The Nurse Licensure Compact, Hospital Developments, and more...

Letting Nurses Care for Their Patients – Wherever They Are

MHA, along with the Organization of Nurse Leaders and a coalition of nursing and patient advocacy organizations, is strongly supporting a bill re-filed by Rep. Kay Khan (D-Newton) and Sen. Joe Boncore (D-Winthrop) that would authorize Massachusetts to join 31 other states that have adopted the national Nurse Licensure Compact (NLC). The NLC allows a nurse to have one license in his or her state of residency and to practice in other states, subject to the nurse practice laws and regulations of each state.

MHA’s V.P. of Clinical Affairs Patricia Noga, RN, said of the NLC, “It’s a common sense improvement that allows nurses to have one multistate license, which will, among other benefits, help facilitate telehealth, a growing part of the healthcare sector that has the potential to reduce healthcare costs and provide convenient care for patients.”

As telehealth adoption increases, the number of nurses who will be required to hold multiple licenses will also increase. Nurses must hold licenses in the state where their patient resides. Technologies like telehealth allow nurses to assist patients after they leave the hospital, and these follow-up virtual visits can contribute to the prevention of unnecessary hospital visits.

There are 14,000 nurses currently residing in Massachusetts who hold a license in another state; joining the Nurse Licensure Compact would relieve them of the maintenance of multiple, costly licenses in each state in which they practice.

Allowing for cross-state care is important since Massachusetts’ renowned hospitals attract patients from across the country. When a patient has completed the necessary care at the bedside, they enter into a complex system of follow-up and remote care that is staffed largely by nurses. In order to continue this care as patients return home to other states, these nurses must hold multiple licenses.

The Nurse Licensure Compact also would allow for better emergency preparedness and more rapid staff response in times of disaster. Nurses from other compact states would be able to assist in Massachusetts without delay in the event of a hurricane or other widespread medical emergency – and vice versa. Responses to recent hurricanes in Texas, Florida, Puerto Rico, and other areas have demonstrated how nurses rally to provide care when other states ask for help.

New Hampshire and Maine already are members of the NLC, and the National Council of State Boards of Nursing is working to get all 50 states on board. 

For the first time last session, the bill was given favorable reports from both the Joint Committees on Public Health and Health Care Financing. Hospitals, the nursing community, and many patient advocates are hopeful that this is the year the NLC bill is enacted in Massachusetts, and a significant barrier to a responsive, flexible healthcare system is removed.

A $50 Million Gift; New Hospital; New Building; New Affiliation

Massachusetts General Hospital: James S. and Carol J. Herscot have donated $50 million to Massachusetts General Hospital to support capital projects, initiatives, and the Herscot Center for Children and Adults with Tuberous Sclerosis Complex (TSC). MGH will name the building that houses the Herscot Center – the Carol and James Herscot Building. TSC is a rare genetic disorder that affects 40,000 to 80,000 people in the United States and as many as 2 million people worldwide.

Baystate Health: Baystate Health announced last week that it will build a new behavioral health hospital at an as-yet-undetermined site in Western Massachusetts. It is partnering with New York City-based US HealthVest in the hospital venture. Baystate Health said the new facility will increase inpatient care capacity by more than 30% for adults and children in the area. US HealthVest already has a presence in Massachusetts, partnering with UMass Memorial Medical Center to open the new 120-bed Hospital for Behavioral Medicine in Worcester. That hospital is scheduled to open this week.

Cape Cod Hospital: Cape Cod Hospital has joined the Dana-Farber Cancer Care Collaborative, which the facilities said in a press release “helps disseminate the latest and most effective, evidence-based best practices and standards to member hospitals and physician practices. Members undergo a rigorous review of their oncology operations and agree to implement key recommendations to meet Dana-Farber standards. Members also take advantage of ongoing consultations and access to support services, such as on-site specialty second opinion clinics, clinical trials, tumor board conferences and physician lectures.”  Dana-Farber and Cape Cod Hospital will also collaborate on physician recruitment to Cape Cod Hospital, and the two will continue to offer an on-site specialty second opinion clinic.

South Shore Health System: South Shore Health System, Brigham Health/Partners HealthCare, and FoxRock Properties last Thursday announced their plan to build a 200,000 square foot medical building in Quincy Center. Additionally, South Shore Health System plans to open a primary care practice at 1495 Hancock Street in Quincy in the summer of 2019.  “It’s vital that the people of Quincy have every opportunity to obtain exceptional healthcare, at the right time, and in the right places,” said Quincy Mayor Thomas Koch. Steward Health Care was allowed to close the 124-year-old Quincy Hospital in 2014. Steward operates a satellite emergency facility in Quincy under the Carney Hospital license.

