Modern Practice Podcast

The impact of COVID-19 on health care: Lessons learned—Part 1

COVID-19 has wrecked havoc on health care at all levels, from the bedside to the supply room. It has adversely affected patients and clinicians alike and stretched resources to the breaking point. Yet, lessons from the pandemic are emerging, and this two-part series examines in-depth what clinicians and health care organizations can take away from this crisis.
 
Guest speaker:David DiLoreto, MD, MBAConsulting PrincipalSg2
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice President, Clinical ResourcesVizient
 
Show Notes:[01:15] Main lessons learned[03:06] Clinical-supply chain integration[04:55] Working at top of license[06:14] Changing roles[08:23] Explosion of virtual care
 
Resources:Vizient COVID-19 webinar page, including May 27 webinar “Roundtable discussion: moving forward through lessons learned during COVID-19”: click hereVizient’s disaster-preparedness site: click hereSg2 Perspectives: A new podcast connecting you to Sg2 thought leadership … anytime, anywhere: click here“The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention” (JAMA Internal Medicine): click here“After COVID-19—Thinking Differently About Running the Health Care System” (JAMA Network—JAMA Health Forum): click here“Life after COVID-19: What Will Change?” (The Medical Futurist): click here
 
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Lessons learned in pharmacology

Welcome to Modern Practice. This episode will focus on the effect of the COVID-19 crisis on pharmacy practice, which has magnified challenges already existing and caused new ones. We’ll look at lessons learned and consider strategies for the future.
 
Guest speaker:
Steven Lucio, PharmDVice PresidentPharmacy Solutions Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
Show Notes:
[01:08] Main pharmacy areas of focus
[02:43] Working together
[03:08] Repurposing legacy drugs
[04:44] Continuing to deal with drug shortages
[07:01] Changed FDA regulations
[08:54] Virtual care
[09:55] The new norm
[11:10] Dealing with a secondary surge
[12:56] What to do right now
 
Links | Resources:
Essential medications and managing drug shortages: Click here
Vizient’s disaster-preparedness site: Click here
Pharmacy Readiness for COVID-19: Click here
6 federal pharmacy policy changes in response to the COVID-19 pandemic: Click here
Pharmacy Technicians Rise to Meet Patient Needs During Coronavirus Pandemic: Click here
 
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The role of Patient and Family Councils (PFACs) in resuming elective procedures

This episode features the voices of patients and family members who share their feelings about safely resuming elective procedures. We’ll examine the role those attitudes play in the strategy of health care organizations to ramp up surgeries in the COVID-19 era.
 
Guest speakers:
Kellie Goodson, MS, CPXP
Director, Programs
Vizient
 
Mark Larson, MBA
Vice President
Sg2
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Special thanks to these patient and family participants (and their organizations):
Katherine Nyholm – Beth Israel Deaconess
Ronnie Freeman – INTEGRIS
Paula Boffa-Taylor – Temple Health
Marcia Johnson – INTEGRIS
Sue Drontle – CentraCare
Diane Whitman – Emory Healthcare
Anissa Chadick – INTEGRIS
Helen Miyasaki – UF Health
Katie Alyea – Reid Health
Rachel Weissburg – Sutter Health
Frank Chatmon – INTEGRIS
Kelly Loyd – The Medical University of South Carolina
 
Show Notes:
[00:00] Patients voice their concerns
[02:40] PFAC definition and role
[04:50] Care strategies with patients in mind
[07:12] Survey: what patients are saying about elective surgeries
[08:08] More patient comments
[12:20] Four waves
[14:50] Personas
[17:40] Importance of engaging patient and family advisors when reopening services
[21:42] More patient comments
[24:01] Physician communication with patients
 
Links | Resources:
Connecting with patients during COVID-19: Click here
Key talking points from patient and family advisor webinar (May 1, 2020): Click here
Restarting elective surgery in the COVID-19 era (Dr. Joe Geskey, Medical Economics): Click here
Vizient’s Guidance for Resumption and Management of Electively Scheduled Surgery and Procedures in the COVID-19 Era (White Paper): Click here
Patient and family engagement at UCLA (PowerPoint): Click here
Vanderbilt Patient and Family Involvement: Click here
 
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Guidance for resumption and management of electively scheduled surgery and procedures (ESS) in the COVID-19 era

During this pandemic, we’ve have had to suspend almost all elective procedures. This has negatively impacted patients needing or desiring those procedures, organizations depending on those procedures for revenue and clinical staff who have suffered pay cuts due to fewer work hours available.
On this episode, we’ll discuss steps and considerations organizations should make to resume elective procedures effectively and safely.
 
