Modern Practice Podcast

2020-07

Episodes

Tuesday Jul 28, 2020

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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Tuesday Jul 28, 2020

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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Thursday Jul 23, 2020

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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Thursday Jul 16, 2020

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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Thursday Jul 09, 2020

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:Kellie Goodson, MS, CPXPDirector, ProgramsVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
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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Thursday Jul 02, 2020

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:Kellie Goodson, MS, CPXPDirector, ProgramsVizient
 Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice President, Clinical ResourcesVizient
Show Notes:[02:04] Social determinants of health (SDoH) defined[03:01] SDoH and health care[04:59] VCU study on neighborhood and life expectancy[06:25] COVID-19 and SDoH[08:04] Historical context—“The Forgotten Aim”
Links | Resources:
Health care disparities in the age of coronavirus (The Harvard Gazette)Click here
Rush Health Equity ReportClick here
Novant Health SpotlightClick 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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