The Research And Educational Foundation Of The Ohio Hospital

THE MISSION OF THE RESEARCH AND EDUCATIONAL FOUNDATION OF THE OHIO HOSPITAL ASSOCIATION IS TO EVALUATE, FOCUS AND ENGAGE IN CHANGE ACTIVITIES THAT LEAD AND ENABLE THE PURSUIT OF EXCELLENCE IN SAFETY AND QUALITY AND IN IMPROVING THE HEALTH OF OUR COMMUNITIES.

DISASTER PREPAREDNESS COVID-19 INITIATIVES AND FUNDING: - FACILITATED OHIO GOVERNOR'S EXECUTIVE ADVISORY GROUP - FACILITATED WEEKLY SURGEON/PROCEDURALIST FORUMS - COLLABORATED WITH OHIO DEPARTMENT OF ADMINISTRATIVE SERVICES FOR PROCUREMENT OF VIABLE PPE PRODUCT OPTIONS - FACILITATED AND UPDATED CONGREGATE CARE AND HOSPITAL PAIRING LIST - MEMBER OF VACCINE PLANNING WORKGROUP - FACILITATED BI-WEEKLY FORUM OF INFECTIOUS DISEASE PHYSICIANS - SERVED ON MONTHLY HOUSING AND HOMELESSNESS FORUMS - COLLABORATED WITH ODH/GOVERNOR'S OFFICE ON CREATING A STAFFING RELIEF RESOURCE - ADMINISTERED THE HOSPITAL ASSOCIATION COVID-19 PREPAREDNESS GRANT FUNDING FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE (ASPR)

SAFETY & QUALITY SEPSIS MORTALITY: FOR THE SEVENTH YEAR, THE OHA STATEWIDE SEPSIS INITIATIVE WAS FACILITATED IN RESPONSE TO THE OHA BOARD-DIRECTED GOAL OF A STATEWIDE REDUCTION IN SEPSIS MORTALITY TO 14.9%. ONE HUNDRED TWENTY-FIVE MEMBER HOSPITALS HAVE MAINTAINED THEIR COMMITMENT TO PARTICIPATE IN THE ONGOING INITIATIVE WHICH INCLUDES DATA SUBMISSION REGARDING COMPLIANCE TO THE ELEMENTS OF THE 3-HOUR SEPSIS BUNDLE, MONTHLY EDUCATIONAL/COACHING CALLS, AND DISSEMINATION OF EFFECTIVE PRACTICES. A SEPSIS WEBSITE WAS HOSTED AND MAINTAINED. EVIDENCE-BASED, APPROVED, CONTINUING EDUCATION WEBCASTS WERE POSTED TO THE SITE ALONG WITH EVIDENCE-BASED LITERATURE AND RESOURCES. OHA ANALYZED AND PROVIDED QUARTERLY SEPSIS COMPARATOR DATA OUTCOMES REPORTS TO PARTICIPATING HOSPITALS. REPORT ENHANCEMENTS WERE MADE TO INCLUDE THE ADDITION OF LIVE LINKS TO WEB-BASED SEPSIS RESOURCES. A "COVID-19 LANDMARKS" DOCUMENT WAS DEVELOPED AND IS UPDATED MONTHLY, FOR USE WHEN INTERPRETING DATA AND AS A TOOL TO CONSIDER THE LANDMARKS THAT OCCUR THROUGHOUT THE EVOLVING PANDEMIC. CONTINUOUS SERVICE READINESS (CSR): ACCESS TO CONTINUOUS SURVEY READINESS SERVICES FOR HOSPITAL ACCREDITATION WERE FACILITATED FOR 85 MEMBER HOSPITALS VIA SUBSCRIPTION TO THE CSR CONSULTANT SERVICE. BOTH SPRING AND FALL CONFERENCES WERE PROVIDED VIRTUALLY, RELATED TO ACCREDITATION STANDARDS. REGIONAL QUALITY COLLABORATIVES: REGIONAL QUALITY COLLABORATIVES WERE FACILITATED IN THE NORTHEAST, CENTRAL AND NORTHWEST OHIO REGIONS. EACH COLLABORATIVE WAS FACILITATED BY A CHAIRPERSON OR TWO CO-CHAIRS. COLLABORATIVE SERVICES INCLUDED FACILITATING MEETINGS AND PROVIDING QUARTERLY DATA REPORTS INCLUDING PATIENT SAFETY INDICATORS (PSI), READMISSIONS, AND SEPSIS. HAND HYGIENE: IN 2021, THE HAND HYGIENE PROGRAM CONTRACTED HAND HYGIENE OBSERVERS AND REPORTING CONTINUED. CERTAIN HOSPITALS AND HOSPITAL SYSTEMS SAW THE NEED FOR CONTINUOUS HAND HYGIENE MONTHLY MONITORING AND AT HIGHER THRESHOLDS OF OBSERVATIONS THAN ASSOCIATED WITH PROJECTS TYPICALLY LED BY OHA. IN 2021, THE HAND HYGIENE SUBSCRIPTION SERVICE EXPANDED FROM 42 HOSPITALS TO 58 HOSPITALS.