Guest speaker:
Jay B. Prystowsky, MD, MHPE, MBA
Principal, Solution Architecture
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[01:53] Vizient/Sg2 approach to resuming elective procedures
[03:50] Strong and expanded governance
[09:21] Testing, surveillance and screening
[14:55] Clinical prioritization
[17:36] The perioperative process
 
Links | Resources:
Vizient/Sg2 Guidance for Resumption and Management of Electively Scheduled Surgery and Procedures in the COVID-19 Era (White Paper): Click here
Restarting elective surgery in the COVID-19 era (Dr. Joe Geskey, Medical Economics): Click here
Ten Considerations for Resuming Elective Surgery: Click here
State Guidance on Elective Surgeries: Click here
Vizient’s clinical workforce well-being playbook: Click here
 
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Electively scheduled surgeries and procedures (ESS) in the COVID-19 era: patient engagement needed

As health care organizations adjust to the vagaries of the COVID-19 pandemic, and the new normal it represents, they are beginning to consider resuming elective surgeries. Winning back patient confidence is a key to this process. This episode focuses on engaging patients when resuming electively scheduled surgeries and procedures.
 
Guest speaker:
Joseph Geskey, DO, MBA, MS-PopH
Principal
Data Science and Member Insights
Vizient
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Show Notes:
[01:03] Looking at resuming elective procedures
[02:28] Importance of gaining or re-gaining patient trust
[03:43] Resuming elective procedures effectively and safely
[06:22] Communicating the limitations of testing and surveillance
[09:47] Techniques for effective communication with patients
[11:25] Shared decision-making (SDM)
[09:42] Factors to consider when communicating with patients and families
[17:32] Patient and Family Advisory Councils (PFACs)
 
Links | Resources:
Vizient’s Guidance for Resumption and Management of Electively Scheduled Surgery and Procedures in the COVID-19 Era (White Paper): Click here
Restarting elective surgery in the COVID-19 era (Dr. Joe Geskey, Medical Economics): Click here
Ten Considerations for Resuming Elective Surgery: Click here
State Guidance on Elective Surgeries: Click here
Vizient’s clinical workforce well-being playbook: Click here
 
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Clinical workforce wellbeing: leading through COVID-19 and beyond

Returning to normal in the era of COVID-19 may not be possible. Instead, we are likely heading toward a new normal, the disease having taken a huge toll on our lives and forcing a changed approach to health care. For caregivers, the toll has been devastating. Some clinicians have faced an overwhelming surge of coronavirus patients while others a dropping census and corresponding drop of hours and pay. Reports of caregiver PTSD are on the rise, and this episode will cover ways health care leaders can support their caregivers in this challenging time.
 
Guest speaker:Robert Dean, DO, MBASenior Vice PresidentPerformance Management Vizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
Show Notes:
[02:00] Impact of COVID-19 on clinician workforce
[03:37] How leadership matters
[05:15] Four keys to establish a favorable environment
[07:30] Effects of quality of leadership
[08:48] Vizient’s clinical workforce wellbeing playbook
[10:53] What clinical staff members need most right now
[12:27] “Compassionate leadership”
[16:33] Investing in the engagement, resilience and retention of clinicians
 
Links | Resources:
Caring for our caregivers during COVID-19: Click here
Outbreaks can be stressful: Click here
Vizient’s clinical workforce well-being playbook: Click here
Addressing staff resilience and PTSD during COVID-19 (PowerPoint—including presentation from Steve Swenson of Mayo Clinic): Click here
Vizient’s disaster preparedness page: Click here
 
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Considerations for discharging patients from hospitals and SNFs

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, CPHMSenior Principal, Operational EffectivenessAdvisory SolutionsVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
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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Expanded waivers and their impact on increasing scope of practice

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-ACDirector, Nursing Programs/CAP2™ Vizient
Susan Cymbor, MDPhysician Accreditation AdvisorVizient
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
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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Forecasting the operational and financial impacts of COVID-19

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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Accessing federal funds through the CARES Act

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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