Archive for April 2020

Discharging patients that have had a known or suspected COVID-19 infection has become a crucial undertaking for hospitals straining for resources during this crisis. This episode will provide guidelines for patient discharge, including symptoms to look for, testing procedures, precautions and patient mental acuity.

 

Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Senior Principal, Operational Effectiveness
Advisory Solutions
Vizient

Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient

 

Show Notes:

[01:12] CDC and AHA guidelines on discharges

[01:47] Test-based approaches

[03:21] Non-test-based strategies

[05:25] Transmission-based precautions

[07:20] Discharge planning

[09:19] CMS waivers for transfers

[11:45] When a patient no longer requires transmission-based precautions

[12:30] Cooperation to deal with surges

[13:15] Three-midnight rule and the 30-day discharge waiver

 

Links | Resources:

Vizient COVID-19 Resource Page: Click here

CDC Guidelines on Discharging Hospitalized Patients: Click here

Post-Acute Care for Vulnerable Populations with COVID-19: Click here

Hospitals: CMS Flexibilities to Fight COVID-19: Click here

Accepting Admissions from Hospitals during COVID-19 Pandemic: Click here

Patients from Nursing Homes Are Stuck in Hospitals After Contracting COVID-19: Click here

 

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COVID-19 has shattered restrictions on Advanced Practice Providers (APPs), resulting in expanded scope of practice in states across the country. On this episode, two leading experts return with an update on the sweeping changes occurring in just the last couple of weeks, including expanded waivers and increasing scope of practice.

 

Guest speakers:
Christen Hunt, DNP, NP-C, CPNP-AC
Director, Nursing Programs/CAP2™
Vizient

Susan Cymbor, MD
Physician Accreditation Advisor
Vizient

 

Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient

 

Show Notes:

[01:30] Changes to expanding the scope of practice

[03:56] Changes with processes regarding locum tenens

[04:43] What organizations can do in changing scope of practice

[06:25] New waivers and effect on MIPS reporting and telehealth

[08:07] How long will these scope-of-practice changes be in effect?

[09:42] New flexibility regarding beds and patient placement

[11:02] Waivers regarding patient discharge

[12:25] Two types of waivers

[13:06] Challenge of getting out of emergency operation plans in future

 

Links | Resources

Vizient’s disaster preparedness page: Click here

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

CMS Waives Certain Requirements to Expand Healthcare Workforce, Put Patients over Paperwork: Click here

Trump Administration Makes Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge: Click here

 

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The COVID-19 crisis has disrupted the financial and operational aspects of care delivery. Looking ahead, health care organizations will face even more changes.

Join Dr. Tom Villanueva as he leads a discussion with two leading experts on strategies to prepare for the next stages of the crisis and even for the aftermath. They will look at maximizing capacity, the impact of payer mix operationally, patient issues and restarting the business side of care.

 

Guest speakers:

Brian Esser, MBA

Associate Principal

Intelligence

Vizient

 

Ryota Terada

Director

Intelligence
Sg2

 

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Show Notes:

[01:42] Financial impact health care organizations are experiencing

[02:49] Getting back to normal

[05:13] Patient attitudes/preferences as a factor in capacity

[05:53] Need for discussions among hospital leaders before restoring capacity

[08:32] Areas for testing before procedures undertaken

[09:47] Payer mix

[11:46] Communicating that safe care is available; building trust

[13:18] Virtual care

[16:00] Role/re-emergence of the independent practitioner

 

Links | Resources

Vizient COVID-19 Resource Page: Click here

University of Wisconsin: Financial and Operational Impacts: Click here

The COVID-19 impact on the revenue cycle for hospitals and other healthcare providers: Click here

 

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To support providers during the COVID-19 crisis, Congress has passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, a $2 trillion stimulus package designed to provide funds for health care organizations across the country.

Join Dr. Tom Villanueva as he discusses this law with a colleague from Sg2, who will describe how organizations can access the funds provided through the CARES Act.

