IHA Daily Briefing: April 29

Thursday, April 29, 2021
IDPH Issues Updated Maternal Morbidity/Mortality Report 
Updated Star Ratings, Leapfrog Grades Released 
MAPS Report Highlights Member Patient Safety Efforts 
FCC COVID-19 Telehealth Application Portal Now Open 
Chicago Eases COVID-19 Restrictions 
State, National, Global COVID-19 Updates

IDPH Issues Updated Maternal Morbidity/Mortality Report 
The Illinois Dept. of Public Health (IDPH) today issued the second edition of the Illinois Maternal Morbidity and Mortality Report, covering deaths that occurred in 2016-2017. The report is the culmination of work by two maternal mortality review committees (MMRCs) and IDPH and addresses maternal deaths, the causes, whether the deaths were directly related to pregnancy, if they were preventable, and recommendations to prevent future deaths.

“This report shows us that there are two stories of maternal mortality: Black women continue to die at an unacceptable disparity due to medical causes, and the rate of White women dying due to mental health causes of suicide and overdose has grown,” said IDPH Director Dr. Ngozi Ezike. “The report also gives us key recommendations on how we can all can come together to improve the health care system for all pregnant women in Illinois.”

Key findings of the report include:

  • An average of 75 Illinois women died while pregnant or within one year of pregnancy each year during 2008-2017, with the highest number recorded in 2017 (a total of 103 deaths).

In 2016-2017:

  • 34% of women who died while pregnant or within one year of pregnancy died from a cause related to pregnancy.   
  • The leading cause of pregnancy-related death was mental health conditions, including substance use disorders, which comprised 40% of pregnancy-related deaths. The next three most common causes of pregnancy-related death were pre-existing chronic medical conditions that were exacerbated by pregnancy, hemorrhage, and hypertensive disorders of pregnancy.   
  • Black women were about three times as likely to die from a pregnancy-related condition as White women.   
  • Black women were more likely to die from pregnancy-related medical conditions while White women were more likely to die from pregnancy-related mental health conditions.   
  • One-third of pregnancy-related deaths occurred more than two months after pregnancy.   
  • The MMRCs determined that 83% of the pregnancy-related deaths were potentially preventable.  
  • 85% of the pregnancy-associated deaths by suicide and 35% of the pregnancy-associated deaths by drug overdose were determined to be pregnancy-related.   
  • The MMRCs determined that nearly all the pregnancy-associated homicide, suicide, and drug overdose deaths were potentially preventable.

Key recommendations include:

  • Health insurance plans, including Illinois Medicaid, should reimburse for telehealth, including phone-based services, regardless of patient or provider location.   
  • The state and collaborating programs should expand and facilitate coordination of home visiting programs for pregnant and postpartum women with complex medical or mental health conditions. 
  • The state should expand implementation of promising practices for improving maternal outcomes and empowering women to engage with healthcare providers.   
  • Hospitals should participate in the upcoming statewide birth equity quality improvement initiative with the Illinois Perinatal Quality Collaborative and should provide training and resources to staff on racism, implicit bias, stigma related to substance use disorder, and trauma-informed care.   
  • Hospitals should establish policies and protocols to ensure appropriate treatment of pregnant or postpartum women with substance use disorders.   
  • Providers should ensure that following delivery, all women are discharged from the hospital with an appointment for an early postpartum visit with an obstetric care provider within the first three weeks postpartum, followed by a comprehensive postpartum visit no later than 12 weeks postpartum.   
  • Providers should seek consultation when prescribing, changing, or discontinuing anti-depressants or other psychotropic medications during pregnancy, and that they ensure the patient is connected to mental health services in addition to medication therapy.   
  • Community-based organizations should educate women on the importance of getting prenatal care early in pregnancy.   
  • It is important that all women have an annual well-woman visit with a primary care provider to identify and manage any chronic conditions. It is also important for women with a recent pregnancy to reconnect with, or establish care with, a medical home for continued medical care beyond the postpartum visit.

See IDPH’s summary and press release on the report.

Updated Star Ratings, Leapfrog Grades Released 
On Wednesday, the Centers for Medicare & Medicaid Services updated the overall hospital quality star ratings at Care Compare. The ratings are now calculated using a revised methodology finalized in the calendar year 2021 outpatient prospective payment system final rule. CMS’ latest formula equally gives weight to each quality and safety measure and groups hospitals by the number of measures they report.

The impact of the revised methodology varies among hospitals. According to Modern Healthcare, 45% of acute-care hospitals received the same star rating as before; nearly a quarter (22.7%) hospitals had worse ratings. The impact on critical access hospitals was substantial: 76.3% received 3 or more stars compared to 94.3% previously. Overall, nationally, more hospitals scored 4 and 5 stars; an additional 59 hospitals received a 5-star rating; 45 fewer hospitals received 1 star.

The star ratings data release often generates interest from local media, and IHA and AHA encourage hospitals and health systems to review and understand what CMS’ revisions and methodology mean for them. Last month, AHA issued a Member Advisory with more details and talking points to help hospitals prepare for questions about their organization’s performance. AHA members must be logged into the AHA website to access the full advisory.

Today, the Leapfrog Group released its spring Hospital Safety Grades, which assign an “A,” “B,” “C,” “D,” or “F” letter grade to more than 2,700 general acute-care hospitals in the U.S. 

