From the President’s Desk

 

Dear AAHQ Team,

I cannot believe Fall is upon us and this will be the last letter I write as AAHQ 2016 President! Where has the time gone? The saying, “Time flies when you are having fun,” has always proven true for me. Your AAHQ Board has been having fun and also very busy working on the fall conference, a most fabulous and successful CPHQ review course, a slate of nominees for election of officers of the Board, and a strategic plan that will guide OUR organization while we move forward as a driving force for healthcare quality in Arkansas.

It would be amazing to see all our members at the fall conference on November 4, 2016. As usual, the Professional Development Team has planned a tremendous program just for you. Remember, you can get continuing education hours for the conference. We also have great vendors participating. So, mark your calendar. Please encourage your colleagues to attend and those who are not AAHQ members to take advantage of the join and register option for the conference registration.

At the risk of being redundant, I will repeat my plea to encourage you to get involved in one or more of the action teams or put your name on the slate for one of the elected offices. It is very rewarding to be an active part of a team. The AAHQ Board members are all volunteers and many of us have served on the Board for many years of our healthcare quality career. Additionally some of the Board members are active at the national level on National Association for Healthcare Quality or Healthcare Quality Foundation teams. The organization needs all hands on deck to maintain our strength and status as a leader in healthcare quality.

I hope to see each of you at the fall conference!

Sincerely,

Phyllis Dorrough, MA, RNP, CPHQ
President

Protocol Update

It is time to develop a list of nominees for election of officers of the AAHQ Board of Directors.  Nominations are sought for the office of the 2017 President-Elect and the 2017-2018 Secretary. 

The office of President-Elect is a three year commitment as this position will transition into the President and Past President positions for 2018 and 2019, respectively. The duties of the President–Elect and subsequent offices are described below.

Please submit all nominations to Cindy Harris at CHarris@arkhospitals.org or Pam Cochran at pamela.cochran@va.gov  by October 21, 2016. 

Duties of the Offices throughout the Three Year Commitment:

• President-Elect – In the absence of the President, the President Elect shall perform the duties of the President. The President Elect shall perform all duties assigned by the President, and will become familiar with and prepare for the duties of the office. In the event the President cannot fulfill his/her tenure of office, the President Elect shall serve out the unexpired term, and then begin his/her own term of office. This individual will serve in this position in 2017.
• President – The President shall preside at all meetings of the Association and the Board of Directors. The president shall appoint any special committees and team leaders. The president shall be an ex-officio member of all committees and Action Teams and shall attend all usual duties pertaining to the office.  This office will be served throughout 2018.
• Past President – In the absence of the President and President Elect, the Past President shall perform the duties of the President. The Past President shall perform all duties assigned by the President.  This office will be served throughout 2019.

Qualifications for Nominees for President-Elect:

• Member in good standing in the organization for a minimum of 2 years.
• Currently employed by an AHA affiliated organization.
• Nominee must submit a picture and pertinent biographical sketch of their professional activities and services to the Association, which shall be included with the ballot.

Duties of the Secretary throughout the Two Year Commitment:

• The Secretary shall be responsible for recording all minutes, and performing other duties as requested by the Board.

 Qualifications for Nominees for Secretary:

• Member in good standing in the organization for a minimum of 2 years.
• Currently employed by an AHA affiliated organization.
• Nominee must submit a picture and pertinent biographical sketch of their professional activities and services to the Association, which shall be included with the ballot.

Professional Development Round-up

CPHQ Review Course-September 15-16, 2016 Recap

The CPHQ Review Course, presented in partnership with NAHQ, on September 15-16 was a resounding success! With 36 attendees from around the state and country, the Review Course offered great preparation for the CPHQ Exam and excellent networking opportunities. Joyce Hall was a terrific instructor whose varied career experiences enhanced her practical examples of the concepts of Quality. One attendee has already passed the CPHQ exam! The feedback from attendees has been tremendous:

“The review session was a great preparation for the exam. Thanks again for your help and the great hospitality during the review session.”
Kamal Hijjazi, CPHQ

“I don’t think I have ever been to any event that was so personable and welcoming.”
Michelle Sharp, MSN, RN, CPPS

“I want to thank you for an awesome experience at the CPHQ Review Course. Everything was amazing! But, more importantly, EVERYONE was awesome. Your strong commitment to quality is evident in everything you do – thank you so much!
Ginger Glory, RN

AAHQ was particularly pleased that four members received scholarships to attend the course.

2016 AAHQ Education Conference: Quality in Arkansas-November 4, 2016

Registration is now open for the Fall Education Conference on Friday, November 4. The brochure and registration form can be found here. The conference is titled “Right Here, Right Now: Quality Projects in Arkansas” which reflects AAHQ’s commitment to highlight and promote healthcare quality in our state. The speakers and presentations cover a variety of topics and care delivery centers and should give great insight into the current activities occurring in Arkansas. Please join us for a great day of learning, networking, and AAHQ hospitality!

