Tag Archives: End of Life

Leadership Pulse – April 15, 2014

New Release! Patient Safety: Transforming Culture Toolkit

Despite tremendous efforts to address preventable harm to patients in healthcare, we continue to see high rates of harm. Research confirms the key relationship between organizational culture and the ability to consistently deliver services which provide value and good outcomes.

A safe culture is an environment in which there is shared responsibility, role clarity and open and frequent communication related to safety. By the nature of your roles leading care in the community, at the bedside in clinical units, and in acute care operations; you as physician leaders are well-positioned to have a substantial influence in creating a safe culture.

Through the Partnership for Patients initiative, WSHA and WSMA developed a toolkit to support physician leaders in strengthening your organizations’ culture to achieve safe, timely, effective, efficient, equitable and patient-centered care. The focus of the toolkit is on high-impact approaches that are effective in a clinic or hospital’s journey toward a safe culture. Click here to access the toolkit.

If you would like more information about the initiative, please contact Jessica Martinson, WSMA’s director of clinical education and professional development at jessica@wsma.org.


Have you had the conversation?

April 16 is National Health Care Decision Day and the Honoring Patients’ Choices work group wants to know if the hospital and clinic Medical Officers have started the conversation about advance care planning in their own institutions…and at home.

Washington State Hospital Association and Washington State Medical Association, in alignment with the Medical Officer Call to Action and the Honoring Patients’ Choices work group have partnered with Institute of Healthcare Improvement (IHI) Conversation Ready to increase awareness and education on advance care planning for both the community and in the health care setting. The Conversation Project is promoting community awareness through mass communication surrounding the April 16 Health Care Decisions Day.  Recognizing the importance of respecting what patients want and the tremendous efforts regarding end of life and advance care planning, WSHA and WSMA aligned with Twin Cities Medical Society Honoring Choices® and have plans to affiliate the trademark to create Honoring Choices Pacific Northwest®, which will provide a resource rich website for both community and clinicians.  More exciting news to come as WSHA and WSMA work with leaders to continue to inspire, educate and empower the public and providers about the importance of advance care planning.

For more information on the initiative, please contact Tanya Carroccio, WSHA’s director of quality and performance improvement, at tanyac@wsha.org.


Washington State Choosing Wisely Task Force

The goal of the statewide Choosing Wisely task force is to develop a pragmatic system to implement Choosing Wisely across the state, with a focus on changing behaviors, driving results and creating measurable improvement. The task force is comprised of 20 physician leaders from clinics and hospitals across the state who are leading efforts within their organization to implement the Choosing Wisely recommendations. The Washington State Medical Association, the Washington Health Alliance and the Washington State Hospital Association jointly support the statewide task force.

Recent work has focused on developing technical specifications to analyze performance using claims-data at a county level on select Choosing Wisely recommendations with the goal of educating physicians across the state on opportunities for improvement. No current measurement specifications exist, so the task force’s “Choosing Wisely Claims-Based Technical Specifications” packet will be the first of its kind in the nation.

Going forward, the task force plans to identify one Choosing Wisely recommendation on which everyone will focus their efforts with the goal of creating measurable change. We will also develop education and communication strategies and ultimately a toolkit to support physicians’ efforts to integrate the Choosing Wisely recommendations into their practice.

If you would like to confirm who is representing your organization on the Choosing Wisely Task Force, please email Jessica Martinson, WSMA’s director of clinical education and professional development, at Jessica@wsma.org.


2014 WSMA and WSHA Joint Legislative Advocacy Priorities

The Washington State Medical Association and the Washington State Hospital Association work together on statewide advocacy efforts that are of paramount importance to physicians and hospitals. As partners in these efforts, these two associations worked together on policy and budgetary issues during the 2014 legislative session.