Mid-Winter Leadership Forum Explored AI, Politics

More than 300 people attended MHA’s 52nd Annual Mid-Winter Leadership Forum last Thursday in Framingham. A highlight of the gathering was a panel discussion on “Artificial Intelligence (AI) for High-Value Healthcare” moderated by Francis X. Campion, M.D., the senior clinical informaticist at IBM Watson Health and an internist at Atrius Health.

Noting that medical data is expected to double every 73 days by 2020, Campion then led a discussion with Massachusetts hospital leaders on how they’re weaving AI into their operations. For example, Carlo Reale, director of Patient Care Services at Baystate Health System and Deb Baker, R.N., a nurse manager at Baystate Health System talked about how their system is using predictive technology to prevent pressure ulcers. Michael Docktor, M.D., a pediatric gastroenterologist & clinical director of innovation at Boston Children’s Hospital, discussed how AI is helping place patients in beds – a game changer for patient flow. Haipeng (Mark) Zhang, D.O., medical director of Brigham Digital Innovation Hub and Digital Health Implementation, at Brigham Health said there’s “an open-door” policy for any sort of technological advance that may be able to be transformed into groundbreaking change.

Mid-Winter attendees also heard from David Gergen, director of the Center for Public Leadership at Harvard Kennedy School and senior political analyst for CNN. A self-described centrist, who has worked in the White House advising Presidents Nixon, Ford, Reagan, and Clinton, Gergen gave a critical overview of the current state of American politics. Elisabeth Rosenthal, M.D., editor-in-chief of Kaiser Health News and the author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, presented a no-holds-barred look at healthcare and how, among other faults, high-deductible plans are eroding the system.

A Renewed County-by-County Fight Against HIV

President Donald Trump focused part of his State of the Union speech last week on HIV and AIDs, urging a bipartisan approach to “eliminate the HIV epidemic in the United States within 10 years.”

The president said, “Scientific breakthroughs have brought a once-distant dream within reach,” adding that his budget will call on Democrats and Republicans “to make the needed commitment” to eliminate the epidemic.

In-depth details of the plan were not available, but a two-page overview from U.S. Health & Human Services indicates that a key part of the strategy is to focus on 48 counties; Washington, D.C.; San Juan, Puerto Rico; as well as seven states that have a substantial HIV burden.

Last week, Massachusetts DPH sent out an advisory noting that it has detected an increase across Massachusetts in newly diagnosed HIV infections among persons who inject drugs. DPH is asking healthcare providers to enhance their vigilance for, and increase their testing and reporting of new HIV infections.

In 2018, DPH and the federal Centers for Disease Control and Prevention investigated an outbreak of HIV infection attributable to injectable drug use in Lowell and Lawrence. Since mid-November 2018, a small cluster of similar infections has been identified in Boston, and recently in Worcester. “Surveillance data indicate that new HIV infections attributed to [injectable drug use] exposures are increasing statewide,” DPH wrote. From 2014 to 2017, the proportion of new HIV diagnoses in Massachusetts attributable to injectable drug use exposures increased from 5% to 17%.

Suffolk University Creates New Online Health Admin. Masters

Suffolk University’s Sawyer Business School will launch a new, all-online Master of Healthcare Administration degree program this fall. The 42-credit hour program, with a 3-credit internship is for students who do not have experience in U.S. healthcare and can be completed in as few as 28 months. Students will be able to participate at their own convenience 24/7.  The course mirrors Suffolk’s face-to-face MHA program and will be taught by the same faculty. The on-campus MHA program has also been redesigned with an emphasis on analytics, performance improvement, innovation, strategy, and change management.

Lean in Healthcare Certificate Program at Emerson Hospital

Today more than ever, hospitals are challenged to improve quality and reduce costs as they deliver better care to patients. At the same time, healthcare workers are faced with broken processes, as well as equipment and supply issues that frustrate patients and staff alike.  This intense, 8-day course provides participants with hands-on experience learning and applying both the technical science and social science of “Lean.” The technical science of Lean focuses on learning and applying Lean tools and techniques, while the social science aspect of it focuses on people and organizational development. Both are necessary for an effective Lean implementation. This inspirational and informative course is taught and facilitated by experienced Lean in Healthcare practitioners and runs on successive Wednesdays beginning March 6 and ending May 1 (with April 17 skipped). It will be held at Emerson Hospital in Concord so participants can get real-life, hands-on experience in addition to their classroom instruction. SPECIAL BONUS: If you send three employees from your organization, the fourth attendee participates for free.  Learn more, including registration details, by clicking here.

John LoDico, Editor