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Missouri Hospital Association

Sharing Promising Practices & Lessons Learned Based on an Assessment of the State’s COVID-19 Response Efforts

August 2021


Since the beginning of the COVID-19 pandemic, the state of Missouri has encountered four predominant surges in COVID-19 cases — the first in April 2020, one in July 2020, a third when hospitalizations peaked in December 2020, and the most recent beginning in late June 2021 with the presence of the Delta variant. The impact of each surge presented its own unique challenges and learning opportunities for Missouri hospitals. Even as new response-related priorities emerged— from overcoming vaccine hesitancy to controlling the spread of the Delta variant — the Missouri Hospital Association (MHA) identified the need to identify, document, and share member hospitals’ promising practices and opportunities for improvement to inform future decisions.

Response Activities:

MHA used funding from ASPR’s Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement to organize efforts related to the evaluation and assessment of Missouri hospitals’ response through the peak surge in December 2020 and vaccine administration through the first two quarters of 2021. MHA conducted these evaluations by utilizing an established statewide hospital assessment that has been distributed annually since 2005. The tool was able to capture how hospitals handled COVID-19 response activation; implemented clinical strategies, such as testing, care coordination with long term care facilities, treatment protocols, and vaccine administration; as well as addressed shortages and sourcing of personal protective equipment, or PPE. 

MHA hosted focus groups with clinical and executive leaders, during which MHA gathered initial preparedn​ess and response-related leading practices and lessons learned to incorporate into its analysis. MHA also created topic-specific facilitation materials to help hospital staff conduct internal discussions, which became useful in identifying key issues within their facilities and ultimately led to improvement planning activities. ​

These combined effeorts resulted in a thorough evaluation of MHA's response to COVID-19 and lead to the publishing of the Mid-Response Assessment: Missourireport cover book image Hospitals' Response to the COVID-19 Pandemic and Missouri's COVID-19 Response: A Clinical and Operational Reflection for Missouri Hospitals; both containing data that provide insight into the challenges Missou​ri hospitals faced. These data included summative results from hospital assessments, as well as data spotlights produced throughout the response by MHA and its nonprofit organization, the Hospital Industry Data Institute, to capture notable case and hospitalization rates and vaccination progress, for example. In addition to the release of each report, MHA led a “lessons learned” series with hospital staff to share insight into future response activities. The ​first series, released in October 2020 through MHA's education arm, the MHA Health Institute, served as a touch point for hospitals statewide and provided resources and updates during the active response. The second report (see image) was released in August 2021. Throughout fall 2021, the MHA will host biweekly meetings, covering specific lessons learned and serve as a touchpoint, yet again, for hospitals dealing with new challenges daily.


MHA’s efforts in publishing these reports and hosting these webinars are a great example of the state to local education, training, and response coordination that is a hallmark of the National Special Pathogen System’s tiered approach. Additionally, ASPR’s Hospital Association COVID-19 Preparedness and Response Activities cooperative agreement funding helped lay the foundation for MHA to develop well-informed reports and resources that assisted their response to the COVID-19 pandemic. These efforts not only prepared them for an evolving COVID-19 response but also helped hospitals to develop an informed and comprehensive strategy for future health care emergency response situations, beyond the capabilities developed via annual exercises or simulations. By compiling its findings into a report and webinar series, the MHA has created an invaluable shared resource to support hospitals during an unprecedented pandemic.