Lehigh Valley Health Network recently participated in a Vizient Performance Improvement Collaborative that reduced the use of opioids in orthopedic surgery. The key to success was convincing clinicians to join the initiative and fully participate. On this podcast, you’ll hear from two leaders at Lehigh Valley who share how they used data to accomplish this goal.

Guest speakers:

Matthew McCambridge, MD, MHQS

Senior Vice President

Chief Quality and Patient Safety Officer

Lehigh Valley Health Network

Joshua Rosentel, BSN, RN

Senior Clinical Quality Information Specialist

Lehigh Valley Health Network

Moderator:

Marilyn Sherrill, RN, MBA, CNOR, CPHQ

Knowledge Transfer Director

Vizient

Show Notes:

[00:26] The interview that started the initiative

[01:38] Joining the Vizient collaborative

[02:20] An opioid problem in Pennsylvania

[02:40] The challenge of provider variation

[02:52] Physicians and data

[03:21] One slide is all that’s needed

[04:17] Telling the story

[05:02] Data transparency and benchmarking

[06:12] Taking the approach to other clinical areas

[07:09] The role of Vizient’s CDB

Links | Resources:

Program handout from October 28, 2020 Vizient Medical Leadership Series webcast Click here

Link to October 28 webcast Click here

“The Opioid Epidemic: Impact on Orthopaedic Surgery” (Journal of the AAOS) Click here

For more information, email [email protected]

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Hospitals are constantly faced with the pressure to improve quality and outcomes while reducing costs. Keir Mitchell and Kendra Pitts from the University of Illinois highlight their achievements in establishing a utilization protocol – with appropriate resources, including implants, for the orthopedic product category. They also discuss how participation in a Vizient Performance Improvement Collaborative focused on establishing protocols for orthopedic implants shaped their efforts in the process.

Guests:

Keir Mitchell, PT, PhD, GCS

Director, Musculoskeletal Clinical Services

University of Illinois Health

Kendra Pitts, MS

Assistant Director, Value Analysis Program

University of Illinois Health

Carla Stephens, CMRP, LSSGB

Collaborative Advisor

Vizient

Host:

Kelly Randall

Knowledge Transfer Director

Vizient

Show Notes:

[00:00 – 02:20]  Beginning the University of Illinois orthopedic utilization protocol

[02:20 – 03:23]  Working with Physicians on the orthopedic utilization protocol

[03:24 – 04:12]  Selection of team members

[04:13 – 05:54]  Building a case for change

[05:55 – 06:12]  Importance of data in developing orthopedic utilization protocol

[06:14 – 06:45]  Results from the protocol

[06:46 – 07:23]  Working with new technology

For more information, email [email protected]

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Transitions of care can be arduous for clinicians and confusing to patients. Often, clinicians and patients alike face unreal expectations as to the level of care that results. As an answer, NYU Langone Health fostered better communication between clinicians in the acute-care areas and clinicians in the post-acute facilities to improve on the inefficiencies and drawbacks involved in care transitions.

Ana Mola, PhD, ANP-BC

Director

Care Transitions and Population Health Management

NYU Langone Health.

Adrienne Goldberg, MPT

Director

Post-acute Innovation and Special Projects

NYU Langone Medical Center

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Hospitals all over the country are overwhelmed by an increasing number of patients with behavioral health issues. Many use the emergency department to access care and end up staying in the hospital for a more extended time.  These patients jeopardize health care workers safety and impede their own ability to receive necessary care. The University of Kansas Health System developed a Behavioral Response Team to intervene with these patients that has shown positive results for the organization and their patients.

Guests:

Teresa Long, MD

Associate Professor for Psychiatry and Internal Medicine

University of Kansas Health System

Heidi Boehm

Quality Outcome Coordinator

University of Kansas Health System

Show Notes:

[00:00 – 01:17]  Beginnings of the Behavioral Response Team

[01:18 – 02:36]  Recognizing the need for safety and improving the care of patients

[02:37 – 03:39]  Specific skillsets of Response Team

[03:40 – 04:39]  Training and partnering with police department

[04:40 – 05:57]  Prevention intervention

[05:58 – 06:42]  Importance of Documentation

[06:43 – 08:16]  Challenges and changes

[08:17 – 09:42]  Setting up for success

Links | Resources:

Watch the Vizient Behavioral Response Team webcast here for additional details.

For more information, email [email protected]

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Sepsis is a life-threatening infection that kills nearly 270,000 Americans annually.  Another 1.7 million people develop sepsis but survive the experience.  In this podcast, we dive into the work of patient and family advisory councils and why the collaboration between patients, families and their providers can mean the difference between life and death.

Guests:

Armando Nahum, Director, Center for Engaging Patients as Partners, MedStar Institute for Quality and Safety

Jeanne DeCosmo, BSN, MBA, CPHQ, Director, Clinical Quality, MedStar Health

For more information, email [email protected]

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Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. Dr Tomas Spiegel from the University of Chicago and Dr. Martin Lucenti from Vizient return for part 3 of this series summarizing factors that shape emergency medicine today and offer their thoughts on what will be different in the future. In this episode they examine how emergency departments can adjust scope of care and use social determinants of care to help shape their future.