Across all states, 33% of hospitals received an “A”, 24% a “B”, 35% a “C”, 7% a “D”, and less than 1% an “F”. In Illinois, 39 of 112 hospitals graded by Leapfrog (35%) received an “A”, 23 (21%) a B, 44 (39%) a C, 5 (4%) and one (less than 1%) an “F”.

Illinois now ranks 17th nationally, moving up six spots from last fall’s rankings, with the percentage of “A” hospitals improving from 34% to 35%.

MAPS Report Highlights Member Patient Safety Efforts 
In May, members of the Midwest Alliance for Patient Safety (MAPS) Patient Safety Organization (PSO) will receive their 2020 Annual Report—a benefit of MAPS membership—that highlights their organization’s engagement in MAPS activities and compares their adverse event data reporting with MAPS members as a whole and national statistics.

The individualized reports underscore the importance of adverse event reporting, which MAPS facilitates in a protected environment. Event reporting helps:

  • Identify patterns and determine priority areas for patient safety/quality improvement;   
  • Establish benchmarks to track the progress and effectiveness of your improvement efforts;   
  • Operationalize your organization’s Patient Safety Evaluation System (PSES) policy; and   
  • Ensure your organization is receiving feedback to further support your patient safety strategies

Every year, these reports—plus MAPS educational opportunities in a protected environment—allow members to assess and revise their culture of safety.

Earlier this year, MAPS released another benefit of membership, Patient Safety Focus: Top 10 Safety Issues for 2021, an evidence-based white paper on the most urgent healthcare concerns.

MAPS PSO has been federally certified since 2010 and is an IHA company. Members consist of 104 Midwestern health systems, hospitals, critical access hospitals, physicians groups, long-term care and specialty outpatient clinics.

To learn how MAPS can help your organization improve patient safety, email MAPS@team-iha.org.

FCC COVID-19 Telehealth Application Portal Now Open 
The Federal Communications Commission’s (FCC) application portal (www.fcc.gov/covid19telehealth) for Round 2 of the COVID-19 Telehealth Program opened at 11 this morning and will close at 11 a.m. CDT on May 6. About $250 million in funding is available.

Information on the program is here. An FCC press release is here. Email questions about the application process to Round2TelehealthApplicationSupport@usac.org.

The program, which was established in the CARES Act and expanded in the Consolidated Appropriations Act, is intended to provide immediate support to providers responding to the pandemic by fully funding certain telecommunications services, information services, and devices necessary to provide critical connected care services.

Chicago Eases COVID-19 Restrictions  
Chicago Mayor Lori Lightfoot today announced that the city is easing many of its COVID-19 restrictions as part of an “Open Chicago” initiative that includes increasing capacity for restaurants and bars and allowing indoor and outdoor spectator events, theater, performing arts and places of worship.

Due to the improvement in Chicago’s reopening metrics and the ongoing distribution of COVID-19 vaccines – 2 million doses administered so far – the city will be loosening Phase Four regulations to allow for higher capacity across industries effective immediately. If the city’s reopening metrics remain stable or continue to decrease for the next two weeks and reach the criteria set by the state, Chicago will join the state in moving to the Bridge Phase.

Under the new Phase Four Regulations, various changes to increase capacity and allow activities include:

  • Restaurants and bars: Indoor capacity can increase to the lesser of 50% or 100 people.   
  • Spectator events, theater, and performing arts: Large indoor venues, including the United Center, can now operate at 25% capacity.   
  • Meetings, conferences, and conventions: Large indoor venues can now operate at the lesser of 25% or 250 people.   
  • Places of worship: Large indoor venues can now operate at 25% capacity.   
  • Festivals and general admission outdoor spectator events: Operate at 15 people per 1,000 sq. ft.  
  • Flea and farmers markets: Operate at 25% capacity or 15 people per 1,000 sq. ft.

The full reopening guidelines can be found at Chicago.gov/reopening.

State, National, Global COVID-19 Updates 
The Illinois Dept. of Public Health (IDPH) announced today 3,394 new confirmed and probable COVID-19 cases and 38 deaths.

The total number of cases in the state is 1,331,848 with a total of 21,927 deaths. IDPH says that in the past 24 hours, 89,057 test specimens have been processed, with a positivity rate of 3.8%. The preliminary 7-day statewide positivity rate for cases as a percent of total tests from April 22-28 is 3.5%, and the seven-day test positivity rate is 4.0%.

Statewide COVID-19 hospitalizations in the past 24 hours decreased from 2,154 patients to 2,115 patients. Of that figure, 475 were in the ICU, with 231 patients on ventilators.

The total number of COVID-19 vaccine doses for Illinois is 11,546,345. A total of 9,155,989 vaccines have been administered in Illinois as of last midnight. The seven-day rolling average of vaccines administered daily is 97,434 doses. Yesterday, 107,689 doses were reported administered in Illinois.

Today’s Centers for Disease Control and Prevention (CDC) figures showed more than 32 million confirmed and presumptive positive cases of COVID-19 in the U.S. (a daily increase of more than 53,000 cases), with 571,297 deaths (a daily increase of 876).

Today’s WHO Coronavirus Disease Dashboard showed more than 149.2 million COVID-19 cases globally (a daily increase of more than 870,000 cases), with more than 3.1 million deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 61.6 million cases and more than 1.49 million deaths.