Hospital service volumes expected to rebound, survey finds

Although hospital service volumes decreased significantly in 2020, health system leaders expect most service volumes to rebound by 2022, a new survey found.

Particularly during the early phase of the coronavirus pandemic, healthcare providers experienced sharp declines in service utilization. The drivers of reduced utilization included state restrictions on elective surgery to accommodate coronavirus patient surges and patients deferring care because they feared exposure to the virus in healthcare settings.

The coronavirus pandemic has exposed inequities in the U.S. healthcare system, particularly for racial and ethnic groups, according to the Centers for Disease Control and Prevention. Research published by JAMA Network Open shows Americans with low incomes are also suffering disproportionate coronavirus infection and death burdens.

The new report, which was published by Urban Institute researchers with funding from the Robert Wood Johnson Foundation, examines historical trends for flu vaccination that indicate ways to address racial, ethnic, and economic inequities in the rollout of coronavirus vaccines. The report is based on data from the 2016 to 2018 National Health Interview Survey.

Patient Safety Awareness Week (PSAW) is coming to a close, but the focus on patient safety and healthcare quality will continue on as always. Thanks to all the dedicated professionals who work in healthcare organizations to provide top-notch care during these trying times. We highlighted some of these efforts this week and will continue to do so.

This is Brian Ward and A.J. Plunkett, editors of Patient Safety Monitor Journal and Inside Accreditation & Quality and we are looking for feedback on our newsletters: what we're doing well, what we need to improve, what topics you want more coverage of. To do that, we are reaching out to subscribers to schedule short, one-on-one calls where you can share your thoughts on our newsletters. These calls would be 10-15 minutes and we'll also accept typed answers to the questions below.

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Today’s healthcare system is hallmarked by complexity. The configuration of day-to-day healthcare practice varies considerably, depending on the type and level of care administered. Anyone familiar enough with different types and levels of care can attest to the general informality with which medical answers and solutions get bandied around in the rhythmic press and exigency of ongoing daily activity, especially in settings peppered by periods of downtime. The glaring exception, of course, is those wards where clinical decision-making steadfastly rules, and where medical answers and solutions more directly reflect the serious nature and high stakes of nonstop care.

What looms as aberrantly apparent, to some at least, is how these two worlds of practice exist side by side, yet only one of them reliably produces answers to questions and valid solutions to medical problems. Still, the other world’s cavalier state of practice conveys hasty answers/solutions that are equally conveyed with 100% certainty, presumed to be actionable. This world is peopled by staff who are unaware they’re functioning more or less in “sleep mode.” In other words, they’re sleepwalking.

The world of the waking, so to speak, is precisely the opposite: characterized by its solemnity in generating, examining, and evaluating potential answers or solutions upon which an informed decision will rest. That decision offers the best chance for success, but only after first articulating how success has been defined. This world is populated by critical thinkers. Obviously, this is the world we should expect all healthcare professionals to inhabit.

Hasty or premature conclusions offered as answers to questions or as solutions to be administered are nothing more than hypotheses cloaked as a sure thing. Across many work contexts, these become unwitting fodder for dialogues of consequence between medical staff, or between a staff member and a patient. In a nutshell, such conclusions are too quick-off-the-tongue when they arguably need to be slow-off-the-mark. Why? Because they can have real consequences if acted upon, and those outcomes are just as likely to harm as they are to help. With this in mind, any time an answer or solution gets uttered so freely, the stakes in the dialogue change. No bells will ring, no alarms will sound—yet the potential for things to go sideways has just ratcheted up considerably.

Be aware: As COVID-19 cases go down, your odds for an on-site reaccreditation survey might go up.

CMS is continuing to limit its on-site hospital surveys, except those involving complaints of immediate jeopardy to patients or in cases where patients are considered to be in imminent danger.

In a memo initially issued January 20 to CMS’ state survey agencies (SA) and revised on February 18, the federal overseer of Medicare said it was directing accreditation organizations (AO) to also limit hospital surveys based on certain criteria.

The directive was first set through mid-February, then renewed for 30 days through March 22, and could be renewed again.

However, in many cases hospitals still may be subject to their regular on-site, triennial reaccreditation survey. And that survey will be unannounced, as usual.