Guests:

Thomas Spiegel, MD, MS, BA, ED

Medical Director

University of Chicago Medicine

Martin Lucenti, MD, PhD

SVP & CMO, Solution Architecture

Vizient

For more information, email [email protected]

Show Notes:

[00:00-08:13] Switching scope of care model in emergency department away from convenient care and making it easier for patients to access care.

[08:14-09:36] Training providers differently for the change in scope of care in emergency department.

[09:37-12:36] Role of specialists in emergency department when changing to a new care model.

[12:37-15:30] The transition of the emergency department to point of access for all service lines an organization.

[15:31-18:24] Role of community in helping emergency medicine in the future.

[18:25-26:56] Taking strain off emergency medicine by tapping into the resources of the community.

[26:57-29:43] What’s on the horizon for emergency medicine.

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Escalating drug costs along with decreasing reimbursement have increased pressure for the pharmacy departments to oversee cost effective medication management. Becky Sillaman, System Director, Clinical Pharmacy Services for Premier Health, discusses how her team collaborated with Premier’s Anesthesiologists on specific strategy that reduced inpatient spend on one drug while continuing to provide high-quality care for patients.

Guest:

Becky Sillaman, PharmD

System Director, Clinical Pharmacy Services

Premier Health

Show Notes:

[00:00 - 00:57]   Comparing Cost of IV Acetaminophen vs Oral Acetaminophen

[00:58 - 02:32]    Building the case for the initiative to use less IV Acetaminophen

[02:33 - 03:03]      Getting Anesthesiologists to buy into the initiative

[03:04 - 05:15]       Changing culture to make positive change in cost savings

[05:16 - 07:41]       Getting key stakeholders on board and workflow adjustments

[07:42 - 09:33]       Results and how to define success

For more information, email [email protected]

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Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. Dr. Tomas Spiegel from the University of Chicago and Dr. Martin Lucenti from Vizient return for part two of this three-part series. They explore factors shaping emergency medicine today and tomorrow. In this episode, they outline how operational strategies and payer models could evolve to better support emergency medicine in the future.

 Guests:

Thomas Spiegel, MD, MS, BA, ED

Martin Lucenti, MD, PhD

For more information, email [email protected]

Show notes:

00:00-3:58     The Emergency Room as an independent, immediate care service line.

03:58-07:57   Positioning the Emergency Department to serve as a support system to route patients towards other service lines.

07:58-14:30 Helping providers shift to take on different roles and address patient satisfaction.

14:31-18:19   Changes to payment reimbursement models and how they affect the emergency department.

Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. In this bonus edition to the Emergency Medicine of the Future three-part series, Dr. Thomas Spiegel from the University of Chicago summarizes factors shaping emergency medicine today and offers his thoughts on what will be different in the future.  The broad-ranging discussion covers everything from emergency room current challenges, to implementing operational efficiency, operations management and functioning as a diagnostic center and COVID-19 patient hub for the organization.

Guest:

For more information, email [email protected]

Show Notes:

[00:00 – 01:33]  Adjusting to COVID-19 in the Emergency Department

[01:34 – 02:33]  Caring for COVID patients in the Emergency Department

[02:34 – 03:46]  Separating patients into care spaces

[03:37 – 05:44]  Identifying and treating COVID-19 cases

[05:45 – 06:05]  Guideline: The 5 liters of oxygen

[06:06 – 09:55]  Ventilators vs. high-flow nasal cannula approach

[09:56 – 12:02]  High-flow nasal cannula differs from oxygen delivered though the standard nasal cannula

[12:03 – 15:57]  Continuous Positive Airway Pressure Helmets or CPAP

[15:58 – 16:54] Contraindications for co-morbidity patients

[16:55 – 17:42] Drawbacks for treatment options

[17:43 – 18:39] Lessons learned – Prevent the vent

[18:40 – 20:25] Future of Emergency Medicine

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Dr. Carol Solie and Jennifer Gallagher from the Wyoming Medical Center knew they needed better staff training for maternal mortality by post-partum hemorrhage and hypertension. They decided on the obstetrical training simulation process and the results were astounding. They join us on this program to discuss their decision, including the challenges and benefits.

Guests:

Jennifer Gallagher

Clinical Educator for Obstetrics

Wyoming Medical Center 

Dr. Carol Solie

Vice President of Quality and Medical Safety

Wyoming Medical Center 

Resources:

Watch the Vizient Reducing Maternal Mortality collaborative webcast for additional details.

For more information, email [email protected]

Show Notes:

[00:00 – 02:40]  Recognize the need for better training

[02:41 – 03:39]  Bedside simulation program with hands on training

[03:40 – 04:15]  Doctor education

[04:16 – 05:25]  Simulation pre-briefing scenarios and objectives

[05:26 – 06:05]  Identifying roles and scripting

[06:06 – 06:59]  Team building and positive experiences

[07:00 – 09:50]  Simulation challenges and benefits

[09:51 – 11:29]  Setting up for success

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