges and gaps in practices, as well as support participants in identifying and testing interventions
Although registration has passed, all resources, tools and virtual events are accessible to all hospitals.

Future improvement sprints include surgical site infections and post-op sepsis, as well as patient and family engagement and implementing a PFAC.
Top Performing CAHs in ALL EDTC Composite Scores
While emergency care is important in all hospitals, the emergency department is particularly important in critical access hospitals where the distance to urban tertiary care centers makes the effective triage, stabilization and transfer of patients an area of focus. ED transfer communication measures allow CAHs to show how well they carry out the important stabilize-and-transfer role for rural residents. This measure is required of hospitals participating in the FLEX MBQIP program in Missouri and across the nation.

As of the first quarter of 2019, the following CAHs achieved 100 percent compliance in the ALL EDTC composite score, putting them in the top performers list of CAHs in Missouri and the nation.
  • Carroll County Memorial Hospital
  • Cox Monett Hospital
  • Cox Barton County Hospital
  • Excelsior Springs Hospital
  • Harrison County Community Hospital
  • Iron County Medical Center
  • Lafayette Regional Health Center
  • Pike County Memorial Hospital
  • Perry County Memorial Hospital
  • Putnam County Memorial Hospital
  • Ste. Genevieve County Memorial Hospital
  • Wright Memorial Hospital
HCAHPS — Spotlight Hospitals
Congratulations to Cox Monett Hospital and Cox Barton County Hospital for achieving a five-star rating on their Hospital Consumer Assessment of Healthcare Providers and Systems survey for the reporting period starting the third quarter 2017 through the second quarter 2018 discharges.                      
Hospital Preparedness Program Update
MHA has submitted the 2019-2020 Office of the Assistant Secretary for Preparedness and Response Hospital Preparedness Program application and the $1.6 million budget to the Missouri Department of Health and Senior Services. Program priorities include sustaining and refining existing systems of interoperable communication, and continuity of operations and medical surge, all of which is coordinated through regional health care coalitions. Funding will support programming for workplace safety and health care system recovery following catastrophic incidents. A renewed focus on acute inpatient care and a requirement by new ASPR guidance prompted the addition of dedicated clinical expertise to MHA’s preparedness section. Clinical staff will lead FFY 2019 planning on pediatric surge management, align emerging infectious disease response planning with daily hospital infection prevention efforts and provide technical assistance to member hospitals, as requested.
Save the Date: 2019 MHA Quality and Safety Convening
The 2019 MHA Quality and Safety Convening is for anyone committed to and passionate about improving health care quality and safety for patients, families and those who work in a health care setting. Patients and families are uniquely positioned to provide the best perspective and work in partnership with health care across the continuum to achieve the triple aim of better care, better health and lower costs. However, the quadruple aim includes the addition of increasing the health care worker’s joy in work. Developing a reliable, resilient workforce has never been more important. How can we create synergy among patients, families and health care workers to optimize and balance the needs and experiences of all involved? This convening serves as an opportunity to further explore and discuss the critical issues that contribute to the overall health care experience by all stakeholders and advance toward achieving the quadruple aim.

The 2019 MHA Quality and Safety Convening will take place Thursday, July 25. Registration and additional details will be available soon.
Hospital Quality Improvement Award 2018 Hospital Quality Improvement Award Winners
MHA is pleased to recognize the 20 Missouri hospitals awarded the 2018 Hospital Quality Improvement Award through TMF® Health Quality, Missouri’s QIO-QIN contractor. With advancements in the health care industry, hospitals continue to make great strides in quality data reporting and readmissions reduction to improve patient safety and outcomes.
IPFCC 2019 Seminar
The Institute for Patient- and Family-Centered Care is hosting their 2019 Seminar on Thursday, June 13, and Friday, June 14, in Detroit, Mich. DeeJo Miller, Patient and Family Engagement Program Manager for Center for Clinical Effectiveness at Children’s Mercy Kansas City, will be presenting on “Advancing Patient- and Family-Centered Care in Pediatric Settings.” Miller also serves as a charter member of MHA’s Statewide Patient Family Advisory Council.

The registration site is open, and the full agenda and brochure are posted. Registration is available online.
Missouri STR/SOR Offers Free Buprenorphine Waiver Training
The Missouri Opioid State Targeted Response and Missouri State Opioid Response, along with the Missouri Coalition for Community Behavioral Healthcare, is offering a free Buprenorphine waiver training. The first four hours of the course will be in person, and the last four hours will be individual online work. The in-person training will take place from 8:30 a.m. to 12:30 p.m. Saturday, May 25, in Kansas City, Mo. Online registration is available.

This coursework will go toward APN or PA 24 hours of training. Once completed, finish the other 16 hours of work to get your certificate. For additional information, contact Emily Conde at, or 573/634-4626, ext. 103.
Save the Date: Nurse Leadership Forum
The Missouri Organization of Nurse Leaders is excited to invite nurse leaders in every sector of health care to their first Nursing Leadership Forum. Nurse leaders recognize the potential of the nursing profession to be the catalyst for driving health care transformation and will convene to network and hear from local and nationally recognized thought leaders in nursing.

The forum will be held Friday, Aug. 9, at the Courtyard by Marriott in Columbia, Mo. CEUs will be offered. More information and registration information will be available in the upcoming weeks.
HAI Projects from MU Nursing Outreach
The University of Missouri Nursing Outreach has an updated website. The new site features a health care-associated infections page, which hosts a collection of more than 100 learning resources, including the latest references regarding best practices, video clips, online tools and practice kits. Webinar-based online courses also are available on the site. A flyer has been developed to assist with site navigation.

Don’t miss a thing! Follow MU Nursing Outreach on Instagram @mu_nursing_outreach.
CMS Announces Preview Period For July 2019 Hospital Compare Data
Read more.
CMS Updates April 2019 Hospital Compare Downloadable Data
Read more.

More news can be found in MHA Today.
Upcoming Events

Emergency Preparedness Fundamentals
Missouri Hospital Association
Jefferson City, Mo.


2019 MHA Quality and Safety Convening
Columbia College  Jefferson City Campus
Jefferson City, Mo.


Orientation for New Quality Improvement Directors
Columbia College  Jefferson City Campus
Jefferson City, Mo.

Upcoming Virtual Events

2nd Quarter Emergency Preparedness
Program Update Webinar
11 a.m.

For additional MHA events, visit the MHA calendar.

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