Modern Practice Podcast: Recent Episodes
Dr. Tom Villanueva and Vizient Medical Leadership Team
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. Hosted by Dr. Tom Villanueva and brought to you by the Vizient Medical Leadership team.
This episode of our award-winning podcast concludes our discussion on a new approach for medical groups in this time of drastic change. Only those models undergoing change will succeed.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal, Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:11] Academic medical centers and the need for innovation
[02:46] Meeting the physician shortage challenge
[04:51] Resistance to a new care model
[06:23] Reimbursement, technology and consumer desires will drive the new model
[07:06] The physician compensation factor in the new model
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here
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All the drastic changes occurring in healthcare, particularly in the way it is delivered, necessitate corresponding changes in how we structure medical groups. This episode of our award-winning podcast continues the discussion on the need for a new strategy for medical groups, and an expert returns to consider what that strategy might be.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal, Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:11] Academic medical centers and the need for innovation
[02:46] Meeting the physician shortage challenge
[04:51] Resistance to a new care model
[06:23] Reimbursement, technology and consumer desires will drive the new model
[07:06] The physician compensation factor in the new model
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here
Subscribe Today!
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The huge flurry of changes in how we deliver healthcare have brought into question the viability of the conventional medical group model, whether it’s sustainable and gives us a competitive advantage or whether we need to invest in something else. On the next three episodes of this award-winning podcast, an expert joins Tomas to consider the future of medical group practices.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal, Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:46] Current medical group model
[02:58] Impact and role of medical groups
[04:12] Drawbacks and limitations of current model
[06:13] Different care and practice models emerging
[07:49] The disruptors have been fantastic
[09:47] Different approach for medical groups affiliated with academic medical centers
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here
Subscribe Today!
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On this final episode of a three-part series, Tomas finishes his discussion with two experts on high-reliability organizations who examine the crucial role of learning areas in the success of top performers. High-performing organizations take care of not only their patients but their staff and indeed enable staff to be at their best.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:54] Need for change-ready units in the organization
[01:32] Overcome the perception “this is one more thing”
[03:17] Example: skeptical ICU nurse – “This is going to fail”
[04:56] Taking a phased approach
[05:37] Measuring success of learning areas: the benchmarks to use
06:22] Excited staff members
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site: Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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On this episode, Tomas continues his discussion with two expert guests about learning areas and how they are proving effective and essential in developing high-reliability organizations.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:41] Who engages in learning areas?
[03:17] A flood of kudos in the ED – an example of lifting morale
[05:10] Team participation in barcode scanning – an example of improving compliance
[07:02] A resource for senior leaders
[07:55] A safety concern that, once identified, was quickly corrected
[08:44] Real-time nature of rounding and issue resolution
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site: Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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Learning areas have become an effective aspect of high-reliability organizations in healthcare. Employing floor or departmental huddles as the focal point for these learning areas, the experience of the huddles has been augmented and reinforced by bulletin boards and whiteboards. Even more effective is the newest wrinkle in the experience – LENS (Learning & Engagement System) boards, which are dynamic, digitally-based visual boards that can transmit messaging on a 24/7 basis in a designated learning area. On the next three episodes, Tomas discusses learning areas with two expert guests, who will share the rationale behind them and how to make them work for you.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[01:58] Developing and sustaining learning areas
[03:02] Elements employed in a learning area
[05:00] The cornerstone of high reliability
[06:07] The visual management role
[07:37] Advantages of the LENS board
[09:07] Selecting a unit to be a learning area
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site: Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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The healthcare workforce is in a state of crisis: shortages of healthcare workers, rampant burnout, schedules in flux and outbreaks of violence in the workplace. On this episode, Tomas continues his discussion with a leading expert on the healthcare workforce on steps organizations can take to alleviate this crisis.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guests:
Eric Burch, MBA, RN, FACHE
Executive Principal, Operations and Workforce Services
Vizient
Show Notes:
[00:32] Need for collecting and leveraging data
[02:12] Reflecting the community in recruiting and retention
[03:28] Addressing regulatory issues
[06:10] Unions
[07:06] Taking the pulse
[07:35] Expanding the pipeline
[09:23] Fostering wellness and resilience
[10:52] Short- and long-term strategies
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Eric’s email: eric.burch@vizientinc.com
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Before the Covid outbreak, the healthcare workforce was already in a state of crisis. Covid made it much worse. On this new series of our award-winning podcast, we examine the varied causes behind workforce challenges and shortages of nurses, physicians and other related disciplines. We’ll also explore steps we can take to alleviate this crisis. Joining is us a leading workforce expert to provide an overview.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guests:
