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Monday, July 21, 2003
ODH to Launch Freestanding Cardiac Cath Pilot
The Ohio Department of Health (ODH) last week announced its plans to create a pilot program allowing adult diagnostic cardiac catheterizations on low-risk patients in a freestanding setting.

The issue could be of concern to Ohio hospitals and their patients because it means moving these services traditionally provided in Ohio’s hospitals to freestanding locations. There is a potential for over utilization when specialty services are offered in freestanding settings, especially in combination with physician ownership. This move could prove harmful to many Ohio hospitals' ability to continue providing a full range of needed services, since cardiac catheterizations are one of the more profitable health care services, which helps hospitals deal with low reimbursement for other services and continue to provide charity care to the uninsured and underinsured. OHA’s Research and Educational Foundation (REF) passed a motion to oppose the ODH pilot program at its last meeting. Using the REF recommendation, the OHA Board of Trustees will formalize its position on the program at its upcoming meeting in August.

Providers accepted into the pilot program will operate under Ohio Administrative Code criteria for the operation of an adult cardiac catheterization service and under the Condition for the Operation of a Freestanding Service, which covers service standards, personnel and staffing, facilities, equipment and supplies, patient selection and utilization, and data collection guidelines. OHA will continue to examine the program and keep members updated. Please share comments or concerns with Bridget Gargan, bridgetg@ohanet.org or 614.221.7614.

Tuesday, July 22, 2003
Trauma Committees Seek Hospital Reps
The Trauma Registry Advisory Subcommittee (TRAS) is seeking a hospital representative. TRAS oversees the trauma registry, which was created to collect and analyze data necessary to evaluate the delivery of trauma care within the state.

The State EMS Board’s Trauma Committee is also seeking a representative from a hospital that is not a trauma center, but actively provides emergency care to trauma patients. Persons eligible include hospital administrators, physicians, nurses or other clinical professionals.

Along with other state organizations, OHA is eligible to submit three nominees for each open committee seat. If you would like to nominate yourself or any individual from your hospital for either committee, please contact Bridget Gargan at OHA at 614.221.7614 or bridgetg@ohanet.org. Nominations for TRAS must be submitted by Monday, July 28, and nominations for the Trauma Committee should be sent by Friday, Aug. 29.

Quality Initiative Offers Updates
Several Ohio hospitals have elected to participate in The Quality Initiative: a Public Resource on Hospital Performance, an initiative of the American Hospital Association, the Association of American Medical Colleges and the Federation of American Hospitals to engage hospitals in collecting and share hospital performance information. Involved hospitals should be aware of the following updates:

The initial posting of quality data will be delayed two months, and will now occur in September.

The hospital patient perspectives of care survey (HCAHPS) will not be required by the government but will be an expected component of the voluntary Quality Initiative. Hospitals may comment on the survey until July 28 and a second comment period will be offered this fall with the final tool and implementation instructions expected by late fall.

Hospitals that pledged to report third- and fourth-quarter 2002 data should have received a preview of their data, a national average and the 90th percentile of performance. If a hospital is registered on Q-NET Exchange, its data was posted July 15, and other hospitals received e-mail notification on this date.

If data looks correct and there are no questions, take no action. Contact the appropriate Quality Improvement Organization (KePRO) immediately with questions to resolve all issues by Aug. 13.

At its August meeting, the OHA Board will discuss the Quality Initiative and its official position on the initiative. (Rosalie Weakland, rosaliew@ohanet.org)

Manger Seminar Around the Corner
Hospital managers won’t want to miss the upcoming seminar, Business and Budget Essentials for Non-Financial Managers, to help improve their understanding of hospital finances that affect decision-making. The seminar is Friday, Aug. 8 at the Wyndham Dublin Hotel in Northwest Columbus. Register online at www.ohanet.org/education/education_programs.asp.

Wednesday, July 23, 2003
Ohio Considers Patient Compensation Fund
At its third meeting, the Ohio Medical Malpractice Commission, created out of tort reform legislation passed last session, discussed creating a patient compensation fund (PCF) in Ohio. The goal of such a fund is to help offset medical malpractice insurance costs in the state. The PCF is one of the many issues currently being considered by the commission.

At last week’s meeting, Robert J. Walling, Pinnacle Actuarial Resources, Inc., presented the results of a Pinnacle study requested by the commission that examines the feasibility of a PCF in Ohio. Walling proposed that funding for the PCF would come from rates per physician or per bed for hospitals and participation would be voluntary. However, if in the future the Ohio Supreme Court should deem the caps on non-economic damages established in last session’s Senate Bill 281 to be unconstitutional, then the premium rates would immediately need to increase in order to recover funding losses, and the PCF would not be an acceptable solution to the medical malpractice crisis.

Walling also made other recommendations to help curb the medical malpractice crisis in Ohio, citing that the six states deemed “okay” by the American Medical Association share the following reform features: caps on damages, medical review boards, limitations on attorney contingency fees, and repealing of collateral source rules. Consequently, Walling suggested that Ohio establish a Medical Review Board and expand data reporting to create a statewide claim database.

