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Monday, November 14, 2005
OHA Staffing Program Reaches Milestone
After less than a year in business, the OHA Solutions staffing program this week filled its 8,000th order. OHA Solutions contracts with 80 agencies to help the 75 participating OHA member hospitals fill per diem and long-term staff vacancies. The service provides staffing for nursing vacancies as well as those in radiology, rehabilitation services, laboratory and respiratory therapy.

In December, OHA Solutions will celebrate one year in business and move into a second year of service. The organization will soon announce new services, including a program to help hospitals use internal employee resources to help book shifts. For more information on OHA Solutions, contact Nancy Melcher-Webb at 614.221.7614 or nwebb@ohanet.org.

OHA Supports Revised Rules on Electronic Drug Record-Keeping

The Ohio State Board of Pharmacy last week approved revisions to rules for institutional pharmacies, including greater flexibility in using electronic record keeping systems. The pharmacy board worked with a team of hospital clinical administrators recommended by OHA to develop the revisions, which address problems such as overly-rigorous identification requirements for electronically recording the prescription, administration and dispensing of drugs. Jean Scholz, OHA’s director of health policy, testified to the board, giving OHA's support for the rules. View the testimony at www.ohanet.org/advocacy/state/regulations/4729-17.pdf. The revisions now go to the Joint Committee on Agency Rule Review (JCARR) Dec. 5 and are planned to take effect Jan. 1.

At OHA’s request, the board will publish the names of hospitals approved by the board for their electronic record-keeping systems to help hospitals share innovative solutions to problems encountered. The board is also considering OHA’s recommendation that certain pharmacy board field staff inspectors be designated as experts in working with hospitals for approval of regulations for electronic drug record-keeping.

A February conference will invite hospital pharmacy and information technology associates, pharmacy board staff and members and compliance officers to work together on making the implementation of the rules run smoothly. A frequently-asked-questions document is under development as well, and will be released when the rules are finalized. (Jean Scholz, jeans@ohanet.org)

Tuesday, November 15, 2005
CMS Returning to Original Flu Bed Waiver Process
Hospitals may no longer contact the Centers for Medicare & Medicaid Services (CMS) directly to request the use of prospective payment system-exempt beds for flu and seasonal illness. CMS Region 5 has announced it will return to its original process of granting waivers for hospitals, requiring hospitals to work through their regional hospital associations to funnel information about the need for a regional or statewide waiver to OHA. If and when appropriate, OHA will ask the Ohio Department of Health to declare a public health emergency and request that CMS issue a bed waiver. For more information on the 2005-2006 flu season, visit www.ohanet.org/flu/. (Carol Jacobson, carolj@ohanet.org; Rick Sites, ricks@ohanet.org)

Wednesday, November 16, 2005
State Auditors’ Office to Begin Medicaid Audits
OHA is working with the Auditor of State Betty Montgomery as she develops a process to begin a performance audit of the Ohio Medicaid program and Medicaid provider audits. Charged as the new authority for conducting these audits in the state’s biennial budget bill, Montgomery’s office this week announced the start of new Medicaid provider audits as well as a statewide Medicaid program performance audit.

The scope of the program performance audit will focus on the following operational areas:

Organizational issues, including state and local responsibilities, Medicaid program goals and desired outcomes and funding methods.
Medicaid service provisions, including evaluations of long-term care and pharmaceutical programs, and eligibility determination.
Care management, including opportunities to enhance care management and identify desired outcomes for Medicaid-eligible populations.
Technology and program management, including current technology and potential future enhancements.
Program integrity, including current and recommended practices to detect and deter fraud and abuse.

The state auditor and OHA are also working with the Ohio Department of Job and Family Services (ODJFS) on a special project to recover what are reported to be millions of dollars in Medicaid credit balances being held at hospitals while ODJFS processes hardcopy adjustment requests. OHA has requested the special project focus on assisting ODJFS implement electronic adjustments. The state auditor plans to issue interim and final reports in the spring and fall of next year, preceding the primary and general elections, and OHA will follow up with additional information as it becomes available. (Charles Cataline, charlesc@ohanet.org)

Hospitals Hone Skills at Pollution Prevention Training
OHA will host the next Pollution Prevention University (P2U) at Firelands Regional Medical Center, Sandusky, Jan. 30-31 and hospitals can apply now to participate in that training. The two-day, hands-on session helps hospital evaluate waste systems and design and implement plans for volume reduction and pollution prevention activities.

