First Quarter 2024 Newsletter

From the President’s Desk

Submitted by: Teresa Jeffus

Hello All, I am so excited to be a part of AAHQ again! Working alongside these amazing board members is truly a privilege. The board is currently working on a direct response to what members said they wanted from the association, education! We are planning a conference in October 2024 as well as other educational opportunities including some Journal Clubs sessions and Office Hours. Looking forward to a great 2024 with AAHQ!

Teresa Jeffus, AAHQ President

From the Past President’s Desk

Submitted by: Devin Terry

As I write this almost everyone is celebrating Spring Break with their kids, grandkids, or other family members. The temperatures are warmer, there are blooms everywhere, and the days are longer. This marks the beginning of my favorite time of year! Spring baseball, soccer, and hiking trails are ready to be explored. This can also be a very busy time of year for many people and as healthcare professionals, we tend to forget about taking care of ourselves in the hustle and bustle. I would like to remind you to look after yourselves as you go through this busy time. One way you can do that is by continuing to learn about healthcare quality and how you can make an impact in your facility. I encourage you to be on the lookout for the next AAHQ educational event and attend in person if you can at all. This will be a great opportunity for continued learning and networking with fellow healthcare professionals!

I also want to encourage you to get involved with your AAHQ Board, they are a great group to work with and are passionate about making healthcare better for our patients today, and let’s face it, us tomorrow. This year’s AAHQ Board President is Teresa Jeffus. Teresa is not a stranger to the AAHQ Board or healthcare quality. She has been an AAHQ member for over 25 years and served on the Board as recently as 2017. I know the Board will accomplish many great things in 2024, and I can’t wait to see what happens.

Devin Terry, PhD, RN, ACNS-BC, CPHQ

AAHQ Past President

Finance Team Update

Submitted by: Trey McCorkindale

I want to thank you all on behalf of the board for either personally paying or getting processed the annual AAHQ dues through your respective organizations. These funds help pay for the programs and future plans of conferences and other events we hope to have in the coming months. In addition, it helps pay for some individual scholarships should a member wish to attend the NAHQ national conference. If you haven’t sent in your dues or if you aren’t sure, it’s been processed and submitted, please check with your organization or reach out to Cindy Harris (charris@arkhospitals.org) to see if it has been received.

AAHQ is about where we were last year at this time as dues ($3,575) are being received. Additionally, we had a meeting last fall that brought in additional funding ($2,450.00) but we won’t have a meeting this spring like the previous year, so AAHQ is ahead but we’ll probably come close to the same amount of revenue as last year by the end of the year.

YTD (8 months ending 2/29/24) expenses totaled $9,700.50, compared to $6,129.65 the previous year. Again, our expenses are higher but last spring due to the meeting, I anticipate the expenses will be about as much by the end of the year.

	CURRENT	PREVIOUS
	YTD	YTD
	2/29/24	2/29/23
Revenue
Dues	$ 3,575.00	$ 3,770.00
Meetings	2,450.00	225.00

Total Revenue	$ 6,025.00	$ 3,995.00

Expenses
Bank & Merchant Fees	$ 455.60	$ 749.57
Meetings	2,595.90	1,218.48
National Meetings Expense	6,144.00	3,895.00
Supplies/Printing/Postage		266.60
Other	505.00

Total Expenses	$ 9,700.50	$ 6,129.65

Income Over (Under) Expenses	$ (3,675.50)	$ (2,134.65)

Cash	$ 24,403.43	$ 26,426.80

Trey McCorkindale, Finance Team Lead

Communications Update

Submitted by: Joel Anderson

Happy Spring! The AAHQ Communications’ Action Team goal is to promote recognition and visibility of the AAHQ organization through our website, newsletter publications, and social media platforms. One way to accomplish this is by increasing our followers on social media. If you were not following us on Facebook and LinkedIn , I would highly encourage you to do so! We would love to spotlight your organizations quality achievements in 2024. Please feel free to email newsletter submissions and team pictures to andersonj@jrmc.org

Another way to get involved with AAHQ is by becoming a member of one of our action teams. Not only will you be networking with quality leaders from around the state, but also you can learn so many other things that can enhance your skillset, (i.e., website design and maintenance, bylaw creation, organizational finance, conference planning, and membership recruitment activities.) Please reach out to a Board member and join one of our teams in 2024!