Finance Action Team Report

The goal of the Finance Team is to manage funds to support the mission, vision, goals and objectives of AAHQ.

The value of strategic collaborations has truly proven to be an investment in the Arkansas Community. Partnerships have proven to be beneficial to the organization as demonstrated by provision of supplies and AV equipment, donations for door prizes, and representation on AAHQ Board by both American Data Network (ADN) and Arkansas Foundation Medical Care (AFMC).

Reimbursement for CPHQ examination may be considered for members applying for this assistance if funds are available.  If you are interested, you may contact any board member who will be able to respond to any questions you may have about this benefit.

Profits are generally seen from our key revenue generating activities offered each year.    These profits are spent for future conferences and for membership recognition and to assist in support of the mission, vision, goals and objectives of AAHQ. Please thank the Professional Development Team for their great work in generating profits from these conferences.

The financial viability of the AAHQ is strong as evidenced with August 31, 2016 ending with a balance of $31,862.46.  This positive trend has been demonstrated several years with the AAHQ board and member efforts. 

Submitted by:
Louise Hickman
Finance Team Leader

Membership Services Update

 

 

 

 

 

 

 

 

 

Member Spotlight

Beth M. Schooley, RN, BBA, CPHQ, CPPS

Beth is Director of Performance Improvement at Howard Memorial Hospital in Nashville, AR. Like many of us in a smaller hospital, she wears multiple hats, namely Risk Manager and Compliance Officer. She is one of our newest CPHQ Certified members, receiving that in 2016, and her CPPS Certification in 2014. She is also a member of the 2016 Rural Quality Advisory Council. She graduated from Deaconess School of Nursing in Minneapolis, Minnesota. In 2004, she received a Bachelor’s Degree in Business Administration from Washington State University, while living in Washington and Oregon.

Most of Beth’s nursing experience is in Med/Surg, orthopedics, and as a school nurse. She began working in Denial Management when first coming to Howard Memorial until 2008, when she began in quality as the Assistant Quality Director, moving into the Director Role in 2009. Past honors received by Beth and Howard Memorial include: Top 100 Critical Access Hospitals in 2012; AFMC Quality Excellence Award in 2013; and 2011- present – Avatar’s “Exceeding Patient Expectations for Patient Satisfaction.” A HEN/HRET Spotlight Video for their CAUTI project was completed in September 2016. She has been instrumental in HEN, MBQIP, pharmacy-led antibiotic stewardship, and many other quality projects.

On the personal side, her family is a blended “Brady Bunch”, consisting of Clint, her husband of 2 years, her 3 children and 3 stepchildren, (3 girls and 3 boys), whose ages range from 6-23. Being originally from Wisconsin, she is frequently called a “Yankee” by her husband and friends and her northern accent leads to a lot of teasing. She remains a Green Bay Packer fan. However, she feels she is adjusting quite well to being a “southern” girl, and has learned to hunt and fish (sort of) and has some camouflage garments in her closet. She also now knows what purple hull peas and hushpuppies are.

Beth joined AAHQ around 2009, and felt that affiliating with the top healthcare quality organization in the state would help her learn and grow in her role as Director of Quality at Howard Memorial. Membership in AAHQ, the workshops, knowledgeable speakers, and all the talented and experienced quality professionals she has been able to interact with and to learn from, have helped her to become a better leader in her own organization over the past several years. She states that she appreciates the willingness of everyone to share their knowledge with those new to the field of quality and feels that membership in AAHQ is very important for those reasons.

PEPPER

Prepared by the Centers for Medicare and Medicaid Services

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a Microsoft Excel file summarizing provider-specific Medicare data statistics for target areas often associated with improper Medicare payments due to billing, DRG coding and/or admission necessity issues. Target areas are determined by the Centers for Medicare & Medicaid Services (CMS).

PEPPER facilitates the prioritization of areas on which a provider may want to focus auditing and monitoring efforts.  Providers are encouraged to conduct regular audits to ensure that medical necessity for admission and treatment is documented and that bills submitted for Medicare services are correct.

PEPPER can be used to review three years of data statistics for each of the CMS target areas, comparing performance to that of other providers in the nation, Medicare Administrative Contractor (MAC) jurisdiction and state.  PEPPER can also be used to compare data statistics over time to identify changes in billing practices, pinpoint areas in need of auditing and monitoring, identify potential DRG under- or over-coding problems and identify target areas where lengths of stay are increasing.  PEPPER can help providers achieve CMS’ goal of reducing the likelihood of improper Medicare payments.