Sponsored by OHA’s Environmental Leadership Council, the P2U trainings only accept a small number of participants and require a $100 registration fee. Those interested in attending the January P2U should visit www.ohanet.org/p2/ or contact Susan Zabo at 614.221.7614 or susanz@ohanet.org.

OHA thanks Memorial Hospital of Union County for hosting the November training. To view a photo of participants, visit www.ohanet.org/p2/.

Hospitals’ Heartbeat
A 2005 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Carol Wise
Director of Quality Resource Management
The Children’s Medical Center of Dayton, Dayton
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A look inside Carol’s nomination –
“As director of quality resource management for The Children’s Medical Center of Dayton, Carol Wise believes passionately in maintaining the highest standards of patient safety and quality for all of the children in the Miami Valley region. A member of Dayton Children’s staff for 17 years, Carol has led the hospital to outstanding Joint Commission scores by maintaining rigorous standards for education and compliance throughout the hospital. She is an outstanding leader and holds several state positions related to quality and patient safety. In addition to her tireless work for Dayton Children’s, Carol is active with her four children and her church community, serving as outreach ministry coordinator. ‘Carol is the ideal Dayton Children’s employee,’ says Thomas Murphy, MD, vice president for medical affairs at Dayton Children’s. ‘She helps build a culture that encourages safety and puts kids at the center of everything we do.’”

Thursday, November 17, 2005
SmokFreeOhio Collects 150,000 Signatures for Smoke-Free Ohio Bill
As part of today’s national Great American Smokeout, SmokeFreeOhio turned in the signatures of 150,000 Ohio voters to the Secretary of State in support of a statewide, smoke-free bill. The signatures, once verified, will put the bill before state lawmakers in January. SmokeFreeOhio asks lawmakers to take no action and allow the campaign to collect a second round of signatures to put the issue on the ballot in November 2006.

"Every Ohioan has the right to breathe clean indoor air, and every Ohioan should have the right to vote on it," said Tracy Sabetta, co-chair of the SmokeFreeOhio campaign.

The American Cancer Society is leading the campaign, in partnership with the Ohio Hospital Association, the American Heart Association, the American Lung Association, the Association of Ohio Health Commissioners, the Campaign for Tobacco-Free Kids, and the Ohio State Medical Association. More than 150 organizations have endorsed SmokeFreeOhio. For more information, go to www.smokefreeohio.org. (Lynne Ayres, lynnea@ohanet.org)

Hospitals’ Heartbeat
A 2005 nominee for the Albert E. Dyckes Health Care Worker of the Year Award

Mary R. Nicholson, RN, BSN, CIC
Nurse Epidemiologist
The Christ Hospital, Cincinnati
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A look inside Mary’s nomination –
“Mary’s dedication to creating a safe and healthy hospital environment is evident in everything she commits to. Some think infection control is just about hand washing, but it isn’t. Mary’s work can mean the difference between life and death for patients, and the difference between thousands of dollars in expense or savings for the hospital. One of Mary’s critical projects was establishing a cardiac surgery protocol that has reduced staphylococcus aureus surgical site infections by 75 percent. This is absolutely phenomenal. The process began before the start of surgery when nasal cultures were obtained on all cardiovascular surgery patients and treatment with intranasal mupirocin occurred. Mupirocin was stopped if the culture returned negative, and continued for seven days if the culture returned positive. In addition to reducing infection risk, Mary’s initiative saved the hospital more than $300,000!”

Friday, November 18, 2005
A Broken System: Who Can Fix the Health Care Billing and Collections System?
The underlying principle is simple: for every dollar a hospital spends providing care to patients, it needs at least one dollar of reimbursement to survive. The question of who should provide this compensation is much more complex—a dilemma requiring collaboration and more than a quick fix.

To remain open, hospitals must fill the gaps left by shortfalls in reimbursement and charity expenses. They adjust their charges to end up with payments that cover the ever-increasing costs of providing services, maintaining facilities and improving capabilities to meet the needs of their communities. And while government and private insurers pay at or below costs, and often far below what the hospital charges, unfortunately those least able to pay sometimes are billed the full amount charged by the hospital.

A well-designed health care payment system should balance the needs, responsibilities and limitations of the hospital with the patients it serves. Working together, hospitals, government, employers and patients can design a more fair, efficient and rational health care payment system. Learn more about what each of these groups can do to help fix the broken health care billing and collection system in the November Healthbeat, online at www.ohanet.org/healthbeat/2005/1105.htm. (Mary Sterenberg, marys@ohanet.org)