Quadruple Aim: Innovation in Virginia Healthcare

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Registration is now open for the 2024 Virginia Patient Safety Summit, which will be held as a virtual event on Thursday, February 22, 2024 from 9:30 a.m.-3:45 p.m.

Having an innovative mindset in healthcare is in high demand right now. Healthcare delivery innovation is necessary to find new ways to improve quality, enhance the patient experience, expand safety initiatives, increase efficiency, and reduce costs.  As hospitals and health systems pursue innovative solutions in all aspects of their care delivery and quality and safety improvement efforts, they are making real strides toward what the industry refers to as quadruple aim:

• Higher quality of patient care with improved and equitable outcomes
• Increased value for both the patient and provider
• Improved patient satisfaction
• An improved care provider experience

The 2024 Virginia Patient Safety Summit will highlight the progress being made in Virginia, and across the country, in these efforts.

Some of the keynote speakers for the 2024 Summit include:

• Dr. Aditi Mallick, the Acting Director of the CMS Office of Minority Health
• Bonnie Clipper DNP, MA, MBA, RN, CENP, FACHE, FAAN,  an internationally recognized nurse futurist and nursing innovation expert

Register now for the 2024 Virginia Patient Safety Summit. If you have any trouble registering an account or creating a new password, please reach out to [email protected] for immediate assistance.

Registration is free of charge for staff and providers associated with all Virginia hospitals/health systems, members of the Virginia Patient Safety Summit partner organizations – Medical Society of Virginia (MSV), the Virginia Nurses Association (VNA), and the Virginia Pharmacists Association (VPhA); federal and state health partner organizations, and event sponsor organizations and students. Others may register for a fee of $95. 

 

SafeHaven Provides Safe Space to Discuss Concerns Without Fear of Repercussions

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As burnout in the medical profession is at an all-time high and the well-being of physicians, PAs and health practitioners has become a national concern, a program established in Virginia is launching across the country.

SafeHaven, created by the Medical Society of Virginia, is a confidential resource that provides physicians, residents, PAs, nurses, pharmacists and their families a safe space to address burnout, career fatigue and mental health concerns without the fear of repercussions to their medical license and professional reputation.

Launched in 2020 in Virginia, the program has expanded through a pilot period to Illinois, Michigan and Minnesota. Thanks to a grant from the Physicians Foundation, the Medical Society of Virginia (MSV) is working with a cohort of five states – Arizona, Georgia, Indiana, Montana and Pennsylvania – on legislative efforts to begin offering burnout and mental health resources to health practitioners as part of SafeHaven’s national expansion.

“For far too long, the medical profession has endured a stigma for simply admitting there are times – just like for the rest of us – when they need assistance or care,” said Melina Davis, CEO and executive vice president of the Medical Society of Virginia. “We’ve created a program that not only equips our health professionals with resources for issues like burnout and mental health, but also encourages them that it’s OK to seek the help they need. It’s past time that we provide those who take care of us with resources to take care of themselves.”

Dr. Russell Libby, a board member of the Physicians Foundation said: “SafeHaven transforms the landscape of how clinicians can access behavioral health resources and support. This means that more clinicians will get the help they need when they need it. It will help sustain and grow our healthcare workforce, reinforce their enthusiasm and increase access to care and better patient outcomes.”

In the latest survey about burnout conducted by the American Medical Association (AMA), the Mayo Clinic, Stanford University School of Medicine and the University of Colorado School of Medicine, 63% of physicians reported at least one manifestation of burnout in 2021, an all-time high. The Medscape Physician Burnout & Depression Report 2023 showed a rate of burnout of 53% in 2022, a 26% increase since 2018.

Similarly, the Journal of the American Medical Association (JAMA) reported in 2022 a burnout rate of 49% – including 60% in 2021 – over a three-year window (2019-21). It estimates the annual cost of burnout-related physician turnover to be about $5 billion.

“It’s clear that our healthcare professionals, from doctors and nurses to pharmacists and lab technicians, are overwhelmed,” said Dr. John Whyte, chief medical officer of WebMD. “What’s also clear is that our healthcare professionals are choosing to leave their professions at alarming rates, in part because we’ve failed to appropriately address their needs. SafeHaven embraces the healthcare community, welcoming those who need support and providing them the level of care they deserve.”

MSV pushed for legislation to address physician burnout, fatigue and mental health issues during Viginia’s 2020 General Assembly session. The House and Senate bills for the creation of the SafeHaven program passed unanimously and became law on March 8, 2020. MSV began offering the suite of services to Virginia physicians in July of 2020.

“Demand was intense,” Davis said. “Based on the response we saw in Virginia, we knew SafeHaven would benefit healthcare professionals throughout the country.”

In addition to Virginia, SafeHaven services are available in Illinois, Michigan and Minnesota. In all, more than 6,500 clinicians have participated in the SafeHaven program, and national associations including the American Society of Clinical Oncology (ASCO) have begun offering the solution to their members.

Since its inception, SafeHaven has had a 47% engagement rate, a rate that far exceeds traditional employee assistance programs.

