May 2023 | Issue 26
On-Demand Videos and Nursing Education Units (CEUs):
Infection Prevention and Control for Nursing Leaders
There is great news for those who missed last month’s two-part series on infection prevention and control (IPC)! The Partnership to Advance Tribal Health (PATH) and the Indian Health Service (IHS) National Nursing Leadership Council Executive Committee released the series as on-demand videos. The course features three speakers with decades of combined experience in IPC and covers important IPC concepts for an experienced or emerging nurse leader to know, champion and monitor.  
Three (3) hours of nursing CEUs are available through April 2025 for those who did not attend the live sessions and are taking this course for the first time. 
We are here to help! If you have any questions or need more information, please email us at
Better Management of Your High-Risk Patients Using Risk Stratification
Risk stratification is “the process of assigning a health risk status to a patient and using the patient’s risk status to direct and improve care,” according to the American Academy of Family Physicians (AAFP). It allows for risk-based care management, where practices manage patients based on their assigned risk level, resulting in better use of limited resources, anticipation of needs and more proactively managing their patient population.

Risk stratification aims to help patients achieve the best health and quality of life possible by preventing chronic disease, stabilizing current chronic conditions and preventing movement to higher level of care or emergent conditions.

PATH prepared some resources to educate and guide you in determining how to implement risk stratification and how to use the Resource and Patient Management System (RPMS) I-Care software to implement algorithms to assign risk scores.
  • Risk Stratification to Manage High-Risk Patients Guide - This toolkit helps identify and manage patients using risk stratification. Risk stratification uses a mix of objective and subjective data to assign risk levels to patients.
  • Risk Stratification to Manage High-Risk Patients (recording) - This video provides an overview of the technical tools available in the IHS information systems for the management of high-risk patients. Demonstration of the concepts presented can be walked through in the accompanying written guide.

This is one session from a series that explores strategies and tools around care transitions within the ambulatory setting in support of Patient-Centered Medical Home (PCMH). The sessions were presented with Billings Area Indian Health Staff and include discussion on how they have incorporated risk stratification in their facilities, the successes and the challenges. 

Additional resources:

Whatever method you use, risk stratification should be seen as a dynamic process. You should reevaluate risk scores regularly and as you become aware of changes in the patient's status.
PATH Produces First Audiocast Series: Candid Conversations

PATH is excited to introduce its first ever audiocast series Candid Conversations. Throughout the series, the host and special guest co-hosts share real-life examples and challenges experienced by both patients and staff in emergency care settings. The conversations allow for reflections on key changes that can potentially lead to positive outcomes and improve both the patient and provider experience. Some key topics discussed throughout the series will include
  • emergency department (ED) length of stay,
  • triage or medical screening exam (MSE) times,
  • scenarios of left without being seen (LWBS)
  • and more!

The first recording is now available! Listen to Episode 1- Should I Stay; Should I Go: When to Use the ED. 
In our inaugural episode, hear from PATH team quality improvement advisors (QIAs) Tasha Peltier (host) and Jess Danko (co-host) as they bring both their health care clinical expertise and experience with health services in response to a submitted patient story. Our expert hosts reflect on the patient’s decision to leave the ED before being seen by a provider and offer views and recommendations from both the patient and provider perspective.

We hope you find these conversations helpful as we work to support systems, staff, patients and family members in understanding all our roles in improving the overall experience in these health care settings. 

Check out PATH events on best and promising practices for ED care:

Additional resources:

If you have any ideas or suggestions for a patient story you would like us to discuss as part of our Candid Conversations audiocast, please email us at
IHS Hospital Makes Strides in Improving Charting and Documentation
An IHS facility’s quality team and CEO were looking to improve the service unit’s documentation. What steps could the facility take to make sure nursing and provider charting is comprehensive, creates a whole picture of the patient’s care and is within best practice standards and requirements?

May is a time of year when many welcome the changing of the weather, new spring blooms and celebrations. We want to take the time to thank all health care heroes for the work you continue to do to support American Indian and Alaska Native communities.

There is a Native American proverb that says, “We will be known forever by the tracks that we leave.” The quote exemplifies how the work you do has a greater impact on the world around you.
We know the health care profession is rewarding. However, it can also be highly stressful and exhausting, especially in today’s climate. As you come to the close of this week and look forward to next, take the time to refresh and renew.

Here are some helpful tips you can do this week:
  • Practice self-care: Get adequate sleep, nutrition and exercise. 
  • Show appreciation and gratitude: End each day by listing three things that happened for which you are grateful. 
  • Reframe: Change your perception of a situation by thinking more objectively. 
  • Communicate with your coworkers, supervisors and employees about job stress. 
  • Exercise. When away from work, get exercise when you can. Spend time outdoors either being physically active or relaxing. Do things you enjoy during non-work hours. 

For other tips on how to nurture your mind and body daily, check out the National Institutes of Health (NIH) Wellness Toolkits.

Be on the lookout! We are excited to let you know about a new series, Take 5 for Safety. Each month in The PATH Post, we will share information, resources and best and promising practices to support you on your Culture of Safety journey. 
Maternal Health Tribal Learning Community Webinars | Learn more
Did you know the National Indian Health Board and the Centers for Disease Control and Prevention (CDC) are hosting a webinar series to address maternal health disparities in Indian Country? The next session (June 27) is entitled "Advancing Health Equity: Strengthening Community Engagement and Partnerships."

And don't forget about the IHS Tele-Behavioral Health Center of Excellence webinar series. Events in June will focus on child and adolescent behavioral health.
2023-2024 18-Month DTA Calendar | Download PDF file
Did you know the Centers for Medicare & Medicaid Services Division of Tribal Affairs (DTA) provides
free outreach materials and resources that can be downloaded or ordered?
The DTA just released a new calendar with information intended to help Tribal families take steps
toward better control of their health. The calendar can be downloaded, or
visit the Tribal Products Ordering Page to order the calendar or any of the DTA materials.

Other materials from the Tribal Products Ordering Page include:
National Healthcare Safety Network (NHSN) User Tips and FAQs | Register now! | View event flyer
Wednesday, June 7
3-4 p.m. ET | 2-3 p.m. CT | 1-2 p.m. MT | 12-1 p.m. PT

Experts from the Centers for Disease Control and Prevention (CDC), the Indian Health Service (IHS) and PATH come together to share tips and best practices and respond to frequently asked questions (FAQs) related to NHSN. All levels of users, from beginners to experts, are welcome to join, learn from the partner organizations and ask questions. This event is free, but registration is required.
Understanding Indigenous Drivers of Health | Register now!
Thursday, July 20
3-4 p.m. ET | 2-3 p.m. CT | 1-2 p.m. MT | 12-1 p.m. PT

Join PATH as we host IHS leaders for a timely discussion on the unique characteristics health care workers face when working with indigenous communities. This session will highlight The Joint Commission requirements to reduce health care disparities (effective January 2023), provide guidance on implementing a health equity program, share creative ways to use electronic medical records (EMRs) to manage social drivers of health and more. Let's come together, as we aim to improve the health and wellness of Indigenous communities and close the disparity gap. This event is free, but registration is required.
Did You Know?
We know life happens, and though you may have wanted to attend a live event, a time conflict or any other many possible reasons kept you from it. Not to worry! PATH has got you covered. Many of our past event recordings, key takeaways, flyers and resources can be found on our event page on our website. 

Please feel free to check out our PATH Events page if you missed an event or would like a refresher. While you are there, check out some of our other postings and materials available to you.
This material was prepared by Comagine Health for the American Indian Alaska Native Healthcare Quality Initiative under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. NQIIC-AIHQI-373-05/18/2023