OHIO PATIENT SAFETY INSTITUTE PATIENT SAFETY ORGANIZATION (OPSI PSO) PATIENT SAFETY DATA COLLECTION AND ANALYSIS WAS CONTINUED FOR 49 MEMBERS VOLUNTARILY PARTICIPATING IN OHIO PATIENT SAFETY INSTITUTE PATIENT SAFETY ORGANIZATION (OPSI PSO) WHILE SECURING UNIFORM FEDERAL CONFIDENTIALITY AND PRIVILEGE PROTECTIONS. OPSI MAINTAINED ITS THREE OBJECTIVES: 1. OPSI SHALL SET THE OHIO PATIENT SAFETY AGENDA AS THE CONVENER OR FACILITATOR BY: - IDENTIFYING, SHARING, DISSEMINATING BEST PRACTICES, AND USING THOSE PRACTICES TO SET STATEWIDE BENCHMARKS - ACTING AS THE CATALYST TO PROVIDE SAFE PATIENT-CENTERED CARE ALONG THE CONTINUUM 2. AS A DESIGNATED PSO, OPSI WILL BE A CONDUIT TO IDENTIFY OPPORTUNITIES FOR IMPROVEMENT AND EFFECTIVE PRACTICES BY: - ADOPTING AND DEVELOPING TOOLS TO ENHANCE PATIENT SAFETY - PROVIDING LEADERSHIP AND CONSULTING SERVICES TO INTEGRATE EVIDENCE-BASED SAFE PRACTICES IN HEALTHCARE SETTINGS - WORKING WITH LOCAL, STATE, AND NATIONAL PARTNERS WHENEVER POSSIBLE 3. OPSI SHALL BE A LEADER IN CREATING A LEARNING CULTURE THAT EMPHASIZES PATIENT SAFETY THROUGH PROFESSIONALISM, COLLABORATION, INTERPERSONAL SKILLS, AND TEAMWORK BY: - SPREADING A CULTURE OF SAFETY, MITIGATING RISKS, FACILITATING EFFECTIVE COMMUNICATION, AND ENHANCING SAFE BEHAVIOR OPSI PSO CONDUCTED USER GROUPS AND PROVIDED MULTIPLE WEBCASTS. OPSI AWARDED THE FOLLOWING RECOGNITIONS IN 2021: - OPSI PATIENT ENGAGEMENT BEST PRACTICE AWARD TO UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER FOR "CONTINUOUS REMOTE MONITORING PROGRAM IN PATIENTS AT HIGH RISK OF DECOMPENSATION WHO WERE DISCHARGED FROM THE EMERGENCY DEPARTMENT WITH COVID-19" - OPSI COVID-19 BEST PRACTICE AWARD TO UNIVERSITY HOSPITALS FOR "COVID-19 INTERCEPT STRATEGY" - OPSI ACUTE CARE BEST PRACTICE AWARD TO LAKEHEALTH FOR "ELIMINATING POST-OPERATIVE RESPIRATORY FAILURE"

COMMUNITY HEALTH OPIOID RESPONSE INITIATIVE (ORI): THE OPIOID RESPONSE INITIATIVE BEGAN AS A TARGETED INITIATIVE AIMED AT HOSPITALS MOST DISPROPORTIONATELY AFFECTED BY THE OPIOID EPIDEMIC. THE GOALS OF THE ORI ARE DIVIDED INTO THREE FOCUS AREAS OF ADVOCACY, INTERVENTION AND ECONOMIC SUSTAINABILITY WITH CLINICAL INTERVENTIONS GROUPED INTO TARGET AREAS OF PREVENTION, HARM REDUCTION, AND TRANSITION TO TREATMENT AND RECOVERY. IN ADDITION TO THE REMARKABLE CLINICAL INITIATIVES LAUNCHED BY MEMBER HOSPITALS AND SHARED AMONG ORI PARTICIPANTS, MUCH OF THE EFFORTS HAVE BEEN CONCENTRATED IN TWO AREAS: DATA SUPPORT AND GRANT DEVELOPMENT. DATA SUPPORT: -CONTINUED SUPPORT FOR THE PUBLIC DATA RELEASE FOR OPIOID OVERDOSE WITH DATA PRESENTED STATEWIDE, BY MARKET AREA, AND BY COUNTY, WITH APPROPRIATE HIPAA RESTRICTIONS -THE