“We wouldn’t tell our patients they can handle their mental health concerns on their own, yet that’s exactly what many healthcare professionals try to do,” said Dr. Sterling Ransone Jr., board chair and former president of the American Academy of Family Physicians. “Traditionally, we’ve put physicians in a no-win situation where they feel they can’t share their feelings of depression, anxiety or stress without retribution. With SafeHaven, the stigma of physicians being honest with themselves is removed.”

SafeHaven offers assistance through VITAL WorkLife’s Clinician Well-Being Resources, a comprehensive solution that includes peer coaching, counseling sessions for the physician and their family, leadership development and work-life balance resources to support well-being for physicians, PAs, nurses, pharmacists and medical, nursing, PA and pharmacy students.

“Through our program, we are challenging the historic culture of medicine, working to decrease traditional control elements,” Davis said. “We also are working to add more innovative services as we learn more about the needs of our clinicians.

“Most important, we think that normalizing this ongoing concern is one of the most important things we can do. It’s OK for health professionals to say they’re not OK.”

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About SafeHaven

SafeHaven, the first of its kind in the nation, was founded in 2020 after recognizing a greater need to provide physicians and PAs the support they need to stay well and prevent burnout. As of 2021, the SafeHaven resources have been expanded to include nurses and pharmacists as well as medical, nursing, PA and pharmacy students. To learn more, visit www.SafeHavenHealth.org.

 

via VDH

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Dear Colleague:

Respiratory virus season has started and the Centers for Disease Control and Prevention (CDC) predicts we will see a similar number of hospitalizations due to respiratory illness as last season. Please read below for updates on how to prepare for the upcoming season to help keep you and your patients healthy and safe.

Immunizations Available to Protect Against Three Major Respiratory Illnesses

Fortunately, we now have immunizations to protect against three major respiratory illnesses: respiratory syncytial virus (RSV), COVID-19, and influenza (flu). Please see VDH’s summary table on fall and winter immunizations that you can share with your patients. The VDH Respiratory Diseases in Virginia website provides clinical and communication resources, including the VDH Respiratory Disease Toolkit.

Thank you for your partnership in ensuring all eligible Virginians have access to these important immunizations. VDH administers the Virginia Vaccines for Adults – Bridge (VVAB) Program and the Virginia Vaccines for Children (VVFC) Program. The VVAB program ensures access to COVID-19 vaccines for under and uninsured adults in Virginia. The VVFC program ensures access to the CDC Advisory Committee on Immunization Practices (ACIP) routinely recommended vaccines for uninsured and Medicaid-enrolled children in Virginia. I encourage you to offer these immunizations in your office and enroll in these programs if applicable. To learn more about these programs, you can contact our team via the VDH Immunization Webpage.

FDA Advises Health Care Providers to Ensure Correct Moderna Vaccine Dosing

On November 1, 2023, the U.S. Food and Drug Administration (FDA) issued a MedWatch alert regarding the Moderna COVID-19 Vaccine (2023-2024 Formula) for children aged 6 months to 11 years. The single dose vial of the Moderna COVID-19 Vaccine for this age group contains notably more than the actual dose (.25 mL), and there is concern that some providers may administer the entire contents of the vial. Please work with your staff to ensure the correct amount of vaccine is withdrawn from the vial to ensure patients receive the correct dose. For more information, visit the FDA webpage.

CDC Provides Options for Clinicians in Response to a Limited Supply of Nirsevimab

On October 23, 2023, CDC issued a Health Alert Network (HAN) Health Advisory in response to a limited supply of nirsevimab, a monoclonal antibody product to protect infants and young children from lower respiratory tract infection caused by RSV. For the 2023–2024 RSV season there are not sufficient 100mg dose prefilled syringes of nirsevimab to protect all eligible infants weighing ≥5 kg and supply of the 50mg dose prefilled syringes might also be limited. Below is a summary of the CDC recommendations to protect infants from RSV during the shortage; please refer to the CDC Health Alert for complete detail:

• Prioritize 100mg doses of nirsevimab for infants at the highest risk for severe RSV disease: young infants (age <6 months) and infants with underlying conditions that place them at highest risk for severe RSV disease.
• Avoid using two 50mg doses for infants weighing ≥5 kilograms (≥11 pounds) to preserve supply of 50mg doses for infants weighing <5 kilograms (<11 pounds). Please note that some insurers may not cover the cost of two 50mg doses for an individual infant.
• Suspend using nirsevimab in palivizumab-eligible children aged 8–19 months during the current RSV season. These children should receive palivizumab per American Academy of Pediatrics recommendations.
• Continue to offer nirsevimab to American Indian and Alaska Native children aged 8–19 months who are not palivizumab-eligible and who live in remote regions, where transporting children with severe RSV for medical care is more challenging, or in areas with known high rates of RSV among older infants and toddlers.
• Discuss nirsevimab supply issues when educating pregnant people about RSVpreF vaccine (Abrysvo) as RSV vaccination during pregnancy is safe and effective (when given at 32-36 weeks) and will reduce the number of infants needing nirsevimab during the RSV season.

