CMS says it will enforce staff vaccine mandate where it can

By January 27, hospitals in half of the nation’s states must ensure that all staff have at least one dose of the COVID-19 vaccine or have a qualified exemption, or face termination from the Medicare and Medicaid health insurance programs. By the end of February, staff must be fully vaccinated.

During the coronavirus pandemic, the failure to elevate the role of primary care providers on the frontline alongside public health officials has resulted in several missed opportunities to respond to the crisis, a recent study found.

The pandemic has highlighted weaknesses and vulnerabilities in the country’s healthcare and public health systems. For example, primary care and public health have been underfunded in the United States, limiting their ability to react to the pandemic. The United States allocates about 6% of national healthcare spending on primary care, which is less than half of the average expenditure on primary care in other high-income countries

Delayed or deferred care likely contributed to excess deaths in New Jersey during the first year of the coronavirus pandemic, a recent report from the New Jersey Hospital Association’s Center for Health Analytics, Research & Transformation (CHART) says.

Health systems, hospitals, and other healthcare organizations have reported significant decreases in service utilization in the early months of the pandemic linked to patient concern over becoming infected with COVID-19 in a healthcare setting. In a September 2020 New Jersey Hospital Association survey of a representative sampling of Garden State adults, 83% of survey respondents reported being concerned about going to a hospital due to fear of contracting COVID-19.

Mac's Safety Space

In what has become one of the constants of the final quarter of the calendar year, our friends at CMS once again take aim at the disparities between their oversight of the accreditation process (through validation and complaint surveys) and what the various accreditation organizations are identifying during their survey visits. And, continuing the trend of the last few years, the physical environment once again is taking (somewhat) center stage in the disparities sweepstakes ( a sweepstakes in which the facilities being surveyed do not obtain any prizes).

Mac's Safety Space

It would seem that the likelihood of ongoing remote surveys is growing in relation to the number of organizations awaiting survey. To be honest, I’ve not seen an official accounting of where the various accreditation organizations (AO) are falling relative to survey delays. That said, I can’t imagine that there must be a fairly significant backlog of surveys to be conducted, so I suppose we’d best be prepared for at least some of that process to occur remotely—particularly document review. To that end, if you missed this news item, I think it will help provide an understanding of how the process is evolving (mutating?!?); the focus of the piece is how DNV is administering the process, but there are certainly some clues as to how the process in general is likely to “exist” over the next little while.

Newsletter: Inside Accreditation & Quality

In 2022, CMS plans to restart its pilot project to improve validation surveys but is likely to continue pressure on accrediting organizations (AO) to be more vigilant in finding deficiencies in physical environment (PE), infection control (IC), fire safety, and patients’ rights.

Concerns that AOs are missing significant patient safety problems also means more pressure on governing bodies and quality improvement programs, two other categories called out by CMS officials in the agency’s latest “Report to Congress: Review of Medicare’s Program Oversight of Accrediting Organizations and the Clinical Laboratory Improvement Amendments of 1988 (CLIA) Validation Program.”

Newsletter: Patient Safety Monitor Journal

As the COVID-19 pandemic rolls into its third year, many healthcare workers have had enough. Long hours, crushing workloads, and cultural tensions about vaccines and the virus have accelerated the number of people leaving the healthcare field. While this is damaging enough in the short term, experts warn that the trend could lead to even more disastrous results in the future if it isn’t reversed, says Ken Rohde, senior consultant for patient safety and process improvement at The Greeley Company.

Rohde, an expert on high reliability in healthcare, says that managing employee retention is critical to the overall operation of your facility.

When leadership doesn’t address high turnover, he says it leads to lower reliability, which leads to more patient harm. We spoke with Rohde about addressing this problem

Newsletter: Healthcare Safety Leader

Plan now for how you are going to flush toilets if you lose water for several hours or even days, or you might find yourself and your staff having to deal with toilet paper disposal by hand.

During a prolonged and extreme cold snap in February 2021, Houston Methodist West Hospital lost running water and had to ask patients and staff to not put toilet paper in the commodes because the hospital had limited or no water to fully flush the system.

Winter Storm Uri had a national impact but crashed the electrical grid through most of Texas, according to a presentation by Melody Peeples, a member of Methodist West’s quality and patient safety team as well as an emergency management incident command leader, and Tommy Wong, the hospital’s facility manager.

Newsletter: Healthcare Life Safety Compliance

Someone’s always checking for compliance when it comes to fire safety, especially in healthcare facilities. Naturally, that includes several regulatory agencies: CMS, The Joint Commission (TJC), Department of Health, and the local fire department, just to name a few. They will all be looking for evidence of compliance, patterns of negligence, and participation records for select staff.

Of course, a good fire prevention and compliance program includes successful fire drills. And those drills should involve a bit more than just pulling an alarm randomly and seeing how quickly staff respond.

Here are some tips for running fire drills in healthcare facilities.

Newsletter: Medical Environment Update

In 2020, telehealth investments focused on speed, not strategy, as healthcare providers and payers rushed to meet the need for virtual care during the pandemic. Now, a recent Amwell/HIMSS survey shows there’s a need to move toward purposeful growth in telehealth.

Use cases for telehealth are diversifying beyond urgent care and behavioral health to encompass primary care, specialty care, wellness programs, and more. In tandem with this uptick in usage, technology challenges—from lack of integration and interoperability to platform sprawl—contribute to a disjointed care experience, say healthcare leaders, clinicians, and support staff. Most payers and providers use at least three platforms or systems for virtual care—and more than a quarter have five or more platforms in place.