TMF, at CMS’ direction, has developed various types of PEPPER including:

• Short-term acute care hospitals (developed in 2002),
• Long-term acute care hospitals (developed in 2005),
• Critical access hospitals, inpatient psychiatric facilities and inpatient rehabilitation facilities (developed in 2011),
• Hospices and partial hospitalization programs (developed in 2012),
• Skilled nursing facilities (developed in 2013), and
• Home health agencies (developed in 2015).

Visit PEPPERresources.org for more information on PEPPER, including sample reports, user’s guides, recorded training sessions and national-level comparative data. View the PEPPER distribution schedule and information on how to get your organization’s PEPPER.

If you have questions, visit our Help Desk to request assistance with PEPPER.

Arkansas Hospitals Join Movement to Drive Change Using Near Miss Analytics
Susan Allen

 

In an effort to advance a growing culture of safety in Arkansas hospitals, the Arkansas Association for Healthcare Quality has endorsed a year-long campaign that encourages the recognition and reporting of patient safety risk before harm happens. The Good Catch campaign, led by American Data Network PSO, offers participating hospitals opportunities to significantly increase near miss reporting, reveal process and system vulnerabilities, and develop and implement proactive data-driven improvement activities.

A good catch, often referred to in hospitals as a near miss or close call, is an event that does not reach a patient but only because of chance or timely intervention. A good catch is a win for patients, staff and hospitals because corrective action is taken, and it presents the opportunity to prevent future risk.   

“This initiative is grounded in efforts to promote and support patient safety activities including education to increase awareness, encourage non-punitive reporting, and analysis of near miss data that holds valuable predictors of vulnerabilities that can lead to actual incidents,” Phyllis Ragland, RN, CPHQ, CPPS, Clinical Patient Safety Advisor with ADN PSO, said. “The initiative incorporates a tiered awards program to spotlight individual clinicians and physicians who recognize and report near miss events, as well as teams and organizations that design and implement innovative improvement strategies and processes proven to mitigate risk and harm.”  

ADN PSO has extended the invitation to participate to all Arkansas-based hospitals. While growth within the movement continues, the following healthcare facilities have signed participation agreements to date: Baptist Health Medical Center(6 facilities), Baxter Regional Medical Center, CrossRidge Community Hospital, Conway Regional Medical Center, Saline Memorial Hospital, St. Bernards Medical Center, Unity Health – Harris Medical Center, Unity Health – White County Medical Center, and White River Medical Center. Hospitals have until December 31, 2016 to join the campaign which will officially launch on January 1, 2017. Final results and awards are set to be presented in March 2018 in correlation with statewide Patient Safety Awareness Week activities.

To learn more about participation in ADN PSO’s Good Catch campaign, contact Phyllis Ragland by emailing pragland@americandatanetwork.com or by calling 870.672.1788. Campaign details and registration are also available by clicking here to visit the Good Catch web page.

Arkansas Care Transitions Coalitions Foster Greater Communication Among Care Partners
Melodie Zipfel, MSN RN

Reducing readmissions and avoidable admissions by way of improving patient care transitions and the patient’s health care journey has become a major focus for health care in the United States. Research has shown 1 in 5 Medicare beneficiaries will readmit to the hospital within 30 days of being discharged. In October 2012, the Affordable Care Act Hospital Readmissions Reduction Program began applying financial penalties to hospitals demonstrating higher readmission rates for targeted populations than were expected. TMF Health Quality Institute believes the problems associated with poor transitions of care and 30-day hospital readmissions are not solely the responsibility of the community hospitals, they often result from a breakdown in communication across the continuum of care.

TMF has partnered with the Arkansas Foundation for Medical Care, Primaris in Missouri and the Quality Improvement Professional Research Organization, Inc. in Puerto Rico to form the TMF Quality Innovation Network Quality Improvement Organization (QIN-QIO), under contract with the Centers for Medicare & Medicaid Services (CMS). As a result of this partnership and the focus on improving care transitions, the TMF QIN-QIO is convening community coalitions across the state of Arkansas that consist of partners, hospitals, skilled nursing facilities, home health agencies, physicians, payers, patients, caregivers and other stakeholders in an effort to address identified problems and improve care coordination. The TMF QIN-QIO set overall goals for these community coalitions which include:

1. Reduction of hospital readmission rates for Medicare patients by 20 percent
2. Reduction of hospital admission rates for Medicare patients by 20 percent
3. Increase number of days Medicare patients spend at home by 10 percent
4. Reduction in adverse drug events, emergency department visits and observation stays or readmissions for Medicare patients

There are currently nine designated Arkansas Care Transitions (ACT) coalitions covering 69 of the 75 counties and representing 96 percent of the Medicare beneficiaries in the state. The number of ACT coalitions has grown from four at the end of 2015 to eight established coalitions, and one more currently in the planning stages (ACT River Valley). The eight coalitions are: ACT Delta, ACT East, ACT North Central, ACT Northwest, ACT Ozarks, ACT Southwest, ACT South Central and ACT Central. View the ACT Coalition Map to see which coalition your organization or facility may be able to join. ACT coalitions meet quarterly and have subcommittees actively working towards change in their communities with a focus on education standardization, diabetes management, behavioral health barriers, hand-off communication and medication safety. Areas of focus are driven primarily by readmissions data provided quarterly by TMF and subsequent root-cause analysis performed by each coalition. Each coalition is encouraged to learn from and participate with the other coalitions to foster communication, shared ideas, encouragement and support across the state.

