Partnering for Progress

IHA and the Indiana State Department of Health work to create a healthier Indiana

The Indiana Hospital Association (IHA) has partnered with the Indiana State Department of Health (ISDH) to improve health care in Indiana for decades. With the retirement of Spencer Grover, IHA’s vice president of regulatory affairs and the main liaison between the two entities for the past 27 years, 2018 finds the two organizations in a period of transition—and one of endless opportunity.

IHA Vice President Andrew VanZee will be assuming Grover’s role as the main point of contact between IHA and ISDH.

“Asking our 170-plus members to know the ins and outs and points of contact for each of the different areas of a state agency would be difficult,” VanZee said. “IHA serves as the conduit to help members navigate the complex regulatory environment in which health care sits and to facilitate hospital-to-state and state-to-provider communication.”

From patient safety to disaster preparedness, IHA and ISDH are partnering on a wide range of programs and initiatives. Each initiative shares a common goal: to help create a healthier Indiana.

PATIENT SAFETY

Since 2010, IHA and ISDH have collaborated on efforts to reduce the number of deliveries prior to 39 weeks of pregnancy that occur without a valid medical reason. Through quality improvement initiatives, Indiana hospitals have been successful in reducing these early elective deliveries to less than 3 percent, compared to 11 percent in 2012.

In January 2013, ISDH formed the Indiana Perinatal Quality Improvement Collaborative (IPQIC) to address ongoing issues related to perinatal care. IHA, ISDH, and IPQIC work together to reduce infant mortality and improve the health of Hoosier babies through a variety of projects, including a recent perinatal substance use conference focused on helping health care providers care for infants and mothers suffering from substance use disorder.

“The Perinatal Substance Use Conference was a huge success. We had a full house,” said Kaitlyn Boller, director of health policy at IHA. “The more ISDH and IHA partner on events like this, the better our programs can be because we’re getting everyone involved and leveraging the resources we both have.”

IHA also is working with ISDH’s Epidemiology Resource Center to combat health care-acquired infections (HAIs) and spearhead an antimicrobial resistance steering committee. According to the Centers for Disease Control and Prevention (CDC), between 2013 and 2014, Indiana hospitals reduced the following HAIs by significant numbers:

  • Central line-associated bloodstream infections decreased by 39%
  • Surgical site infections from abdominal hysterectomies fell 30%
  • Methicillin-resistant Staphylococcus aureus (MRSA) infections decreased by 23%
  • C. difficile infections dropped by 6%

“We work collaboratively with the folks at the Epidemiology Resource Center to identify best practices, tools, and resources that can support hospitals, as well as long-term care and outpatient providers, regarding all things infection prevention,” said Annette Handy, clinical director of IHA’s Indiana Patient Safety Center.

If the above statistics are any indication, the collaboration is working.

DATA SERVICES

IHA’s Data Services division has worked with ISDH for more than 20 years to provide information required by the state’s financial disclosure law.

“Information on every inpatient and outpatient seen in Indiana hospitals comes to us,” said Bernice Ulrich, vice president of data services and information technology at IHA. “We’re a subcontractor to ISDH, and we make sure everything’s there for them.”

One of the primary uses for the data is reporting related to Indiana’s high priority public health issues, like opioid abuse and infant mortality.

“Our hospitals’ data helps them track trends in public health issues seen in our emergency rooms and inpatient units,” Ulrich said. “Our partnership has allowed ISDH to focus on fixing the problems instead of ways to collect the data.”

In addition to ensuring that the information ISDH receives from IHA-member hospitals is complete, IHA has played a key role in disseminating information from ISDH in an easily digestible manner. IHA packages data on everything from the opioid epidemic to public health outbreaks in ways that hospitals can understand and put to use. Five years ago, for example, IHA, ISDH, and the Indiana University Kelley School of Business launched IndianaINdicators.org, a website where hospitals can access data for community health needs assessments.

DISASTER PREPAREDNESS

“A major issue over the years has been emergency preparedness of health care facilities,” said Terry Whitson, assistant commissioner of the Health Care Quality and Regulatory Commission at ISDH. “From 9/11 to the Hurricane Katrina response to the significant flooding we experienced in Indiana in 2008, disaster preparedness has become a significant need for the state.”

In an effort to ensure hospital were prepared to deliver care during a disaster, IHA and ISDH partnered to create 10 public health preparedness districts throughout the state. These self-governing coalitions routinely meet to share information and resources, operating primarily on grant money from ISDH.

“These districts were only made possible because the state of Indiana received a federal grant and passed it out to the hospitals and other local health departments and nursing homes to make sure that, when disaster strikes, everyone in those communities would know who the players are and what their capacity is to help,” Grover said.

TRAUMA

“As an extension of IHA and ISDH’s work on disaster preparedness, there was a need to improve the trauma care capacity of hospitals in Indiana,” Whitson said.

In 2011, the two organizations collaborated to develop the Triage and Transport Rule that would help EMS providers determine where to take a patient who had experienced trauma.

“Do the drivers take them to the nearest hospital or the nearest trauma center? And how long do they have to make that decision?” asked Art Logsdon, ISDH’s assistant commissioner of health and human services. “We passed the Triage and Transport Rule in 2011 to help providers answer those questions.”

The Triage and Transport Rule was just the beginning. From 2011 to today, the number of trauma hospitals in Indiana has increased from six to 20. In addition, the number of ISDH employees dedicated to improving trauma care in the state has multiplied from four in late 2012 to 25 in 2018.

Finally, the Indiana State Trauma Committee, which IHA and ISDH helped establish in 2009, convenes six times each year to ensure that Hoosier hospitals are meeting the evolving needs of trauma patients across the state, which has become increasingly important as the opioid epidemic has spread.

“The opioid epidemic further complicates the work that trauma centers have to do,” Logsdon said, “but the trauma system is awakening to its role in combating the epidemic.”

STRONGER TOGETHER

These collaborations are just the beginning. As the health care challenges Indiana faces become more complex and nuanced—see the opioid epidemic—and the importance of public health initiatives continues to increase, a strong partnership between IHA and ISDH will become more vital than ever.

“I think it’s a win-win that we can jointly be a voice for public health and issues that are affecting our hospitals so we can have healthier Hoosiers,” Handy said. “That’s what everyone wants at the end of the day. The stronger we can build those relationships, the better off we can be.”