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ASHNHA | Alaska State Hospital & Nursing Home Association

December 23, 2014

ASHNHA Connection

Your Link to News from the Alaska State Hospital and Nursing Home Association

A Message from our CEO…

Happy holidays from the staff at ASHNHA! We hope you are enjoying time with friends and family, celebrating holiday traditions and taking time away from work obligations.

Work slows down during this season for many, but at ASHNHA, we remember the caregivers in our member facilities, for whom work continues throughout the year. People are in need of care 24 hours a day, seven days a week, 12 months a year and our hospitals and nursing homes are open to meet those needs.

We’re proud to work with facilities committed to their communities. This commitment extends beyond just open doors. In fact, in this issue of ASHNHA Connection we wanted to share with you some very important work going on to improve quality in our hospitals.

Many of our hospitals have been engaged in a national initiative called the Hospital Engagement Network. The goal is to reduce harm, through reducing the incidence of events like hospital acquired infections and patient falls. These avoidable events have a cost on both the patients affected and on the global cost of healthcare. We’re working to support our members' journeys to reduce patient harm, so during this season of celebration, we hope you'll celebrate quality improvement successes throughout Alaska with us.

- Becky Hultberg, President/CEO

Contents…


Alaska's hospitals move the dial on quality

On December 8, 2014 the national CMS-funded Partnership for Patients Hospital Engagement Network (HEN) initiative came to a close. The Partnership for Patients focused on making hospital care safer, more reliable and less costly through reducing preventable hospital-acquired conditions and reducing preventable readmissions. Many ASHNHA member hospitals participated in the HEN, through ASHNHA or their parent companies. While there is a possibility that the funding will be continued as “HEN 2.0,” we would like to thank ASHNHA members for the concerted effort to address quality and patient safety throughout Alaska.
 
Since the HEN began in May 2012, Alaska hospitals have worked toward achieving a reduction in hospital acquired conditions by 40% and preventable readmissions by 20%. Progress toward these nationally identified goals by 12 ASHNHA acute care (non-psychiatric) members is highlighted below:

  • Collectively a 40% reduction in central line infections, catheter associated urinary tract infections, and ventilator associated events was achieved.
  • Six hospitals reduced falls with/without injury by 40%.
  • Twelve hospitals had zero potentially preventable venous thromboemboli.
  • Six hospitals have had a greater than 20% reduction in preventable readmissions. 
  • Nine hospitals have had either a 40% reduction in catheter associated urinary tract infections or zero catheter-associated urinary tract infections for 12 months. 
  • Four hospitals achieved a 40% reduction in central line infections and 3 have had zero central-line associated blood stream infections for 12 months.
Total harm is defined using the 12 measures of harm defined in the national initiative. Alaska’s hospitals achieved a significant reduction in patient harm events over the course of the past two years. We celebrate the success that these facilities have achieved, recognizing that there is more to be done on the quality journey. 


 

Enroll now for 2015 coverage

The open enrollment period for the 2015 plan year will continue through February 15, 2015. The Marketplace offers quality health plans and financial help to pay for the cost of insurance. In Alaska, approximately 88% of those who enrolled in health insurance through the Marketplace last year qualified for financial support.
 
ASHNHA will be conducting an outreach media campaign in January and early February to alert uninsured Alaskans to the opportunity to enroll in health plans through the health insurance marketplace. Newspaper ads will be running in almost all of the rural newspapers in the state along with radio ads on the Alaska public radio network.

Hospitals are taking a proactive role in educating consumers about insurance options. Impartial, objective, and patient-centered education and assistance are essential for getting uninsured Alaskans enrolled in the best coverage for which they are eligible. As trusted health care providers in their communities, hospitals are an ideal position to share information.

ASHNHA has posted many resources to for educating hospital staff and to promote enrollment among patients. Visit the ASHNHA Marketplace webpage
 
There are a variety of ways for consumers to get assistance with enrollment

Rural Alaskan hospitals face challenges

Rural communities in Alaska face significant challenges to health care delivery: long distances to many medical services; shortages of health professionals; and populations that are older, have lower incomes, and tend to be in poorer health. Rural hospitals have limited access to capital as the average age of hospital facilities and the demand for expensive new information systems climb. Medicare margins are the lowest for rural hospitals, with the smallest hospitals having the lowest margins.

Together these challenges make small and rural hospitals less able to weather financial fluctuations. The recent economic downturn hit rural hospitals particularly hard due to declining revenues and increased uncompensated care, leading some to cut services, slow hiring or even to lay off staff.

There are a variety of initiatives to help Alaska hospitals address these challenges including additional payments to support critical access hospitals, loan repayment and incentives to health professionals who practice in rural areas, Alaska trauma fund, and Medicare Rural Flex program initiatives.
 
Alaska has thirteen Critical Access Hospitals (CAH) including four that are tribally operated. These serve the state from Ketchikan to Barrow.  CAHs provide a broad range of services in rural Alaska, including preventative services, long-term services and supports, diagnostic imaging, laboratory, critical care, and 24/7 emergency services. When a CAH has Medicare approval to furnish swing bed services, it may use any of its inpatient beds for either acute care or skilled nursing facility-level care. Since rural hospitals are often the sole site for patient care in the community, they also are more likely to offer additional services that otherwise would not be accessible to residents. Often, rural hospitals step in to offer these services out of a sense of community responsibility. 
 
Small rural hospitals also face many challenges in preparing for the emerging health care environment. Particularly difficult efforts include transitions of care as patients move from one care setting to another, the evolution of new payment approaches such as value-based purchasing, and new care delivery models such as accountable care organizations (ACO), shared savings programs and patient-centered primary care medical homes.
 
ASHNHA is committed to working with small rural hospitals in Alaska to help them develop strategies to succeed in the rapidly changing health care environment.

Alaska Subspecialty Nursing Consortium graduation

The Alaska Subspecialty Nursing Consortium was proud to graduate sixteen nurses   from its perinatal training at a ceremony at Alaska Regional Hospital on December 19, 2014. The Subspecialty Nursing Consortium is an important way that ASHNHA is supporting facilities in training nurses in subspecialty areas. The nurse interns, instructors and ASHNHA would like to thank Alaska Regional Hospital for hosting the graduation. 

The instructors met after graduation to plan the next perinatal training which begins Monday, February 16Nome, Dillingham and South Peninsula hope to place interns in the program. The training curriculum continues to evolve as the instructors take feedback from the nurses and others. Any facility interested in sponsoring nurses in Cohort #3 please contact Dennis at ASHNHA: dennis@ashnha.com or 907-646-1444. Pictured here are the graduates from Providence Kodiak Island Medical Center.

Good news from Alaska hospitals and nursing homes


Upcoming events and educational opportunities


Geriatric Training Series begins in January
January 6 – March 10: Tuesdays from 3 p.m.-4:30 p.m. 
The Area Health Education Center (AHEC) will be partnering with the Northwest Geriatric Education Center to bring 10 weeks of high quality geriatric trainings to Alaska via virtual classroom. The focus of this year’s series is dementia including pharmacotherapy, differential diagnosis, coping with challenging behaviors, end of life symptom management, family support, etc.  Download the registration brochure and either fax to 907-786-6573 or scan and e-mail back to glheiner@uaa.alaska.edu.  You can also register online by clicking here.
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