OPIOID DATA COLLABORATIVE, OR ODC, WAS LAUNCHED JULY 2018 TO SERVE AS A DATA-AGGREGATING AND BENCHMARKING SERVICE FOR OPIOID PRESCRIBING AT PARTICIPATING HOSPITALS WITH A GOAL TO SUPPORT HOSPITALS' INTERNAL EFFORTS IN RIGHT-SIZING OPIOID PRESCRIBING BY PEER-TO-PEER EDUCATION AND LARGE STATEWIDE COMPARISON GROUPS -THE PRACTICE AREAS INCLUDE EMERGENCY DEPARTMENTS, HOSPITAL DISCHARGE, OUTPATIENT SURGICAL CENTERS, AND PHYSICIAN OFFICES -PARTICIPATING HOSPITALS RECEIVE FREE QUARTERLY REPORTS. FIRST REPORTS WERE DELIVERED IN DECEMBER 2019: 1. DATA INTEGRITY REPORT - THIS INCLUDES DATA AT THE HOSPITAL LEVEL AND IS INTENDED TO PROVIDE A VIEW OF THE DATA THE FACILITY HAS SUBMITTED 2. USE CASE REPORT - THIS INCLUDES DATA FOR HOSPITAL(S) AND HEALTH SYSTEM (IF APPLICABLE) AND IS INTENDED TO PROVIDE INFORMATION ABOUT DATA COMPARED TO THE PROJECT-WIDE BENCHMARKS 3. PROVIDER REPORT - THIS INCLUDES DATA FOR EACH INDIVIDUAL HOSPITALS' PROVIDERS AND IS INTENDED TO PROVIDE INFORMATION ABOUT THE HOSPITAL SPECIFIC DATA COMPARED TO THE HEALTH SYSTEM (IF APPLICABLE) AND THE PROJECT-WIDE BENCHMARKS FOR HOSPITALS WHO SUBMIT THIS DATA. -AT THE TIME OF THIS SUBMISSION, THERE ARE 103 PARTICIPATING HOSPITALS AND/OR HEALTH SYSTEMS -IN 2021, 483 REPORTS WERE PRODUCED AS A PART OF THE ODC FOR THESE PARTICIPATING HOSPITALS AND HEALTH SYSTEMS. GRANT DEVELOPMENT: THE EDUCATING OHIO'S PRESCRIBERS GRANT FROM THE COVERYS COMMUNITY HEALTHCARE FOUNDATION PROVIDES EDUCATION AROUND THREE FOCUS AREAS, EACH WITH ITS OWN TIMELINE: COMPLIANCE EDUCATION, COMPARATIVE EDUCATION, AND BEST PRACTICES EDUCATION. COMPARATIVE EDUCATION OPIOID DATA COLLABORATIVE 2.0: AS ESTABLISHED THROUGH THIS PARTNERSHIP WITH COVERYS, THE OPIOID DATA COLLABORATIVE (ODC) 2.0 WORK BEGAN IN 2020 AS A CONTINUATION OF PREVIOUSLY FUNDED WORK. WE CURRENTLY HAVE 103 OHA MEMBER HOSPITALS AND FACILITIES PARTICIPATING IN THE OHA OPIOID DATA COLLABORATIVE. THIS REPRESENTS A VERY LARGE PORTION OF THE TOTAL INPATIENT AND OUTPATIENT ENCOUNTER VOLUME FOR OHIO. OHA HAD BEEN IN THE PROCESS OF COMPLETING AGREEMENTS WITH TWO OTHER LARGE HEALTH SYSTEMS AND TWO INDEPENDENT HOSPITALS WHO WERE CONSIDERING OR WERE IN THE PROCESS OF JOINING THE ODC, BUT THE PANDEMIC IMPACTED AND STALLED THOSE CONVERSATIONS. THE OHA DATA TEAM DEVELOPED A DATA ARCHITECTURE AND FRAMEWORK FOR AGGREGATING, BENCHMARKING AND REPORTING THE DATA BACK TO PARTICIPANTS. THE FOLLOWING DATA METRICS ARE BENCHMARKED FOR HOSPITALS AND PROVIDERS: HOSPITAL REPORT: 1. MORPHINE EQUIVALENT DOSE (MED) CALCULATION -THE MED IS CALCULATED USING THE STATE OF OHIO BOARD OF PHARMACY MME CONVERSION FACTORS AND FORMULA PROVIDED HERE: