June 2023 | Issue 27


Ensuring Triage Accuracy to Improve ED Care

The Partnership to Advance Tribal Health (PATH) hosted an interactive event last month to detail the importance of accurate and efficient patient triage in the emergency department (ED) and understand the Emergency Severity Index (ESI).

Reducing Avoidable Hospital Readmissions

When patients return to the hospital after a previous stay, they not only cost the health care system unnecessary amounts of money, contributing to the $2 trillion spent on health care in the U.S.,

but they are also at risk for harm. Preventable admissions and readmissions indicate a fragmented

health system and lead to poor patient outcomes. PATH recently released two tools for preventing

avoidable hospital readmissions:

On-Demand Videos & Nursing Education Units (CEUs):

Infection Prevention and Control (IPC) for Nursing Leaders

PATH and the Indian Health Service (IHS) National Nursing Leadership Council Executive Committee released a recent 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. 

National Healthcare Safety Network (NHSN) User Tips and FAQs 

The Centers for Disease Control and Prevention (CDC), IHS and PATH came together to share tips;

to cover best practices on reporting requirements, key learnings from the March 2023 NHSN training, antimicrobial use (AU) reporting requirements for 2024 and to answer frequently asked questions

(FAQs) related to NHSN. If you missed the session or would like a refresher; you can listen to the event recording and view the NHSN User Tips & FAQs PowerPoint slides.


NHSN Resources: 


IHS Facility Sparks Potential for Future Health Care Professionals

with Hands-on Event

How can health care facilities make long-term plans to alleviate challenges around recruiting and keeping health care professionals? How about get area youth excited about health care and public health!

With the help of local partners, including PATH, that is exactly what one IHS service unit did.

Learn how hospital leadership brought together young people and rallied them around health care careers, planting seeds to bear future and much needed health care and public health professionals.


Walking the Walk: Leadership Rounding Plays Vital Role in Culture of Safety

Leadership and governance at all levels will establish structures that commit to the achievement of total system safety and quality at the agency, area and facility level. 

Goal 1: Indian Health Service Total System

and Quality Strategic Plan, March 2023 

Effective leadership is vital to an organization’s culture of safety, helping reduce preventable harm and improve patient outcomes. Leaders must be visible and drive culture change by demonstrating their own commitment to total system safety and quality care at all levels. When an organization has a strong culture of safety, staff feel empowered to share their concerns and report adverse events and unsafe conditions, because they believe their voices will result in change.  

Although frontline staff directly provide patient care, executives and management can improve safety through more direct interactions with frontline staff through leadership rounding. 


Conducting rounds and talking with staff demonstrate leadership's commitment to safety and provide opportunities to discuss with frontline staff what is working well and what needs improvement. A large study with more than 11,000 health care workers linked safety culture and workforce well-being with positive leadership rounding. 


Check out these strategies for effective patient safety leadership rounding:  

  • Communication should go two ways: Leaders should listen to staff concerns and suggestions and vice versa.  
  • Keep the discussion focused on safety: Do not dilute the safety message by trying to cover other topics. 
  • Institute regular safety briefings: Share issues raised in the briefings (withholding names of the contributing staff members) with other leaders to include in discussions during their leadership rounding.
  • Communicate with managers: Inform unit leads so they understand why senior executives are visiting their departments. 
  • Provide feedback to staff about issues raised and solutions discussed during leadership rounding. 
  • Be consistent: Conduct scheduled leadership rounding on a consistent basis. Leadership rounding can be rescheduled but should not be cancelled.  


Get more leadership rounding tips from the Institute of Healthcare Improvement (IHI):

Conduct Patient Safety Leadership WalkRounds 




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.

SDOH Access to Health Services Infographic | Check it out

Healthy People 2030, a national initiative to address public health priorities, focuses on a number of equity goals. Among those goals is the need to address social drivers of health (SDOH), which contribute to health disparities and inequities.

The Office of Disease Prevention and Health Promotion recently released several SDOH infographics, including the health access one above, which highlights the need for access to affordable, quality, convenient health care.

AIM Obstetric Emergency Readiness Resource Kit | Learn more

The Alliance for Innovation on Maternal Health (AIM) just released an an emergency readiness kit in response to the decline of hospitals providing obstetric services in rural areas and the disparate rates of pregnancy-related mortality based on race, ethnicity and geographic location. The kit includes best practices, resources and planning materials for obstetric emergencies.

Health Care and Resources for Native Veterans | Check it out

Sponsored by IHS, this website presents an interactive map of all of the Veterans Health

Administration (VHA) sites near Native communities and all IHS sites in urban areas. The map

highlights the type of facilities, the number of sites by area and Federally Recognized Indian Land.


National Minority Health Month

With July being National Minority Health Month, and with this month being Pride Month,

it is a good time to focus on the well-being of American Indian/Alaska Native transgender

and two-spirit youth, their relatives and families and their health care providers. Check out this Celebrating Our Magic toolkit, which offers affirming, inclusive and sustainable resources.


UV Safety Month

Ultraviolet (UV) protection from the sun and indoor tanning plays a critical role in reducing

a person’s risk for skin cancer, the most common cancer in the U.S. and one of the

most preventable cancers. Recent research found that American Indian/Alaska Natives use

tanning devices more often when compared to other racial and ethnic groups. Compared to non-Hispanic Whites and Asians, American Indian/Alaska Natives also less frequently use sun protective behaviors such as wearing hats or sunscreen or seeking shade when outdoors.

Share tips and best practices with patients to reduce their skin cancer risk:


Healthy Vision Month

During Healthy Vision Month, remind patients that annual eye exams are important.

Diabetic retinopathy is the leading cause of new blindness in working age adults.

The Indian Health Service has increased access to eye care for American Indians/Alaska Natives

through the IHS-Joslin Vision Network (JVN) Teleophthalmology program. The IHS-JVN program is currently available at more than 80 IHS/Tribal/Urban primary care clinics, allowing patients to obtain a diabetic retinal exam during a regularly scheduled medical appointment.


World Hepatitis Day (July 28)

  • In 2017, American Indians/Alaska Natives were twice as likely to die from viral hepatitis, compared to non-Hispanic Whites.
  • In 2018, the AIAN population was almost three times as likely to die from Hepatitis C.
  • According to IHS, 2004 to 2014 saw a simultaneous increase in hospital admissions for acute hepatitis C and opioid injection, with 80% of new hepatitis C cases related to injection drug use.

The Indian Country ECHO (Extension for Community Healthcare Outcomes) creates a learning environment where clinicians and staff serving AIAN people can get guidance and mentorship from clinical experts on treating and preventing hepatitis C. Check out upcoming Indian Country ECHO events and sessions. Anyone interested in learning a new skill is welcome to join!


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-386-06/16/2023