We wanted to take the opportunity to update you on the status of important issues we partnered on during the session:


  • Telemedicine – Advocated for legislation to guarantee that if an insurer covers a clinical service on a face-to-face basis, they will also cover the same service if it is provided using video technology; payment levels subject to negotiation.Status: Unsuccessful. This bill died in the Senate due to concerns about increasing access to “webcam abortions.” This was exceptionally frustrating as the bill would in fact increase women’s access to help to maintain high-risk pregnancies.  We urge WSMA and WSHA members to express their disappointment to members of the Senate Republican Caucus.
  • Crisis Standards of Care – Advocated for legislation to provide liability relief if providers follow state triage requirements in a government-declared major disaster or emergency when adequate health care personnel or supplies are not available, such as an earthquake or H1N1 outbreak, and allow for emergency credentialing.Status: While weakened, this bill did pass and allows for easier emergency credentialing. It grants health care providers immunity from civil liability arising out of credentialing or granting of practice privileges during an emergency.
  • Mental Health Funding – Advocated for legislation to correct an error in mental health funding tied to Medicaid expansion, secure additional funding for capital and operating costs for new evaluation and treatment centers, and create new pathways for the integration of behavioral and mental health care.Status: The legislature made major new investments totaling almost $18 million in mental health.  This includes $4.5 million to correct the previous error and will pay for mental health services that are not matched by Medicaid, including providing funding for Institutes for Mental Disease (free-standing psychiatric hospitals with more than 16 beds).  It also includes funding for three Evaluation and Treatment (E&T) facilities in King, Spokane, and Thurston-Mason counties, which if built, should help to reduce inpatient need; Program of Assertive Community Treatment teams in King, Pierce, and Spokane counties to serve people who are high risk for rehospitalizations; and recovery services in the Greater Columbia, Grays Harbor, and North Sound regions to serve people who have been committed and are transitioning back into the community.

    WSHA and WSMA also advocated for significant mental health funding in the capital budget to help create new inpatient psychiatric capacity, but the legislature reached an impasse on the capital budget and did not enact any capital funding for any projects this year. This is very disappointing. It is unclear if without capital funding, the new Evaluation and Treatment facilities can move forward.

  • Health Care Reform – Advocated to defer decision on whether to create a new state operated program (Federal Basic Health) to eliminate almost all premiums for those less than 200 percent of poverty until more information on enrollment is known. The decreased premiums are proposed to come in part through providers accepting Medicaid-like rates.Status: The decision was deferred. The legislation that took shape would have required the Health Care Authority (HCA) to perform econometric modelling and reporting regarding the establishment of the Federal Basic Health Care Program, but this was not passed.  The future of the program is unclear. The two associations will continue their strong work to enroll people in Medicaid and the Exchange and work for the success of those programs.
  • Transparency and All-Payer Claims Database – Supported the development of meaningful, accessible data that includes physician- and hospital-friendly policies when implementing a statewide All-Payer Claims Database.Status: The bill that passed includes provisions to create and implement a statewide all-payer claims database but includes only those claims from state and federal monies (i.e., Medicaid, etc.).  This is a first step, but its usefulness remains to be seen.
  • Access to Primary Care – Advocated to retain funding for primary care support through continuing the Medicare rates increase for Medicaid providers.Status: Unsuccessful. Given the slimness of the state budget, this budget request was a heavy lift at $24.8 million and was not adopted by the state legislature.

If you would like to learn more about the legislative priorities listed above and how to get involved next year, please contact Katie Kolan, WSMA’s director of legislative and regulatory affairs at kak@wsma.org or Cassie Sauer, WSHA’s senior vice president of advocacy and government affairs at cassies@wsha.org. Click here for WSMA’s 2014 Legislative Summary.


Upcoming Events

April 30 or May 1 WSHA Patient Safety CEO & Trustee Summit
May 16-17 WSMA Annual Leadership Development Conference
May 28 Washington Patient Safety Conference
July 1 Medical Officer Safe Table Learning Collaborative
September 20-21 WSMA Annual Meeting