Joel Anderson, GC-MGMT, BBA

Communications Team Lead

Protocol Update

Submitted by: Erin Bolton

Congratulations to Devin Terry who will serve as President-Elect effective immediately and as AAHQ President in 2025.

Don’t forget that if you need to renew your CPHQ certification, scholarships are available from AAHQ. Maybe you are considering getting your CPHQ certification. Scholarships are also available for new certifications. Please contact me if you would like additional information (boltone@jrmc.org).

I am very excited about the “new” AAHQ and the new opportunities that are going to be available to the members. Journal clubs, office hours, and the fall conference are just a few of the things that we are planning. We want to equip and empower you as we all face an ever-changing world of healthcare quality and having to learn to do more with less.

There are positions available on the Protocol team if you would like to serve. The Protocol team is responsible for elections and review of the by-laws. It’s a great way to get involved without a lot of time commitment. Reach out to me if you are interested!

Have a great spring and I hope to see you at the AAHQ events we have planned!

Erin Bolton, BSN, RN, CPHQ

Protocol Team Lead

Understanding QHIN and TEFCA: Implications for Healthcare Quality

Submitted by: Justin Villines

The healthcare industry is continuously evolving with the integration of technology and data exchange systems. Two significant advancements in this realm are the Qualified Health Information Network (QHIN) and the Trusted Exchange Framework and Common Agreement (TEFCA). These initiatives aim to enhance the quality of healthcare by improving the accessibility and interoperability of health information. QHINs can complement statewide HIEs like SHARE in Arkansas by expanding their reach, standardizing data exchange protocols, enhancing data quality, supporting public health initiatives, improving care coordination, and leveraging federal support. This collaboration can ultimately lead to a more interconnected and efficient healthcare system, benefiting patients, providers, and public health agencies. Expanding Reach: QHINs operate on a national level, facilitating the exchange of health information across state lines. This can complement statewide HIEs by extending the reach of health information exchange beyond the state’s borders, enabling healthcare providers to access patient data from other states.

Qualified Health Information Network (QHIN)

A Qualified Health Information Network (QHIN) is a designation given to entities that meet specific criteria set forth by the Office of the National Coordinator for Health Information Technology (ONC). These networks are responsible for facilitating the secure and efficient exchange of health information across different healthcare organizations and stakeholders. The primary goal of a QHIN is to enable nationwide interoperability, ensuring that healthcare providers can access and share patient data seamlessly, regardless of the electronic health record (EHR) systems they use.

Trusted Exchange Framework and Common Agreement (TEFCA)

TEFCA is a set of principles and guidelines developed by the ONC to promote the secure and interoperable exchange of health information across the United States. It establishes a standardized approach for data sharing, aiming to create a unified and consistent framework that all health information networks can adopt. TEFCA outlines the technical and governance requirements for networks to become QHINs, ensuring they adhere to strict privacy, security, and data exchange standards.

Implications for Healthcare Quality

The implementation of QHINs and TEFCA has significant implications for healthcare quality:

Enhanced Patient Care: By facilitating the seamless exchange of health information, healthcare providers can access a more comprehensive view of a patient’s medical history, leading to more informed decision-making and improved patient outcomes.
Reduced Duplication: Interoperability reduces the duplication of tests and procedures, as providers can easily access previous results, leading to more efficient care delivery and cost savings.
Improved Public Health Reporting: QHINs enable more efficient reporting of public health data, aiding in disease surveillance, outbreak management, and population health initiatives.
Increased Patient Engagement: With easier access to their health information, patients can take a more active role in their healthcare, leading to better adherence to treatment plans and healthier lifestyles.
Enhanced Data Security: TEFCA’s strict privacy and security standards ensure that patient data is protected during exchange, maintaining trust in the healthcare system.

