As health care organizations recover from the first months of the COVID-19 pandemic, they face the unmistakable fact their world has changed. Innovative approaches they have used to stretch resources and increase staffing are now seemingly ingrained in the system. In this session, we examine the changes that have occurred in the role of Advanced Practice Providers (APPs) and the lessons learned so far from those changes.

Guest speaker:

Christen Hunt, DNP, NP-C, CPNP-AC

Director, Nursing programs

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[01:07] The most successful emerging care model

[03:16] Elements of a team culture

[06:03] Importance of communication

[07:02] Productivity: APPs vs. physicians

[08:55] Effect on patient access

[09:28] Compensation

Links | Resources:

Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic Click here

COVID-19 State Emergency Response: Temporarily Suspended and Waived Practice Agreement Requirements Click here

Flattening the Provider Curve: Temporary COVID-19 Measures Expanding Scopes of Practice and Lessons from the Past Click here

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On this episode, we continue the story of a health care organization in New York City, at the flashpoint of the COVID-19 outbreak, and the breakthrough innovations it made to enable continued care during the first wave. Our discussion focuses on the importance of staff resilience, reaching out to patient families, the use of medical students on the frontlines and dealing with the staggering costs of the pandemic.

Guest speaker:

Robert J. Cerfolio, MD, MBA

Executive Vice President

Vice Dean, Medical School

Chief of Hospital Operations

NYU Langone Health

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[00:25] Biggest surprise in past four months

[01:15] Improving communication with patient families

[04:16] Long-term costs to the organization

[04:40] Reaching pre-COVID volumes in elective procedures

[05:02] Innovations to mitigate the financial toll

[05:34] No staff layoffs, furloughs or pay cuts

[05:50] Regaining patient trust; need to care for patients with non-COVID conditions

[07:01] Convincing staff that facility is safe; eliminating unnecessary precautions

[08:21] Message for leaders

Links | Resources:

Health System in Pandemic Epicenter Identifies Outcomes & New Risk Factors of Patients Hospitalized with COVID-19 Click here

9 ways Covid-19 may forever upend the U.S. health care industry Click here

Care for Critically Ill Patients with COVID-19 (JAMA, March 2020) Click here

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New York City has been at the epicenter of COVID-19, and one leading organization there met the pandemic onslaught head-on. On this episode, we’ll hear how that organization sparked innovations in care, staff support and even a key construction project to create a new dynamic and pace for the future.

Guest speaker:

Robert J. Cerfolio, MD, MBA

Executive Vice President

Vice Dean, Medical School

Chief of Hospital Operations

NYU Langone Health

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[02:08] Nimbleness: dealing with the unknown

[02:40] Ramping up number of executive meetings

[03:40] Innovation: accelerating the graduation of fourth-year medical students

[03:48] Innovation: accelerating an ER expansion to months instead of years

[04:10] Continuing to operate at “warp speed” and not going back

[04:27] Ramping up ICUs

[05:20] Innovations in clinical care

[06:20] Innovations in taking care of staff

[07:22] Takeaways in dealing with a COVID upsurge

[08:55] Not just a microangiopathic disease, a hypercoagulable state—use of IV heparin

[09:47] Use of low-molecular-weight heparin

Links | Resources:

Early Heparin therapy improves hypoxia in COVID-19 patients Click here

Health System in Pandemic Epicenter Identifies Outcomes & New Risk Factors of Patients Hospitalized with COVID-19 Click here

9 ways Covid-19 may forever upend the U.S. health care industry Click here

Care for Critically Ill Patients with COVID-19 (JAMA, March 2020) Click here

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In the previous episode, we discussed the benefits of clinical-supply integration (CSI). On this episode, we consider how organizations can achieve CSI, including the skill sets physicians need to work within the team framework. We also review a case study featuring an organization that has found success.

Guest speaker:

Blane Schilling, MD

Senior Principal

Advisory Solutions

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[00:23] Four domains to assess

[03:58] Importance of governance: the PNT Committee model

[05:30] Evaluating by service line

[06:15] Reading and interpreting data as a key for CSI

[07:01] Case study: University of Washington

Links | Resources:

CSI as an evolution of CQVA (Vizient slide deck) Click here

Clinical-Supply Integration: What Does It Mean Post-COVID? Click here

Clinical-supply integration: accelerating performance improvement Click here

Clinical-Supply Integration Click here

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Traditionally, supply chain professionals drove purchases, but the emergence of service lines brought clinician participation and, eventually, the concept of clinical-supply integration (CSI). Despite paying lip service to the concept, organizations have not always committed to it. On this episode, we’ll discuss the current state of CSI and what needs to be done across health care to bring it about.

