Modern Practice Podcast

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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Enhancing appropriate hospital flow during a crisis: Telemedicine

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, MBASenior DirectorVirtual HealthSg2
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient
 
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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Enhancing appropriate hospital flow during a crisis: ED surge plans

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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Modeling surge demand for COVID-19

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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Expanding scope of practice for the COVID-19 surge

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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University of Utah's and University of Wisconsin's COVID-19 experience

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
 

University of Washington's COVID-19 experience

An update to the COVID-19 care plan at the University of Washington Medical Center
 
A leading expert from the University of Washington Medical Center returns to the Modern Practice podcast with an update on what his health system is doing to combat COVID-19 in the Seattle area. He describes his team’s efforts in testing for the coronavirus, what they are doing with elective surgical procedures, their protocols with solid-organ transplants and how they have established new child-care arrangements, web-based town halls and PPE strategies.
 
Guest speaker:
Christopher Kim, MD, MBA, SFHM
Associate Medical Director
Quality, Patient Safety and Clinical Efficiency
University of Washington Medical Center
 
Moderators:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
Lindsay Mayer, MSN Senior Director
Programs, PI Collaboratives
Vizient
 
Show Notes:
[01:16] First case on January 21.
[01:26] First death on February 29.
[01:45] Creation of protocols, guidelines and website.
[02:18] Reaching 3,000 tests per day.
[02:35] Establishing testing sites.
[03:05] Frightening escalation: by March 24 UW Medical Center experienced 1,280 cases and 94 deaths.
[04:09] Need to postpone elective surgeries.
[04:33] Emerging use of telehealth.
[05:15] Special protocols for solid-organ transplants.
[06:00] Establishing child care, networks of colleagues and web-based town halls for staff.
[08:15] Plan for the surge.
 
For additional information on COVID-19 and how Vizient is supporting our members, visit vizientinc.com
 

University of Nebraska's COVID-19 experience

Leading experts from the University of Nebraska describe their approach to COVID-19
 
As the COVID-19 pandemic has begun to spread to the furthest reaches of the globe, the University of Nebraska has been at the forefront of efforts to confront and contain the coronavirus. This episode of Modern Practice features the COVID team from the University of Nebraska, who will discuss how they have approached challenges around viral diagnosis and treatment, use of medications and innovative approaches they have taken with personal protective equipment (PPE).
 
Guest speakers:
Angela Hewlett, MD, MSAssociate ProfessorDivision of Infectious DiseasesMedical DirectorNebraska Biocontainment UnitUniversity of Nebraska Medical Center Mark E. Rupp, MDMedical DirectorInfection Control and EpidemiologyNebraska Medicine Frank Venuto, MAS, SHRM-SCPChief Human Capital OfficerNebraska Medicine Kelly Caverzagie, MDAssociate ProfessorInternal MedicineUniversity of Nebraska Medical Center Terry Micheels, RN, CICManagerInfection Control and EpidemiologyNebraska Medicine
 
Moderators:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
 
 
Lindsay Mayer, MSN Senior Director
Programs, PI Collaboratives
Vizient
 
Show Notes:
[01:39] Wide spectrum of disease
[02:51] Diagnosis and supportive care
[03:57] Investigational therapeutic agents
[05:08] Clinical and operational challenges
[06:50] Interim COVID-19 prevention and control recommendations
[08:55] Use and re-use of PPE
[13:38] Assuring a strong workforce: setting operational principles and goals
[17:36] Just-in-time training (JITT)
 
For additional information on COVID-19 and how Vizient is supporting our members, visit vizientinc.com
 

University of Chicago's COVID-19 experience

In this podcast, Dr. Thomas Spiegel from University of Chicago Medicine shares how COVID-19 is impacting their patients, health care workers and community.
Speaker:
Thomas Spiegel, MD, MS, BA, ED, Medical Director, University of Chicago Medicine

Miriam Hospital's COVID-19 experience

In this podcast, Dr. Dean Roye and Maria Ducharme of Miriam Hospital of the Lifespan system in Rhode Island, share their experiences on the front line of battling COVID-19.
Speakers:
Maria Ducharme, DPN, RN, Senior Vice President, Patient Care Services, and Chief Nursing Officer, Miriam Hospital
G. Dean Roye, M.D., FACS, Senior Vice President, Medical Affairs and Chief Medical Officer, Miriam Hospital