The establishment of QHINs and the adoption of TEFCA represent significant strides towards achieving nationwide health information interoperability. By standardizing the exchange of health data, these initiatives promise to improve the quality of healthcare, enhance patient outcomes, and streamline the delivery of care across the United States. As these frameworks continue to evolve and be implemented, the healthcare industry can expect to see a transformation in how patient information is shared and utilized, ultimately leading to a more efficient and effective healthcare system.

References

Centers for Medicare & Medicaid Services (CMS). (2023, January 31). Interoperability and patient access: TEFCA implementation. https://www.cms.gov/
The Office of the National Coordinator for Health Information Technology (ONC) (2023) Trusted Exchange Framework and Common Agreement (TEFCA). https://www.healthit.gov/topic/interoperability/policy/trusted-exchange-framework-and-common-agreement-tefca
Sullivan, C., & Mandler, M. (2020, December 16). TEFCA: A win for patients and providers alike. https://www.healthindustrywashingtonwatch.com/2022/07/articles/other-health-policy-developments/other-hhs-developments/office-of-the-national-coordinator-for-health-information-technology/oncs-trusted-exchange-framework-and-common-agreement-tefca-impacts-on-health-information-networks-and-health-care-organizations/

Justin Villines, MBA, BSM

Professional Development/External Relations Team Lead

Hospital Quality Spotlight

University of Arkansas for Medical Sciences (UAMS)

Congratulations! H7

Based on the clinical indicators below, your unit has been awarded Outstanding Area of the Month for February!!!

Data Used to Determine Winner: July 1, 2016, to December 31, 2023
Category Rank		Data
Falls with Injury	82 days since last Fall with Injury
Hospital Acquired Pressure Injury (HAPI)	71 days since last HAPI
Catheter Associated Urinary Tract Infection (CAUTI)	305 days since last CAUTI
Clostridium Difficile Infections (CDIFF)	426 days since last CDIFF
Central Line-associated Blood Stream Infection (CLABSI)	180 days since last CLABSI
Methicillin Resistant Staphylococcus Aureus (MRSA)	995 days since last MRSA

Patient Comments:

I love this hospital. Everyone you meet are so nice and courteous. Any questions you have they’re always able to answer. The entire staff is great. I know when I come here, I will be well taking care of. The doctors take their time explaining everything.

…I can say with confidence that my nurses during all shifts were truly giving me the best care possible. They were incredibly kind and helpful, explained what was going on/what plans were in place for my care, and were quick to assist me if I had an issue or needed something. I cannot thank them enough for their work and the way they advocated for me during my stay. I feel that had I not received such amazing care from the nurses and PCTs that I did, my experience would’ve been an absolute nightmare, and this would be a very different response. I hope that those that were assigned to my care are recognized for their outstanding patient care, and I want them to know that I appreciated so much and thank them for their kindness and hard work during my stay.

Adverse Childhood Experiences

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Social Determinants of Health

Submitted by:

Screening for Social Determinants of Health (SDOH) in practices and hospitals has grown increasingly common, using well-established tools to identify the needs of our patients so that we can begin to address their underlying basic needs to improve their health. We commonly screen for anxiety and depression, food insecurity and housing issues, substance abuse, and family and community support and connection, often not realizing that we are screening for the causes and results of what is commonly known as Adverse Childhood Experiences (ACEs). While providers ask the right questions, do we know what to do with all the answers?

Adverse Childhood Experiences (ACEs) are a collection of unfortunately common experiences that occur early in infancy and early childhood during crucial developmental periods of the brain and the body. These experiences cause unneeded and sometimes avoidable “toxic” stress, resulting in a survival response that triggers the release of stress hormones that prepare the body and mind to fight or flee from real or perceived danger. Not being able to remove themselves from this stress results in a prolonged and detrimental response, often repeatedly.