Eric Burch, MBA, RN, FACHE
Executive Principal, Operations and Workforce Services
Vizient
Show Notes:
[01:21] The workforce issue and the pandemic
[02:04] Drivers of the crisis
[04:19] Changing the traditional model
[05:48] Potential technology role in alleviating the crisis
[08:47] Recruitment and retention approaches
[11:22] Leadership and retention
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Eric’s email: eric.burch@vizientinc.com
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On this episode, Dr. Tomas Villanueva and a leading clinical documentation expert finish their discussion on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike, and this episode will clear up what is needed to be successful in coding and documenting these procedures.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:31] Query opportunities and low-hanging fruit
[01:53] Blood loss and the whole clinical picture in querying
[02:50] Using that “magic word” can make a difference – coding to an MCC
[03:43] Other query opportunities
[10:36] When the documentation is wrong
[12:44] Reconciliation and feedback needed
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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On this episode, Dr. Tomas Villanueva continues his discussion with a leading clinical documentation expert on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:41] Rise in spinal surgeries
[01:23] Coding challenges and parameters
[01:53] Predicaments for coding and CDI specialists
[07:22] Common DRGs for spinal surgeries – the need to use the “magic words”
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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Spinal surgery represents a complex challenge for clinical documentation. Difficult to code and representing query situations that can be demanding, this is the area of focus for this episode of Modern Practice. Joining Dr. Tomas Villanueva is a leading expert returning to the podcast to talk about the challenges of spinal surgery documentation.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[01:26] Around 1.62 million procedures per year
[02:22] Procedures on the increase (2.4 times the level of 15 years ago)
[03:54] The most common spinal diagnoses
[05:15] Often not caught by primary care
[06:20 Less common reasons for spinal surgery
[07:09] Reasons for planned surgeries—often a last resort
[08:45] Risks for avoiding surgery
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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Years of medical school, residency and fellowships have proven to do little in teaching physicians how to care for themselves. Physician burnout is at an all-time high. On this episode, a physician who is a leading expert on physician stress discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[00:34] Physician suicide
[02:44] Need connection
[04:03] What organizations need to do
[06:20] A learned skill and resource
[06:37] Mental fitness
[08:20] The Marpe approach
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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This episode of our award-winning podcast continues the discussion on why mental fitness is so crucial for physicians and other clinicians today and yet is a concept that physicians still tend to avoid or downplay. Physician training and medical school have not helped. Join us for this gritty discussion.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[01:00] The in-box, EMR documentation and authorizations have only gotten worse
[01:40] If we don’t change, it’s all going to fall apart
[03:23] Examples from medical school and training—a lack of respect
[06:45] The EMR and the need for a 27-hour day
[08:05] Deficit of 40,000 primary care physicians by 2030 (AAMC)
[08:30] Emerging mental health issues and workplace violence
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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Though physicians spend years in medical school, residency and fellowships to learn how to care for patients, they spend little time learning how to care for themselves. Physician burnout, leading to physician turnover, is skyrocketing. On this episode, a physician who is a leading expert on physician stress, having gone through that stress herself, discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[01:10] Physician heal thyself? Not happening!
[02:35] Weakness means not being the best
[03:31] An ingrained culture of perfectionism
[04:20] The burnout crisis
[06:40] Physician types affected the most
[07:30] Bigger burden on specialists
[09:13] Overcoming – awareness is only 20% of progress
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
Subscribe Today!
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On this episode of our award-winning podcast, Dr. Tomas Villanueva concludes his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Rick May, MD
Senior Principal, Consulting Solutions
Vizient
Show Notes:
[00:38] The burden of reporting
[02:09] Surgical quality and outcomes – technical vs. medical
[03:41] A focus on the systems
[05:00] Systems changes and results
[05:42] Engaging the physicians
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s email: rick.may@vizientinc.com
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On this episode of our award-winning podcast, Dr. Tomas Villanueva continues his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Rick May, MD
Senior Principal
Consulting Solutions
Vizient
Show Notes:
[00:54] Importance clinical documentation
[02:40] Is it possible to eliminate all CLABSIs (or other infections)?
[04:40] Length of stay as quality metric
[05:10] Surgical complications and length of stay
[05:55] Length of stay and complication rates
[06:40] The most heavily weighted metric
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s email: rick.may@vizientinc.com
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Concerning quality measures in healthcare organizations, a common complaint is, “I've got so many people looking over my shoulder, pulling our data in, ranking me, rating me, everything else, and there is no way I can keep track of literally the hundreds of metrics for which we’re accountable.”
On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes back a leading quality expert to discuss how organizations can approach quality metrics today – what metrics to choose and how to apply them.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Rick May, MD
Senior Principal, Consulting Solutions
Vizient
Show Notes:
[01:49] Why measuring quality is crucial
[02:17] If you do quality well, financial success follows
[02:57] Quality attracts staff
[03:46] Has quality improved overall in healthcare?
