September 29, 2017
"How lucky I am to have something that makes saying goodbye so hard."
--Winnie the Pooh
Who could imagine that Winnie the Pooh would so aptly sum up my feelings about leaving MHA? But he does. It is hard to say goodbye because you have made it that way. To a person, Maryland's hospital leaders have enriched the past nine years of my life with your dedication to MHA, your compassion for your patients and staff, your determination to maintain Maryland's unique status as a national leader and, through it all, your friendship.
When I came to the MHA nine years ago, I had done some pretty important national work over the 20 years I spent at the American Hospital Association. None of it was more important than the historic work we did here, together, to modernize Maryland's Medicare waiver, and that is work that must and will continue ... because it is good for Marylanders.
But what has impressed me most is the way each of you has transformed your hospitals, with no real template to model yourselves after, just the promise of better care. You have partnered with others in your communities, you have adopted global budgets - much faster than the agreement called for - and you have in the process made health care better and held costs down. The system is not perfect, and MHA will continue fighting for the right decisions to be made on the details of policy implementation. But in the face of those challenges you are making the kinds of changes that other states are still only thinking about - including the one I am headed to. You can bet my experience here will color my efforts there. 
Perhaps what I am most proud of is that I leave you in the hands of a hugely capable and dedicated - I wouldn't hesitate to say passionate - MHA team. I can tell you from firsthand experience that they are as talented and intelligent and as committed to the hospital mission as any team in any state hospital association in the country.
If I could sum the MHA team up in one word, that word would be credibility. They have established themselves as experts, and they tell the truth. There is no cooking of numbers or shading of language to accent a point. They fight for what's right for you and the people who need you.
I am proud to have been only the third president of the Maryland Hospital Association, after the man who created the association, Dick Davidson, and the man who nurtured it for 16 years, Cal Pierson. That's a sure sign of stability, a stability driven by your participation and support.
I know that whoever is chosen to be the fourth president is in for a helluva wonderful ride. Thank you, each and every one of you, for making my ride such a joy, and for giving me something that, indeed, makes saying goodbye so hard. 

At a final gathering for Carmela this week.
From left to right: Renee Cohen, Chuck Conner, Carmela Coyle,
Dennis Schrader and Mary Pat Seurkamp.

MHA Comments on Rate Application Process, Quality Policy
MHA submitted two comment letters to the Health Services Cost Review Commission this week. The first was on the HSCRC's proposed Rate Application and Approval Procedures regulation. The proposal, introduced at the September public meeting on an emergency basis, would lift the moratorium on full rate applications effective November 1. The regulation outlines full rate application filing requirements and considerations. The Inter-Hospital Cost Comparison methodology, the HSCRC's efficiency measure and foundation for full rate applications, will be discussed by HSCRC staff at the October public meeting. MHA will work with HSCRC staff and hospital members to provide feedback on the proposed methodology immediately following the staff proposal. For more information, contact Brett McCone. The second was on HSCRC's quality policy priorities, principles and direction. The letter urges commission staff to focus on the measures and policies that are needed to support the next phase of the All-Payer model. The letter asks staff to make two quality issues a priority, develop at least one population health metric, and align with the national Hospital-Acquired Conditions measures. For more information, contact Traci La Valle.
Supplemental Staffing Conference Next Week
MHA and the Chesapeake Registry Program will hold a conference next week to bring hospitals and staffing agencies together to identify strategies for collaboration so that hospitals, agencies, employees and patients are better served by successful agency placement. Hospitals' nursing and allied health contacts, chief nursing offices, managers clinical coordinators, directors, human resources representatives and staffing contacts are invited to attend on October 5 at Turf Valley Resort in Ellicott City. To register, contact the Chesapeake Registry Program at 866-796-6235 or This event is free for hospital representatives.
Register Now for Program on Reducing Preventable Harm
A free half-day program to help hospitals reduce preventable harm will be held October 13 at MHA's offices in Elkridge. Attendees will learn about CANDOR ( Communication and Optimal Resolution), a set of strategies and tools developed by the Agency for Healthcare Research and Quality. CANDOR includes interventions that change how we respond to and learn from patient safety events. The program will be facilitated by Dr. Timothy McDonald and his colleagues from MedStar Health, the lead CANDOR pilot site. McDonald, Director of the Center for Open and Honest Communication in MedStar's Institute for Quality and Safety, will share the results of MedStar's systemic implementation of CANDOR as a core patient safety and continuous improvement strategy. The program will be of value to MHA members on a High Reliability Organization journey, as well as those already invested in supporting Just Culture or Care for the Caregiver programs. Members of hospital executive teams are invited to attend the October 13 meeting, to be held from 8:30 a.m. to noon at MHA's Elkridge offices. Registration is required.
Contact: Nicole Stallings
Forums Scheduled on ED Discharge Protocols for Overdoses
The HOPE Act's January 1, 2018, deadline for each hospital to have a discharge protocol for patients treated for a drug overdose, or identified as having a substance use disorder, is fast approaching. These protocols may include: coordinating with peer recovery counselors, connecting patients with community services, and prescribing naloxone. This fall, MHA will convene a series of three forums for hospitals to identify and share the essential elements of protocols for discharging these patients from the emergency department. They will be held October 25, November 8 and November 29. Contact Nicole Stallings with questions.
The Agency for Healthcare Research and Quality is modernizing and moving into the next phase of its 10-year-old teamwork and communications program, TeamSTEPPS®, by focusing on online training, with continuing education credits and a mobile app available at no charge. While the agency will no longer offer in-person training, it provides ready-to-use curricula, including the base curriculum as well as specialty modules for office-based care providers, long-term care settings, and rapid response teams. TeamSTEPPS case studies provide examples of how health systems and offices have benefited from TeamSTEPPS to improve wait times, reduce provider burdens, and improve communication among health care professional teams and patients. 
AHA Assists Puerto Rico Hospital Association
In the aftermath of Hurricane Maria, the American Hospital Association is helping the Puerto Rico Hospital Association provide aid to the U.S. territory's hospital employees. Because PRHA does not have the ability to set up a hospital employee relief fund due to infrastructure challenges, AHA has activated The Care Fund at  Similar to other disaster funds, this information will be shared with all AHA members and the wider health care community. AHA has donated $50,000 to get The Care Fund started. 
Working with Engagement Survey Results
In a recent article in Modern Healthcare, John Johnston of the consulting firm Advisory Board is quoted as stating "having more-engaged employees translates to happier patients." Johnston goes on to cite research that indicates for every 1 percent increase in engagement, hospitals saw a .33 point improvement in patient satisfaction.

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CMS Will Not Update Overall Hospital Star Ratings in October
The Centers for Medicare & Medicaid Services this week announced it will not update its overall hospital quality star ratings on Hospital Compare in October. 

The Baltimore Sun, By Andrea K. McDaniels, September 22
CBS Baltimore, By Denise Koch, September 22
WJLA, By Cheryl Conner, September 25
Herald-Mail Media, By Mike Lewis, September 25
The Daily Record, By Georgia Slater, September 26
The Baltimore Sun, September 26
WMDT, By Brandon Bossert, September 27