At the first MHA Clinical Conversations forum last week, representatives from about 30 of MHA's member hospitals began an insightful and informative discussion of emergency department discharge protocols for patients with a substance use disorder or overdose. Members shared their experiences and challenges with naloxone prescriptions and dispensing, screening, and brief intervention for these patients. The next two forums, to be held November 8 and November 29, will focus on referrals to treatment, the role of non-clinical personnel, and medication assisted treatment, among other topics. MHA's goal is to see where hospitals may develop a consensus on best practices for this patient population. This will help those that are developing their emergency department discharge protocols in order to comply with the state's HOPE ( Heroin and Opioid Prevention Effort) Act of 2017. 

Overdose-related deaths in Maryland continue to increase with 1,172 reported between January and June of this year. Of those, 799 were fentanyl-related deaths. The largest increases continue to be fentanyl-related, carfentanil-related, and from cocaine use combined with opioids. Heroin overdose deaths increased by seven when compared to the same time frame last year, and overdose deaths from prescription opioids fell by seven. The 2nd quarter report from the state can be found here.

 

As the nation's hospitals and health systems continue to address the opioid crisis, the American Hospital Association has developed a new toolkit to provide guidance and information on how to work with patients, clinicians and communities to stem this epidemic. 

Open enrollment for plans sold on the Maryland Health Benefit Exchange begins November 1. In preparation, the exchange has shared open enrollment tool kits in both English and Spanish, and plans to distribute open enrollment brochures to hospitals next week. Please contact Jenny Mancha if you have any questions. 

The Leapfrog Hospital Safety Grades fall release will be made available to the public Tuesday, October 31, and for the first time Maryland's hospitals will be included. The report card assigns a single letter grade to each hospital to indicate overall performance in keeping patients safe from harm. In prior years, data reported under Maryland's unique hospital rate setting system was not comparable to the national CMS data used by Leapfrog to develop its scores. This year, the Maryland Health Care Commission provided Leapfrog with quality metrics directly generated from the Health Services Cost Review Commission's claims database, which has made the inclusion of Maryland's hospitals possible. Hospitals can preview their own grades here. Talking points have been provided to your communications leads. For questions about your hospital's scores, contact Leapfrog.

The American Hospital Association has sent a notice to hospitals about a nationwide shortage of intravenous (IV) fluids, shortages that have worsened as a result of Hurricane Maria's impact on manufacturing plants in Puerto Rico. The most significant and severe shortage is for small-volume parenteral solutions, such as the 50 and 100 milliliter "minibags" of sodium chloride 0.9%, dextrose 5% and IV nutritional products made by Baxter. The American Society of Health-System Pharmacists  in collaboration with the University of Utah Drug Information Service, has compiled a document, " Small-Volume Parenteral Solutions Shortages, Suggestions for Management and Conservation," to assist hospitals and health systems seeking ways to manage these shortages by conserving existing supplies of these IV fluids. AHA encourages hospitals to share the document with your pharmacy, medical and nursing leaders, materials managers and others involved in addressing the current shortages.

A new ransomware campaign, dubbed Bad Rabbit, hit several targets in Russia and Eastern Europe this week and hospitals in the U.S. were alerted by the Florida Hospital Association to be aware of how they could be impacted. Computers can be infected when users download Adobe Flash from an infected site. It is recommended that if a site asks you to download Flash, go directly to the Adobe website to download it instead of using the link that site asks you to use. More from the Wall Street Journal.