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Metro
Alliance of Geriatric Providers
MINUTES
September
18, 2017
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Attendees: S. Atkinson, E. Downing, R. Hastings, J.
Haycraft, C Lauring, G. Leierwood, M. McDonald, T. McCarthy, J. Mielke, C.
Montgomery, C. Parker, K.
Petersen, A. Romstad, D. Rustad, R.
Schoen, E. Schuld, A. Tong, L. Wenker
Phone:
C. Hanson,
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Agenda
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Discussion
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Action/Next Steps
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1.
Welcome/ Introductions
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19 total attendees ; 18 in person and 1 phone
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10 health
care provider organization practices being represented: Allina, Fairview, Genevive,
Health East, Health Partners, HCMC,
Integrated Care by Medica,
Optage, Twin Cities Physicians,
UMP
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3 health organizations represented: Care
Choice, Stratis, University of
Minnesota
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2.
Review minutes
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Reviewed June minutes
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post to website
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Current
Metro Alliance Projects
1.
Computer Provider Order Entry (CPOE)
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Emily Downing
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Discussed the progress of CPOE work group at
length. Pilot at Langton Place; much training for all staff/providers
involved.
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Providers writing orders on standardized order
form, which is entered into the computer by facility staff. Orders are
processed as either routine (4 hours) or stat (1 hour). Thought it was
important to standardize the order format first, and then work with groups
for EHR entry later.
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Developing First Pass Quality Standards for
orders with Metro Alliance endorsement
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Practice leaders to contact Veronica Polinske at: vpolinske@preshomes.org to set up portal
training for their providers that go in to PHS facilities.
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Continue to update group with pilot status at each meeting
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Plan to extend pilot to Presbyterian Folkstone and Bloomington
in late October. Please send names of clinicians who attend these facilities
to Emily Downing for training/information.
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2.
Antibiotic stewardship project
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Cassandra Parker and Cathy Lauring
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Partnership between MDH, Stratis, Metro
Alliance
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Antibiotic stewardship programs are required
to be in place in all nursing facilities by November 2017
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Project is on UTI v. ASB with Walker Methodist
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Intervention completed with UTI SBAR developed
and entered into PointClickCare
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Much staff training, provider education
completed
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Worked on : Provider notification with SBAR
and HE lab for a biogram for e. coli
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Discussion about antibiotic de-escalation
after 48 hours and minimal duration of therapy.
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UTI SBAR developed and shared at meeting
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MDH developed Antibiotic Policy and Procedure
for any facility to use and have in place prior to new regulations starting
November 2017. The UTI SBAR used in the pilot is part of the MDH template
policy.
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Facility is continuing data collection
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Update at next meeting
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3.
Current Alliance SHO – Combined Document
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Alison Romstad, Cathy Lauring, Robyn Hastings, Cheri
Montgomery, Janine Nelson
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Discussion regarding request
for joint set from several organizations.
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Further discussion about
separate LTC, TCU and combined LTC/TCU order documents
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Needing more information if
facilities are using the SHO document before we move forward with decision about
separate and/or combined document
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Care Choice was going to survey facilities to
better understand which facilities are/are not using the standing orders
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Provider groups were going to reach out to
their facilities as well
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SHO task group to meet to create survey monkey
to send
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Update group with results at next meeting
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Clinical Issues
1.
Narcotics After Hours
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Laurie Wenker
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Roundtable discussion
regarding how to minimize after hours calls for “lack of facility staff
planning” as this is affecting all practices. Discussed different approaches
to facilities not planning ahead (ie: Saturday am nurse has 2 pain pills that
are scheduled every 4 hours; now needs after hours provider to get script to
pharmacy). Concerned about patient safety
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Discussed nursing staff,
pharmacy staff and pharmacy delivery systems
involvement
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More discussion needed as to best approach to
the issue: engaging Directors of Nursing, Pharmacies, possibility of med
error if no medication available for the patient
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Further discussion regarding process for
narcotic refills and practices approach
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2.
Antipsychotic Rules
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New rules coming November 2017 ; 14 day limit
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Further discussion about patients on Hospice
or specific behavior based issues
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Further discussion at December meeting
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Ongoing discussions with MAGIC (old MMDA) and Metro
Alliance
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Roundtable discussion about MAGIC and Metro
Alliance meeting structures: Should MAGIC be an overarching entity with Metro
Alliance as one arm of the larger entity? Or should the two groups remain
separate entities, but work collaboratively on clinical issues
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Further discussion at MMDA meeting in October
and at next Metro Alliance meeting in December
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Next Meeting
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Robyn Hastings announced her retirement. Lori
Wenker will be the Director for HealthPartners
and Park Nicollet Community Senior Care.
We will miss Robyn! It’s through her inspiration
and collaboration that Metro Alliance was formed and continues strong – 7
years later!! Thank you Robyn!
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Date of next meeting: 12/4/2017
8:00-10:00 AM Conference room TBD
Community
Senior Care Office, CTC Bldg, 2nd Floor
8170 33rd Ave S, Bloomington, MN
55425
Please send any agenda items to Cathy Lauring or Ali Romstad
We will have a call-in option available – please email either
above for the call-in details 2 business days ahead of time.
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