HTTPS://WWW.OHIOPMP.GOV/DOCUMENTS/MORPHINEEQUIVALENTDAILYDOSECONVERSIONTABLE.PDF 2.AVERAGE DAILY MED -THIS CALCULATION IS APPLIED TO ALL PRESCRIPTIONS IN THE SPECIFIED CARE SETTING AND USE CASE IN EACH REPORT SECTION: TOTAL MED/ NUMBER OF ALL OPIOID PRESCRIPTIONS 3. ACUTE PRESCRIPTIONS -THE DAYS SUPPLY FOR THE PRESCRIPTION IS 28 DAYS OR LESS. 4.NON-ACUTE PRESCRIPTIONS -THE DAYS SUPPLY FOR THE PRESCRIPTIONS IS GREATER THAN 28 DAYS. 5.PRESCRIPTION COUNT PROVIDER REPORT: - EACH BY SPECIALTY AND USE CASE/CARE SETTING: 1. PROVIDER COUNT -NUMBER OF PHYSICIANS WHO WROTE A PRESCRIPTION 2. PRESCRIPTION COUNT -NUMBER OF OPIOID PRESCRIPTIONS THAT WERE WRITTEN 3. AVERAGE DAILY MED BY PHYSICIAN SPECIALTY 4. DAILY MED RANGE BY PHYSICIAN SPECIALTY THE FIRST ROUND OF REPORTS WAS RELEASED TO HOSPITALS IN DECEMBER OF 2019. THIS INVOLVED THE RELEASE OF 154 REPORTS BACK TO PARTICIPATING MEMBERS OF THE ODC. TO EXPRESS THE LEVEL OF DETAIL WITHIN THESE REPORTS, SOME OF THE PROVIDER REPORTS WERE OVER ONE HUNDRED PAGES IN LENGTH. HOSPITALS HAVE RECEIVED QUARTERLY REPORTS WITH THE MOST RECENT BEING FOR Q2 2022 DATA. HOSPITALS RECEIVED A HOSPITAL-LEVEL REPORT THAT INCLUDED BENCHMARK DATA ON FOR FOUR DIFFERENT CARE SETTINGS AND SIX PRE-DETERMINED USE CASE GROUPS. FOLLOWING THE FIRST ROUND OF REPORTS THAT WERE RELEASED TO PARTICIPANTS, OHA HAS BEEN IN ONGOING DISCUSSIONS WITH THE ODC TO EXPLORE THE DATA AND SEE IF THERE ARE ADDITIONAL USE CASES THAT WARRANT BEING INCLUDED IN FUTURE REPORTS. AFTER ALLOWING ENOUGH TIME FOR HOSPITAL TEAMS TO ANALYZE THE REPORTS INTERNALLY, OHA GATHERS FEEDBACK TO BE USED TO INCREASE THE VALUE OF THE REPORTS BACK TO MEMBERS. THIS WILL BE USED INTERNALLY TO DETERMINE HOW WE MIGHT BE ABLE TO ADJUST THE REPORTS, DATA METRICS, AND DATA SUBMISSION FOR FUTURE ITERATIONS OF THE REPORT. SINCE THE ODC BEGAN PRODUCING THEIR FIRST REPORTS IN JULY 2019, FOR Q4 2018 DATA, OHA HAS RELEASED SEVEN ITERATIONS OF THESE REPORTS. PARTICIPANTS RECEIVE THEIR DATA INTEGRITY REPORTS, USE CASE REPORTS, AND PROVIDER REPORTS (FOR THOSE SUBMITTING THAT LEVEL OF DATA). SINCE THE INITIATIVE'S INCEPTION, OHA HAS PRODUCED OVER 975 INDIVIDUAL REPORTS FOR ALL PARTICIPATING HOSPITALS AND HEALTH SYSTEMS. BEST PRACTICE EDUCATION: OPIOID-RELATED WEBINAR SERIES: OHA HAD BEGUN PLANNING FOR THE 2020 EDUCATION OPPORTUNITIES FOR HOSPITALS, BUT THE PANDEMIC CREATED A CIRCUMSTANCE WHERE BOTH OHA AND HOSPITAL RESOURCES WERE LIMITED. IN CONSULTATION WITH COVERYS, IT WAS DETERMINED MOST PRACTICAL TO DELAY THIS WORK. FOUR SESSIONS WERE HOSTED IN 2019. PREVIOUSLY, OHA WORKED WITH HOSPITALS AS A PART OF A FEDERAL GRANT CALLED THE HOSPITAL IMPROVEMENT INNOVATION