Guest speaker:

Blane Schilling, MD

Senior Principal

Advisory Solutions

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[01:12] The true state of clinical-supply integration

[02:29] The case for cost and quality of care

[03:08] Cleveland Clinic example

[04:00] Kind of data involved for better outcomes

[07:11] Engaging physicians first

[10:25] Peer-to-peer physician interaction

[11:02] Dealing with vendors

[12:09] A systemic and sustainable approach

Links | Resources:

CSI as an evolution of CQVA (Vizient slide deck) Click here

Clinical-Supply Integration: What Does It Mean Post-COVID? Click here

Clinical-supply integration: accelerating performance improvement Click here

Clinical-Supply Integration Click here

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On this episode, we consider lessons learned from the impact COVID-19 has made on the already huge disparities in care that racial and ethnic minorities experience. Our discussion establishes how health care organizations, many of whom are struggling financially, can focus their resources on alleviating those care disparities without bearing a heavy burden in the process.

Guest speaker:

Moderator:

Show Notes:

[00:25] Social determinants of health (SDoH) and future pandemics

[01:33] Rural communities

[02:33] Unaddressed social determinants

[03:06] Six questions to ask

[03:55] Responsibility not on physicians alone

[05:18] SDoH as an etiological factor

[06:08] Novant Health example

[07:34] Effective use of resources to alleviate SDoH

[08:53] Rush University Health Equity Report

[09:45] Effectively collecting race, ethnicity and language data: training

[11:07] Lessons from Tuskegee Experiments

Links | Resources

Health care disparities in the age of coronavirus (The Harvard Gazette) Click here

Rush Health Equity Report Click here

Novant Health Spotlight Click here

Steps for resolving health disparities in hospital readmissions (Vizient) Click here

Healthy People website section on social determinants of health Click here

CDC link Click here

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Social determinants of health (SDoH) are those factors in a person’s life—socioeconomic, educational, cultural, environmental—that create disparities in how that person accesses health care. On this episode, we examine how the COVID-19 outbreak has affected social determinants of health and impacted racial and ethnic minorities that already carry a disproportionate burden of morbidity and mortality.

Guest speaker:

 Moderator:

Show Notes:

Links | Resources:

Health care disparities in the age of coronavirus (The Harvard Gazette)

Rush Health Equity Report

Novant Health Spotlight

Steps for resolving health disparities in hospital readmissions (Vizient)

Healthy People website section on social determinants of health: Click here

CDC link: Click here

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This episode continues our discussion on the “weekend effect,” the phenomenon where the comprehensiveness and quality of hospital care drops off on weekends. Having established in Part 1 how this situation occurs, we devote this session to strategies that help you avoid it, including staffing accommodations and leadership focus. In addition to improving patient care and outcomes, health care organizations will find they will gain a significant competitive advantage in addressing this issue.

Guest speakers:

Eric Burch, RN, MBA

Moderator:

Show Notes:

Links | Resources:

The Weekend Effect in Hospitals: Causes (Vizient Brief) Click here

The Weekend Effect in Hospitalized Patients: A Meta-Analysis (Journal of Hospital Medicine, Sept. 2017) Click here

“Who elects the weekend?” Click here

Sg2 Perspectives: A new podcast connecting you to Sg2 thought leadership … anytime, anywhere Click here

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Patients have good reason to fear staying at the hospital over the weekend. Studies have consistently demonstrated the weekend effect, where weekend admissions or stays cause increases in complications and higher mortality rates. This two-part series of Modern Practice examines the reasons behind the weekend effect and strategies for preventing it.

Guest speakers:

Aman Sabharwal, MD, MHA, CPHM

Senior Principal, Operational Effectiveness

Advisory Solutions

Vizient

Eric Burch, RN, MBA

Associate Principal

Advisory Solutions

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

Show Notes:

[01:25] The “weekend effect” explained

[01:57] Multiple causes

[02:17] Data supporting the weekend effect

[07:29] Case management and care transitions

[08:40] Impact of COVID Pandemic

[09:22] Assessing the weekend effect

Links | Resources:

The Weekend Effect in Hospitals: Causes (Vizient Brief) Click here

The Weekend Effect in Hospitalized Patients: A Meta-Analysis (Journal of Hospital Medicine, Sept. 2017) Click here

“Who elects the weekend?” Click here

Sg2 Perspectives: A new podcast connecting you to Sg2 thought leadership … anytime, anywhere Click here

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This episode continues the series on valuable insights gained in the handling of the COVID-19 crisis. We will discuss skills clinical leaders and staff have developed to cope with new risks and responsibilities. Also, we will examine a renewed focus nationwide on patient and family engagement, how to remain competitive when having to shut down operations and how to plan for patient cohorting in the future.

Guest speaker:

Moderator:

Show Notes:

Resources:

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