Both the commission and OHA’s Medical Malpractice Task Force are actively looking for solutions to Ohio’s Medical liability crisis, which both appear to agree is not the fault of insurance companies, but a variety of factors, including high jury awards. (Rick Sites, ricks@ohanet.org)

Thursday, July 24, 2003
Public Health Council Considers Revisions
At its July meeting, the Public Health Council voted to formally propose a number of rule changes that will affect hospitals. Several are positive changes made in response to concerns voiced by OHA and its members.

One set of proposed rules would allow for temporary storage of low-level radioactive waste, making it possible for a commercial facility to be built in Ohio to accept waste on a temporary basis-thereby increasing hospitals’ options for dealing with their low-level waste stream. A second change in current rules would adopt the Centers for Disease Control and Prevention guidelines regarding diagnosis and treatment of tuberculosis in Ohio, and add a new requirement that labs testing for this disease hold CLIA certification.

Revisions to the regulation of inspecting and licensing radiation-generating equipment also were proposed. An earlier draft proposal to mandate that hospital senior hospital executives attend quarterly radiation quality assurance committee meetings was replaced with a requirement of representation at the meetings by hospital administration or a qualified alternate. Other proposed revisions include increased licensing fees for certified radiation experts and reductions in the number of health care workers who must receive radiation safety training related to fluoroscopy procedures. Finally, new rules were proposed that would create an insurance assistance program for persons with hemophilia.

The waste storage rules have already received a public hearing and the remainder of the above proposals are scheduled for public hearings in late August. Hospitals can expect final rules to take effect by November. For ongoing updates, visit www.odh.state.oh.us/Rules/rulemain.html under “Pending Rules.” (Rick Sites, ricks@ohanet.org)

Freestanding Birthing Center Rules Redefined
Following a long, but successful advocacy effort by OHA, freestanding birthing centers that exclusively serve Amish and Mennonite women are now required to register with the Ohio Department of Health (ODH) so the agency can monitor the quality of care and patient safety. Now that the centers are no longer exempt from ODH regulation and licensure requirements, ODH is authorized to inspect these centers, and when necessary, take appropriate enforcement actions. However, these birthing centers will not be regulated to the same extent or in the same manner as other birthing centers.

Eliminating this exemption was a response to concerns that without adequate monitoring, these facilities would potentially reduce the quality of maternity care provided to the residents in these communities. (Rick Sites, ricks@ohanet.org)

Friday, July 25, 2003
Hospitals Lead the Way
Hospitals in Ohio continue to show leadership in their communities through their collaboration with other community organizations, their innovative programs and dedicated employees.

Doctors West Hospital, Columbus, was presented an “Academy Award” at the First Annual Academy Awards Reception hosted by the Greater Columbus Chamber of Commerce. The reception celebrated the accomplishments of the first class of Career Academy graduates and recognized the outstanding support they have received from Greater Columbus business partners.

Northeastern Ohio hospitals are beginning a new campaign, Fast Heart Beat Ohio, to increase awareness about Sudden Cardiac Death. Hospital partners include Akron General Medical Center, the Cleveland Clinic Foundation, Hillcrest Hospital, Mayfield Heights, MetroHealth Medical Center, Cleveland, and University Hospitals of Cleveland. For more, visit www.FastHeartBeatOhio.org.

The Cleveland Clinic Foundation, has partnered with El Barrio, a Latino social services provider, and area schools on a program to train Latino high school students and adults as nursing assistants and to promote health careers in the Latino community.

The American Society for Healthcare Engineering recently named Stephen Blum, Shriners Hospital for Children, Cincinnati, as an Emerging Leader in 2003.

Mercy Medical Center, Canton, recently became the first hospital in the nation to be accredited by the Society of Chest Pain Centers & Providers.

Kyle Allen helped create the Care Coordination Network in order to help bridge the gap between Summa Health System, Akron, and skilled-nursing facilities. The network meets regularly to discuss the patient transfer process and ways to improve patient care.

U.S. News & World Report recognized several Ohio hospitals as “America’s Best Hospitals” in their annual survey report including: Akron General Medical Center, Arthur G. James Cancer Hospital, Columbus, Christ Hospital, Cincinnati, Meridia Hillcrest Hospital, Cleveland, MetroHealth Medical Center, Cleveland, Miami Valley Hospital, Dayton Ohio State University Medical Center, Columbus, Southwest General Health Center, Middleburg Heights, Summa Health System, Akron, The Cleveland Clinic Foundation, University of Cincinnati Hospital, and University Hospitals of Cleveland. For a more complete list of hospitals visit www.usnews.com.

Last Bat for an Old Friend - Hospital Softball Tournament
The 30^th annual Ohio Hospital Softball Tournament will again be held at Berliner Park in Columbus. The men and women's tournaments will be held Aug. 23-24, with coed teams taking the field on Sept. 13-14. After 30 years and thousands of participants, the tournament will be retired after this season. For information on the men and women's events, contact Roger Rill at 614.348.3305 or 614.761.2293. Gary Ogle will be handling the coed event and can be reached at 614.888.3138.