 

Guest speaker:

James Reilly

Senior Principal

Sg2 

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Show Notes:

[01:10] What the federal government has made available to health care organizations

[05:34] Accessing funds

[07:39] Eligibility for funding

[09:23] Special considerations for public hospitals

[11:00] Considerations for severe-outbreak areas

[11:49] Expenses covered and not covered

 

Links | Resources

Sg2 crisis page: Click here

Fact Sheet: Accelerated and Advanced Payment Program: Click here

A Look at the $100 Billion for Hospitals in the CARES Act: Click here

CARES Act: Provisions to Help Rural Hospitals: Click here

CARES Act fund to reimburse providers for uninsured patients: Click here

 

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Understanding the CARES Act

Health care organizations are feeling the huge impact of COVID-19 on a number of fronts. In particular, the impact on the financial front has been onerous and extensive. In response, Congress has passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, the largest stimulus bill in history with various loan and grant opportunities to support hospitals.

On this episode, an expert will provide an update on leading provisions of the CARES Act and what this act can do for health care organizations during this crisis.

 

Guest speaker:

Shoshana Krilow, JD

Vice President

Public Policy and Government Relations

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Show Notes:

[02:00] Explanation of the CARES Act

[03:13] Clinicians included in package

[03:45] Support for health care organizations

[06:55] Immediate goal: to start distribution to providers

[07:40] Start of distribution based on Medicare FFS claims

[09:50] Loans available

[11:00] Medicare Accelerated and Advanced Payments Program

[11:33] Provider relief fund coverage

[16:05] Advocating for assistance

[17:31] Additional package

[18:00] Additional benefits, changes and ramifications of CARES Act

 

Links | Resources

Summary of CARES Act: Click here

Fact Sheet: Accelerated and Advanced Payment Program: Click here

Responding to COVID-19: Using the CARES Act’s Hospital Fund to Help the Uninsured, Achieve Other Goals (Health Affairs): Click here

CARES Act Provider Relief Fund (HHS): Click here

 

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Telemedicine, or virtual health, has been an underused approach to patient care, despite a clearly stated patient preference for it. The reasons for this have been numerous and varied, but in this time of crisis, telemedicine is emerging as a way to fulfill the current need for social distancing while providing appropriate, continued care.

Join Dr. Tom Villanueva as he discusses telemedicine with a leading expert in the field of virtual health. They’ll cover how the COVID-19 crisis has prompted greater efforts in this field to provide the care patients need.

 

Guest speaker:
Chris Pagano, MBA
Senior Director
Virtual Health
Sg2

Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient

 

Show Notes:

[01:49] Acceleration at an unprecedented rate

[02:11] Fighting COVID-19

[02:35] Key policy changes affecting virtual health

[05:24] Areas of focus for health care organizations

[09:57] Challenges for virtual health

[13:20] The new normal

 

Links | Resources

COVID-19 – Using 21st century tools to triage, test and treat (Providence Telehealth): Click here

Coronavirus COVID-19: Telehealth and Virtual Care: Click here

Sg2 crisis page: Click here

COVID-19 will accelerate the age of virtual medicine: Click here

List of payable telehealth services: Click here

Mobile Health and Telemedicine (JAMA page with ongoing updates on telemedicine): Click here

 

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During the COVID-19 crisis, emergency departments are having to grapple with disruptions in patient flow and with shortages and other challenges that are only expected to increase as coronavirus cases surge.

On this episode of Modern Practice, a leading expert in emergency department throughput discusses with Dr. Tom Villanueva how health care organizations can address the new demands they face in this crisis.