[04:42] Choosing the right metrics – 500 metrics exist overall
[05:58] Mishmash in timing of measures – complex and “all over the map”
[08:03] Realistic rate of improvement (hint: it’s not 10%!)
[08:53] Impact of under-capturing documentation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s email: rick.may@vizientinc.com
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In this episode of the award-winning podcast Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, which drastically increases the rate of survival, and how improvements in CRC screening are giving patients better options.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Abdul Aziz Aadam, MD
Interventional Gastroenterologist
Director, Interventional Endoscopy
Medical Director, International Patient Services
Northwestern Medicine
Show Notes:
[01:11] Endoscopic submucosal dissection
[02:10] Prevalence of colorectal cancer
[02:38] Risk factors
[05:10] Reason for the need of early detection
[06:35] Challenges for screening
[07:56] Rise in younger patients
[09:11] Screening of the elderly
[09:54] Increasing screening rates
[11:09] Additional screening options
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Aadam’s email: abdul.aadam@northwestern.edu
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On this episode, we continue our discussion on preventing surgical smoke in the OR.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Rachel Medina, BSBA
Senior Category Manager
Surgical Services
Vizient
Show Notes:
[00:29] Regulation and legislation around surgical smoke
[03:04] Best practices
[04:09] Sustaining efforts on smoke prevention
[05:01] Technological advances in prevention
[06:15] Financial costs and learning curve – outweighed by benefits
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Medina’s email: rachel.medina@vizientinc.com
“As important as the air you breathe” (Vizient Tech Watch, p 38): Tech Watch Medical Device - Volume 2, 2022.pdf
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The daily smoke produced in an operating room is the equivalent of 27-30 cigarettes, and the OR staff breathes this in five days a week. When tools in the OR cut and cauterize human tissue, they generate a plume of smoke containing toxic chemicals, carcinogens, malignant cells and viruses. Surgical smoke can cause a host of conditions, anything from headaches and sore throat to lung disease and lung cancer. On this episode, a Vizient expert discusses the ramifications of surgical smoke and how to begin preventing it.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Rachel Medina, BSBA
Senior Category Manager
Surgical Services
Vizient
Show Notes:
[01:27] Surgical smoke: a byproduct of surgical procedures
[01:51] Health issues from surgical smoke
[02:15] Not considered seriously over the decades
[02:47] Lung disease in physicians and OR staff
[03:34] Financial implications
[04:47] Growing awareness and the role of AORN
[06:33] Toxic materials and the effects of smoke plumes in the OR
[08:30] Vizient platform developing on surgical smoke
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Medina’s email: rachel.medina@vizientinc.com
“As important as the air you breathe” (Vizient Tech Watch, p 38): Tech Watch Medical Device - Volume 2, 2022.pdf
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On this episode of our award-winning podcast, we finish our feature on an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system. We will discuss the phenomenal results of the initiative so far and what is planned for the near future at Sanford Health.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[00:39] Use of data in managing PSI reduction
[03:14] Results of a successful program
[04:05] Lessons learned
[08:15] Expanding and standardizing throughout the enterprise
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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On this episode of Modern Practice, we continue highlighting an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[01:06] Managing PSI notifications to staff – keeping it non-punitive
[03:46 Escalation process versus peer review – addressing practice variation
[05:12] Keys to achieving collaboration
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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This episode of our award-winning podcast continues the success story of how Sanford Health has reduced PSIs through a concerted, multifaceted effort throughout the organization. Tomas interviews members of the clinical team that guided the way.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[00:34] Surgeon’s perspective
[02:04 Role of nurse reviewer
[03:18] Necessities for success
[04:05] Importance of executive leadership; need to be non-punitive (the “gold nugget”)
[06:37] Reliable software and establishing the stop bill process
[08:15] Involving HIM, coding and the CDI team
[10:36] Engaging the clinical staff
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
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Developed by the Agency for Healthcare Research and Quality (AHRQ), Patient Safety Indicators, or PSIs, represent measurements of adverse events that enable healthcare organizations to gauge how they compare to others regarding patient safety. In addition, CMS looks at PSIs in scoring and penalizing organizations. In this series, Tomas talks with members of a clinical team that has seen great results in reducing PSIs throughout the organization.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[02:00] Patient Safety Indicators (PSIs) defined
[02:46] PSI-90 and individual PSIs
[03:43] Hospital Acquired Conditions Reduction Program (HACRP)
[05:06] Documentation and the “dotted line” to quality
[05:44] Benchmarking with the Vizient Clinical Data Base
[06:23] Focused objectives for the PSI reduction program
[07:34] Steps in building the program structure
[09:35] Addressing gaps in education – once clinicians know what to do, they don’t fail
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
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On this episode of our award-winning podcast, a leading expert in electrophysiology concludes our discussion on pulsed field ablation as the newest approach to treating atrial fibrillation.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Thomas Munger, MD