VDH Releases New Respiratory Disease Vaccine Dashboard and Weekly Activity Report

On November 14, 2023, VDH updated its COVID-19 vaccination dashboards to add a respiratory disease vaccine dashboard that displays both COVID-19 and influenza (flu) vaccine data. These dashboard updates will help Virginians more effectively monitor COVID-19 and flu vaccine protection for 2023–2024.

• The COVID-19 Vaccine Summary Dashboard now shows the total doses of 2023–2024 COVID-19 vaccine administered and the percentage of people in Virginia who have received a 2023–2024 COVID-19 vaccine. It will also display the vaccination rate per 100,000 people and a map displaying percentage of the population who has received a 2023–2024 COVID-19 vaccine by locality.
  • Dashboards with previous COVID-19 vaccines and the percentage of people vaccinated with a primary series and who are up to date on COVID-19 vaccines have been retired.
• The Respiratory Disease Vaccine Dashboard displays the percentage of people vaccinated with a 2023–2024 COVID-19 and/or 2023–2024 flu vaccine.

VDH also began publishing a weekly Respiratory Disease Report to provide a summary of key viral respiratory illness activity for COVID-19, flu, and RSV in Virginia. This report will be published weekly on Fridays on the Respiratory Disease webpage.

Thank you again for your continued partnership. Please visit the VDH website for current clinical and public health guidance on respiratory diseases in Virginia and other information.   

Sincerely,

Karen Shelton, MD
State Health Commissioner

The stories are not new, but they become more frequent every year. Nurses assaulted in the emergency room by a patient being evaluated for treatment, surgeons shot to death in their clinics, dental staff threatened by patients over wait times, hospital employees shot to death by coworkers in hospital stairwell, and countless others. While possible everywhere, emergency departments and behavioral health facilities are at the most risk for an incident to occur. According to the World Health Organization, it is estimated that between 8% and 38% of healthcare workers suffer physical violence at some point in their careers. Additionally, per the US Bureau of Labor Statistics, healthcare and social service workers were victims of 76% of all nonfatal injuries from workplace violence in 2020.

What is Workplace Violence?

The Occupational Safety and Health Administration (OSHA) defines workplace violence as any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. Workplace violence ranges from threats and verbal abuse to physical assaults and even homicide. Patients are the largest, but not the only source of violence as family members, visitors, intruders, or even coworkers are also potential instigators. Most incidents are created by systemic factors such as overcrowded areas, staff shortages, long wait times, inflexible visiting hours, and differences of language and culture. When healthcare workers require treatment or miss work because of an injury, employers’ workers’ compensation insurance (whether private or self-insured) will typically bear the expense of continuing to compensate the injured provider while away from work. Non-economic costs include provider stress, fatigue, burnout, and turnover, all of which have been shown to relate to decreased patient satisfaction and an increased risk of error.

Workplace Violence Prevention for Healthcare and Social Service Workers Act

On April 18, 2023, both the Senate and the House reintroduced the Workplace Violence Prevention for Health Care and Social Service Workers Act (HR 2663 and S 1176) that was previously considered in 2021 and 2019. It has been sent by both houses for committee review. The new legislation would require the Secretary of Labor to issue a standard requiring healthcare providers to write and implement a workplace violence prevention plan. If it becomes law, it will apply to many healthcare settings, including hospitals, psychiatric treatment facilities, and substance use disorder treatment centers. The requirements include unit-specific assessments and implementations of prevention measures, including:

• physical changes to the environment
• staffing for patient care and security
• hands-on training
• robust record-keeping requirements
• protections for employees to report workplace violence to their employer and law enforcement

Additionally, the Safety from Violence for Healthcare Employees Act, introduced in September, would make assaulting healthcare workers in hospitals a federal crime with enhanced penalties for assaults resulting in serious bodily injury.

Many states are also passing legislation surrounding workplace violence prevention in healthcare, including Virginia, which recently required every hospital to implement a heightened security plan with staffing of at least one off-duty police officer at all times, absent a waiver. Additionally, The Joint Commission revised workplace violence prevention requirements effective January 1, 2022. The increase in legislation and attention around workplace violence in healthcare recognizes that identifying risk factors and providing education can help to prevent or minimize incidents from occurring.

Hancock Daniel’s Security, Workplace Violence, and Crisis Management Team provides assistance in assessing or creating a compliant program for your organization. Our team provides the full continuum of services from risk assessment to crisis management as well as handling the legal, regulatory, and operational aspects resulting from safety related events occurring in the healthcare setting.

via Hancock Daniel.  Click here for a full PDF version of the advisory.

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The information contained in this advisory is for general educational purposes only. It is presented with the understanding that neither the author nor Hancock, Daniel & Johnson, P.C., is offering any legal or other professional services. Since the law in many areas is complex and can change rapidly, this information may not apply to a given factual situation and can become outdated. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice. Under no circumstances will the author or Hancock, Daniel & Johnson, P.C. be liable for any direct, indirect, or consequential damages resulting from the use of this material.