Modern Practice Podcast
Modern Practice is your curbside consult with top clinicians from around the country. This exciting podcast series features medical experts sharing their ideas and approaches for the latest strategic trends and clinical challenges. Brought to you by the Vizient Medical Leadership team.
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Episodes
Thursday Sep 10, 2020
Thursday Sep 10, 2020
Leaders in health care often confront the simple truth, “You can’t fix what you can’t measure.” In this episode, we explore the crucial need for a comprehensive, data-driven practice model and how to provide that across departments and disciplines. A data-driven model enables complex analysis of clinical practices to drive policy, refine best practices and deliver better outcomes for patients.
Guest speaker:
Lina Patel, MHA, FACHE
Associate Vice President
Product Strategy and Management
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:28] Leveraging the data
[03:02] The Clinical Practice Solutions Center
[03:47] Effect of the decrease and disruption of clinical procedures
[07:16] Virtual care
[09:20] Getting on solid ground
Links | Resources:
Clinical Practice Solutions Center—The Clinical Practice Solutions Center is a performance improvement solution focused on medical practices and developed in partnership with the Association of American Medical Colleges (AAMC) and Vizient. Find more information Click here
Using COVID-19 Learnings from Clinical Practice Solutions Center (CPSC) to Reimagine the System of Care Click here
Understanding the impact of big data on nursing knowledge (Nursing2020 Critical Care) Click here
It’s All about the Data in 2020 and Beyond Click here
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Thursday Sep 03, 2020
Thursday Sep 03, 2020
Due to a number of reasons—physician retirement, limited medical school and residency slots, fewer physicians in rural practices and a population that is aging and growing—the country is beginning to experience a shortage of physicians. This problem is only expected to balloon in the next decade. On this episode, we examine a number of potential remedies for the physician shortage, from greater efficiencies in practice to a reliance on the clinical team approach.
Guest speaker:
Michael Dill, MPA
Director, Workforce Studies
Association of American Medical Colleges
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:33] Steps to address the shortage (cont.)
[01:18] Evaluating the promise of virtual health
[04:49] Evaluating the role of Advanced Practice Providers
[05:50] Evaluating the role of clinical pharmacists
[06:26] Evaluating the role of hospitalists
[07:09] Improving efficiencies to offset the shortage: can it work?
[09:30] Addressing gender issues
[11:38] Addressing generational issues
[13:08] True magnitude of the physician shortage
[13:53] Addressing burnout
Links | Resources:
AAMC Study (2020) – “The Complexities of Physician Supply and Demand: Projections from 2018 to 2033” Click here
New AAMC Report Confirms Growing Physician Shortage Click here
15 things to know about the physician shortage Click here
Physician workforce in the United States of America: forecasting nationwide shortages Click here
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Thursday Aug 27, 2020
Thursday Aug 27, 2020
Currently, fewer and fewer physicians are available to handle a patient population that is surging, mostly due to aging and the conditions that accompany it. The COVID-19 crisis has only heightened the dilemma. A recent study from the Association of American Medical Colleges predicts a shortage of between 54,000 to 139,000 physicians by the year 2033. This episode examines the ramifications of the crisis and how we can address it going forward.
Guest speaker:
Michael Dill, MPA
Director, Workforce Studies
Association of American Medical Colleges
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:25] Summary of the AAMC workforce study and projections
[03:25] An aging physician pool and the effect of COVID-19
[05:09] The crisis in primary care and in small, rural practices
[07:41] A shortage of specialists and the needs of an aging population
[09:27] Diversity in the physician pool and barriers to access
[11:43] Addressing the shortage – three steps
Links | Resources:
AAMC Study (2020) – “The Complexities of Physician Supply and Demand: Projections from 2018 to 2033” Click here
New AAMC Report Confirms Growing Physician Shortage Click here
15 things to know about the physician shortage Click here
Physician workforce in the United States of America: forecasting nationwide shortages Click here
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Thursday Aug 20, 2020
Thursday Aug 20, 2020
Before the COVID-19 pandemic, a number of states were already expanding the scope of practice for Advanced Practice Providers (APPs). The pandemic only accelerated this expansion. On this episode, we continue our examination of what has happened to the role of APPs, discuss the potential benefits this poses for the future and focus on how to realize these benefits in clinical practice.
Guest speaker:
Christen Hunt, DNP, NP-C, CPNP-AC
Director, Nursing programs
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:29] Need for setting up communication patterns and an inclusive governance structure
[02:49] How to continue and propel the benefits of APP inclusion
[03:24] Three pillars to optimize the clinical workforce
[04:05] Taking a stronger look at workflow and improving it
[05:58] Prior authorizations example: who could do this task?
[06:48] Telemedicine opportunities
[07:40] Remote monitoring opportunities
[08:24] Greater access to patients
[09:30] “We’ve gotta change”
[09:54] Facing the challenges of the future
Links | Resources:
Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic Click here
COVID-19 State Emergency Response: Temporarily Suspended and Waived Practice Agreement Requirements Click here
Flattening the Provider Curve: Temporary COVID-19 Measures Expanding Scopes of Practice and Lessons from the Past Click here
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Thursday Aug 13, 2020
Thursday Aug 13, 2020
As health care organizations recover from the first months of the COVID-19 pandemic, they face the unmistakable fact their world has changed. Innovative approaches they have used to stretch resources and increase staffing are now seemingly ingrained in the system. In this session, we examine the changes that have occurred in the role of Advanced Practice Providers (APPs) and the lessons learned so far from those changes.
Guest speaker:
Christen Hunt, DNP, NP-C, CPNP-AC
Director, Nursing programs
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:07] The most successful emerging care model
[03:16] Elements of a team culture
[06:03] Importance of communication
[07:02] Productivity: APPs vs. physicians
[08:55] Effect on patient access
[09:28] Compensation
Links | Resources:
Is It Fair? How To Approach Professional Scope-Of-Practice Policy After The COVID-19 Pandemic Click here
COVID-19 State Emergency Response: Temporarily Suspended and Waived Practice Agreement Requirements Click here
Flattening the Provider Curve: Temporary COVID-19 Measures Expanding Scopes of Practice and Lessons from the Past Click here
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Tuesday Jul 28, 2020
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
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
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
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
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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