NETWORKS. PART OF THAT SCOPE OF WORK INCLUDED OPIOIDS, AND THAT GRANT ENDED IN EARLY 2020. BASED ON THE SPRING OF 2019 HIIN OPIOID GAP ANALYSIS ONLY 12 OUT OF 101 HOSPITALS HAD A COMPREHENSIVE OPIOID STEWARDSHIP PROGRAM IN PLACE. IN REFLECTION OF COVID EFFECT ON HOSPITALS EFFORTS SURROUNDING OPIOID EDUCATION, IT WAS DETERMINED A SERIES ON DEVELOPING A COMPREHENSIVE OPIOID STEWARDSHIP PROGRAM WOULD BE BENEFICIAL FOR MOST HOSPITALS. THE OPIOID STEWARDSHIP PROGRAM DEVELOPED A SIX-PART SERIES WITH AN OPTION FOR AN ADDITIONAL WEBCAST. IN ADDITION, TWO OPIOID REGIONAL COORDINATORS WERE HIRED TO ASSIST HOSPITALS WITH THEIR PROGRESS TOWARD THE DEVELOPMENT OF AN INTERNAL OPIOID STEWARDSHIP PROGRAM. THE OPIOID REGIONAL COORDINATORS WORK ONE-ON-ONE WITH HOSPITALS TO ASSIST WITH IMPLEMENTATION OF OPIOID STEWARDSHIP PROGRAMS; MAKE ROUTINE VISITS OFFER APPROPRIATE SUPPORT; FOLLOW-UP ON AREAS OF OPPORTUNITY FROM OPIOID GAP ANALYSIS; PROVIDE RESOURCES AND SHARE EFFECTIVE PRACTICES WITH HOSPITALS; FOLLOW-UP REGARDING PROGRESS TOWARDS GOALS; AND IDENTIFY AND COLLECT RESOURCES TO SHARE. IN ADDITION, THEY ASSIST WITH THE DEVELOPMENT OF CONTINUING EDUCATION PROGRAMS; SOURCE SPEAKERS FOR MONTHLY OPIOID PRESENTATIONS, AND OBTAIN NECESSARY DOCUMENTATION FOR CONTINUING EDUCATION APPLICATION THE OPIOID STEWARDSHIP WEB SERIES WAS OFFERED AT NO FEE TO PARTICIPANTS AND PROVIDED CONTINUING EDUCATION CREDITS TO PHARMACISTS AND NURSE. AT THE COMPLETION OF THE OPIOID STEWARDSHIP WEB SERIES, THE PARTICIPANT WILL DISCUSS KEY ACTIONS FOR IMPLEMENTATION OF A SUCCESSFUL OPIOID STEWARDSHIP PROGRAM. MATERNAL AND INFANT HEALTH INFANT MORTALITY: -OHA SERVED ON EXECUTIVE/STEERING COMMITTEES FOR THE OHIO PERINATAL QUALITY COLLABORATIVE AND OHIO MARCH OF DIMES. -OHA HAS A SEAT ON THE STATE OF OHIO COMMISSION ON INFANT MORTALITY AND OHIO NEWBORN ADVISORY STEERING COMMITTEE -OHA SERVED ON THE OHIO GOVERNOR'S TASK FORCE TO ELIMINATE DISPARITIES IN INFANT MORTALITY BREASTFEEDING: -THE FIRST STEPS FOR HEALTHY BABIES, A QUARTERLY RECOGNITION PROGRAM FOR HOSPITALS IMPLEMENTING THE 10 STEPS TO SUCCESSFUL BREASTFEEDING, WAS LAUNCHED IN MARCH OF 2015 IN PARTNERSHIP WITH THE OHIO DEPARTMENT OF HEALTH. IN 2021, THE PROGRAM CONTINUED ITS REACH TO OVER 99% OF THE MATERNITY HOSPITALS IN THE STATE. -THE FIRST STEPS PROGRAM PARTNERED WITH THE OHIO LACTATION CONSULTANTS ASSOCIATION (OLCA) AND OHIO BREASTFEEDING ALLIANCE (OBA) TO REVIVE A 'BAG FREE' RECOGNITION PROGRAM FOR HOSPITALS. THIS PROGRAM LAUNCHED IN EARLY 2016 AND WAS CONTINUED IN 2021. 79 HOSPITALS WERE RECOGNIZED IN 2021 FOR THEIR WORK IN 2020. THIS REFLECTS OVER A 50% INCREASE IN PARTICIPATION SINCE THE FIRST YEAR.