 

Guest speaker:

Martin Lucenti, MD, PhD

Senior Vice President and Chief Medical Officer

Solution Architecture

Vizient

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Show Notes:

[01:19] Effect of the COVID-19 crisis on EDs

[01:40] Reduction in ER visits

[02:54] Preparing for the surge—disaster management

[05:42] Examples: New York and Washington

[07:56] ER throughput

[08:41] Example of combat hospital

[09:39] Yale and PPE

[11:33] Providence’s Clinical Disaster Planning Framework

[17:10] Cross-training

[19:06] Regulatory issues

[20:33] Telehealth and the ER

 

Links | Resources

Clinical Disaster Planning Framework: Click here

Yale New Haven Health PPE Strategy: Click here

University Health System: Emergency teams prepare for a surge in patients: Click here

CDC: Steps Healthcare Facilities Can Take: Click here

COVID updates—American College of Emergency Physicians: Click here

 

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Of the many challenges spawned by COVID-19, the demand on resources has hit health care organizations the hardest, obliterating their staffing models as cases have surged. Predicting that demand is of paramount importance. On this episode, two experts from Sg2 describe the features and capabilities of a new modeling approach that can revolutionize how health care organizations plan for surge capacity during this coronavirus crisis.

 

Guest speakers:

Madeline McDowell, MD, FAAP

Practicing pediatrician

Principal and Medical Director

Quality and Strategy

Sg2

 

Meghan Robb

Vice President, Product Management

Sg2

 

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Links | Resources

To download the Surge Demand Calculator: Click here

Sg2 crisis page: Click here

CDC surge planning page: Click here

Cleveland COVID-19 surge plan creates 10,000 new beds: Click here

Emergency department strategic planning: Click here

 

Show Notes:

[01:32] The necessity of predictive models during the COVID-19 surge

[03:46] Features of the SG2 Surge Demand Calculator

[06:10] Insights gained

[11:03] Methodology

[13:37] Rates used in the model

[15:26] Inputs

[17:33] Outputs

[18:30] Feedback on the calculator

[20:00] Acquiring the tool (free of charge)

 

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COVID-19 cases have exploded, disrupting hospital staffing plans and stretching resources well beyond even emergency levels. With cases only expected to surge further, health care organizations need to find innovative ways to increase their staffing levels to meet the care needs of this crisis.

On this episode of Modern Practice, two leading experts in this field discuss with Dr. Tom Villanueva how expanding scope of practice for Advanced Practice Providers is proving to be an answer to staffing challenges.

 

Guest speakers:

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

Director, Nursing Programs/CAP2™

Vizient

 

Susan Cymbor, MD

Physician Accreditation Advisor

Vizient

 

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Associate Vice President

Clinical Resources

Vizient

 

Links | Resources

COVID-19 nurse practitioner policy and practice updates: Click here

APP licensure information state-by-state: Click here

CAP2™ website: Click here

Federal and state efforts to expand clinical workforce during COVID-19: Click here

Texas governor waiving regulations to expand health care workforce: Click here

Christen Hunt’s LinkedIn page: Click here

 

 

Show Notes:

[01:58] What the coronavirus is doing to hospital staffing levels

[03:03] Expanding scope of practice to alleviate these staffing challenges

[04:55] Crisis staffing

[06:36] Current efforts

[10:33] Permanence of changes to scope of practice

 

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Emerging strategies from the University of Utah and University of Wisconsin to combat COVID-19

 

On this episode of Modern Practice, we’ll hear from experts at two leading medical centers who discuss the use of investigational medications to treat patients infected with COVID-19, including the drugs chloroquine, hydroxychloroquine, remdesivir and others.

 

Guest speakers:

Emily Spivak, MD, MHS
Associate Professor of Medicine
Medical Director
Antimicrobial Stewardship Program
University of Utah Health
 
Lucas Schulz, PharmD, BCIDP
Clinical Coordinator
Infectious Diseases
UW Health

 

Moderators:

Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Lindsay Mayer, MSN
Senior Director
Programs, PI Collaboratives
Vizient

 

Show Notes:

[01:10] Overview of investigational agents

[01:50] Chloroquine/hydroxychloroquine

[05:10] Adding azithromycin to the treatment

[06:43] Pros and cons for chloroquine/hydroxychloroquine

[09:22] Lopinavir/ritonavir

[10:25] Remdesivir

[14:00] COVID-19 treatment guideline

[15:40] Further comments on azithromycin

[17:54] Supportive care is the only recommended care

 

For additional information on COVID-19 and how Vizient is supporting our members, visit vizientinc.com

 

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