For more information and to learn about the next coalition meeting in your area, email Jo Nycum (Jnycum@afmc.org) or Melodie Zipfel (Mzipfel@afmc.org).

Visit www.TMFQIN.org for more information and to join the TMF QIN-QIO Readmissions Network, found under the Networks tab.

This material was prepared by TMF Health Quality Institute, the Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS). This content does not necessarily reflect CMS policy. 11SOW-QINQIO-C3-16-107

Our Sponsors

ARKANSAS FOUNDATION FOR MEDICAL CARE

Julie Kettlewell, RNP, AVP of Quality Programs 1020 West 4th Street, Suite 300
Little Rock, AR 72201 Phone 501-212-8740
E-Mail jkettlewell@afmc.org Website www.afmc.org

The Arkansas Foundation for Medical Care (AFMC) was incorporated in 1972 as a private, nonprofit educational organization dedicated to the evaluation and improvement of health care. We are the federally designated quality improvement organization (QIO) for Arkansas. Our staff includes physicians, nurses, statisticians, educators, communicators – professionals with widely varied expertise, at various stages of life and career, who have been on both sides of the health care system. We work with staff in every health care setting and offer free tools and resources, such as educational materials for patients and providers and help with Medicare and Medicaid issues. We review certain types of health care paid for by Medicare and Medicaid to ensure high-quality, cost-effective care and to resolve beneficiary concerns. We help find evidence-based ways to improve preventive care as well as treatment and management of specific illnesses and conditions. We are also a health information technology regional extension center (HITREC), federally funded to provide technical assistance to health care providers as they make the transition to electronic health records. Our roles and responsibilities are constantly evolving, but they all serve the purpose of building support systems and partnerships, and helping focus the efforts of the health care community, agencies and organizations toward common goals. Together, we’re working to make health care safer, more effective and more efficient.

BANCORPSOUTH INSURANCE SERVICES, INC. Tom Hesselbein, CPCU, Executive VP, Healthcare (Ramsey, Krug, Farrell & Lensing) 8315 Cantrell Road, Suite 300 Little Rock, AR 72227 Phone 501-614-1134 Email Tom_Hesselbein@rkfl.com

 

 

AMERICAN DATA NETWORK
Sherry Bird, Director, Business Development 10809 Executive Center Dr., Searcy Building Suite 300 Little Rock, AR 72211
Phone 501-225-5533
E-mail sbird@americandatanetwork.com
Website www.americandatanetwork.com

 

 

Founded in 1994, American Data Network provides clinical, quality, safety and financial data applications and services to healthcare executives, allowing them to better manage costs and care quality, influence physician practice patterns and meet demands for public accountability and disclosure.

2016 Board of Directors

President
Phyllis Dorrough
501-202-1276
501-202-1159 fax
phyllis.dorrough@baptist-health.org

 

 

 

 

 

 

 

President – Elect
Teresa Jeffus
501-296-1009
501686-8175 fax
JeffusTeresaM@uams.edu

 

 

 

 

Secretary
Margaret Corbett
501-5135735
501-513-5312 fax
mcorbett@conwayregional.org

 

 

 

 

 

 

Past President
Position Vacant

Action Team Leaders

Protocol
Pam Cochran
501-257-3087
501-257-3110 fax
autocontrols@att.net

 

 

 

 

 

 

Professional Dev.
Lynette Jack
501-379-8980
501-407-9288 fax
mqrs@comcast.net

 

 

 

 

 

 

 

Membership Srv.
Karen Donaldson
870-382-7657
870-3382-6555 fax
kdonaldson@deltamem.net

 

 

 

 

 

 

Finance
Louise Hickman
870-541-7773
870-541-7204 fax
hickmanl@jrmc.org

 

 

 

 

 

 

Communication
Dalana Pittman
501-537-7944
501-225-5539 fax
dpittman@americandatanetwork.com

 

 

 

 

 

AHA Liaison

Cindy Harris
501-224-7878
501-224-0519 fax
charris@arkhospitals.org

Members at Large

Pam Blake
870-718-1724
PBlake@hospicehomecare.com

 

 

 

 

 

 

Shannon Finley
501-296-1010
501-686-8175
Sfinley55@gmail.com

 

 

 

 

 

 

Editor: Dalana Pittman
American Data Network
Little Rock, AR