The original ACEs study, screening tools, and related information can be found on the CDC website (https://www.cdc.gov/violenceprevention/aces).

Using the ACEs screening, providers can elicit ten possible experiences that have been identified and studied and are now well known to have detrimental effects on long-term health. They include physical, emotional, and sexual abuse, emotional and physical neglect, and household dysfunction, including a caregiver with a mental illness or substance abuse problem, seeing a caregiver treated violently, and parental separation from divorce or incarceration. These ten are not all-inclusive of all traumas. But we know the more ACEs you experience, the poorer your mental and physical health, with an overall reduction in quality of life and early death. An individual with an ACEs score of seven or more is more likely to have a mental illness, use illicit substances and abuse alcohol, have chronic health conditions such as asthma, diabetes, and cancer, and have a significant risk for suicide.

These traumas are unfortunately common. And if you have experienced one, you are more likely to have experienced others. But the critical thing to know is that “all hope is not lost.” Your ACEs score does not commit you to a life of suffering. Trauma and stress are part of the human experience. However, protective factors such as having consistent and nurturing caregivers who provide support and model and build resilience can offset these traumatic experiences. The more positive experiences you have can outweigh the bad. Knowing that your patient has experienced trauma enhances and improves the patient’s experience and outcomes as well.

When we screen for SDOH, we can also assess for ACEs. Take EJ, a 45-year-old accountant treated for high blood pressure, cholesterol, and depression/anxiety. He lives alone after a divorce and admits to drinking heavily. You know from his social and family history and screen that his uncle adopted him after his father was incarcerated for drugs (parental separation due to incarceration). His mother committed suicide after a long struggle with depression (mother with mental illness). Growing up in poverty, he moved from house to house and sometimes wasn’t sure where and when he would have his next meal (physical neglect). He wore tattered clothes to school, where others made fun of him and never felt like he belonged. His uncle did the best he could but often called him “stupid,” and EJ always felt like he was a burden to him (emotional neglect and abuse). He, fortunately, had a grandmother, who, despite poor health, often picked him up from school and kept him on the weekends. She provided a safe and loving place and reminded him of his mother. A schoolteacher saw that EJ was smart and encouraged him to attend college (positive experiences – resilience factors). He got scholarships and found work during college to complete his degree. EJ has an ACEs score of five or more. But he had two positive factors: his grandmother and a teacher.

Just knowing EJ has a high ACEs score, we can identify factors contributing to his mental and physical health. Instead of wondering, “What is wrong with EJ?” we can ask ourselves, “What happened to EJ?” and build a therapeutic and empathetic relationship with him. Research supports that knowing and acknowledging his trauma can improve his health outcomes. Looking at underlying causes, we can address their impact on his social issues. We can address his substance abuse while also addressing his anxiety and depression. Increasing social support for him with his family and community through appropriate referrals will improve his ability to make decisions and make changes to improve his blood pressure, control his cholesterol, and improve his quality of life.

Improving our knowledge of ACEs improves health care. AFMC provides training on ACEs awareness and strategies to better care for our patients. AFMC will host the ACEs and Resilience Summit – “Living in a House of Cards” – on Thursday, August 8th, at Benton Event Center. For more information, visit afmc.org/acesummit

Gold Sponsors

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AFMC’s purpose is solid: to help healthcare providers deliver the best quality of care at the lowest cost and to empower patients to take control of their own health and that of their families. AFMC is a nonprofit organization headquartered in Little Rock, Ark., with an additional office in Fort Smith, Ark. We are dedicated to working with beneficiaries and healthcare providers in all settings to improve overall health and consumers’ experience of care while reducing healthcare costs. We accomplish this through education, outreach, data analysis, information technology, medical case utilization and review, and marketing/ communications services provided by a staff of 270 employees. At the forefront of healthcare reform and practice transformation, AFMC is an established, trusted partner in private, state, and federally-led payment innovations by Medicare, Medicaid, and commercial payers.