Chair, Heart Rhythm Division
Associate Professor of Medicine
Mayo Clinic
Show Notes:
[00:48] New energy source
[01:40] Current electroporation is more controlled
[06:30] Anticoagulation and pulse field ablation
[08:42] Be sure to work with colleagues when wanted to adopt PF ablation
[09:05] Exciting development in electrophysiology
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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On this episode of our award-winning podcast, a leading expert in electrophysiology explains the pathophysiology of atrial fibrillation and how therapies for it have evolved over the years, with pulsed field ablation emerging as the newest approach.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Thomas Munger, MD
Chair, Heart Rhythm Division
Associate Professor of Medicine
Mayo Clinic
Show Notes:
[00:50] Atrial fibrillation: pathophysiology and risk factors
[03:20] Treating rhythm and treating rate
[07:01] Efficacy of ablation and other treatments
[09:40] Pulse field ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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Atrial fibrillation ablation therapies have progressed from rather primitive approaches to improved treatments that have emerged in recent years. In this series of our award-winning podcast, we discuss the history of the practice of electrophysiology and improvements that field has experienced.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Thomas Munger, MD
Chair, Heart Rhythm Division
Associate Professor of Medicine
Mayo Clinic
Show Notes:
[01:06] History of electrophysiology
[01:55] Training to become an electrophysiologist
[02:44] Electrophysiology and the only organ that moves constantly
[04:22] Seizure of the heart
[05:22] The discipline of electrophysiology and evolving practice of ablation
[07:47) The types of ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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Simon Henley was on a video call with his manager when he suddenly disappeared from the screen. He had fallen to the floor with a cardiac arrest. Not to be confused with an acute myocardial infarction, cardiac arrest is usually fatal, requiring a defibrillator and immediate CPR to revive the patient. On this episode, Simon tells his harrowing story, one with a touch of the miraculous, in how he survived those crucial first minutes and embarked on the road to recovery.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Simon Henley, MBA, CMBB
Director, Global Market Growth
Defibrillator Solutions
Medtronic
Show Notes:
[00:51] Simon’s background
[01:25] An avid runner
[01:49] The call
[03:23] Every minute a cardiac arrest goes untreated drops survival rate by 10%
[04:23] No previous symptoms
[05:57] Rehabilitation
[06:55] Dealing with emotions and with recurring cardiac events
[10:19] Changed perspective
[11:12] No guarantees
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Simon’s email: simon.henley@medtronic.com
Sudden cardiac arrest: symptoms and causes (Mayo Clinic):
Click Here
Heart attack and cardiac arrest (American Heart Association):
Click Here
Cardiac care management (Medtronic):
Click Here
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This episode of our award-winning podcast concludes our discussion on a new approach for medical groups in this time of drastic change. Only those models undergoing change will succeed.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal
Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:09] Current state of medical groups
[03:12] Issues around the surgical practice model
[05:01] Sustainability of the group practice model
[06:35] Finding a medical group strategy
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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All the drastic changes occurring in healthcare, particularly in the way it is delivered, necessitate corresponding changes in how we structure medical groups. This episode of our award-winning podcast continues the discussion on the need for a new strategy for medical groups, and an expert returns to consider what that strategy might be.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal
Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:11] Academic medical centers and the need for innovation
[02:46] Meeting the physician shortage challenge
[04:51] Resistance to a new care model
[06:23] Reimbursement, technology and consumer desires will drive the new model
[07:06] The physician compensation factor in the new model
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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The huge flurry of changes in how we deliver healthcare have brought into question the viability of the conventional medical group model, whether it’s sustainable and gives us a competitive advantage or whether we need to invest in something else. On the next three episodes of this award-winning podcast, an expert joins Tomas to consider the future of medical group practices.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Michael Strilesky
Senior Principal
Care Delivery Transformation
Strategy Consulting
Vizient
Show Notes:
[01:46] Current medical group model
[02:58] Impact and role of medical groups
[04:12] Drawbacks and limitations of current model
[06:13] Different care and practice models emerging
[07:49] The disruptors have been fantastic
[09:47] Different approach for medical groups affiliated with academic medical centers
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Michael Strilesky’s email: michael.strilesky@vizientinc.com
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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In this re-air of our two-part, award-winning podcast series, we discuss how physical violence in the healthcare workplace is on the rise. Healthcare workers are more in danger of violence than are police officers or prison guards. Looking at the labor force in general, healthcare workers have five times the likelihood of facing violence than workers across all other industries. And that doesn’t include the verbal abuse. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. On this episode, Tomas and Cecilia finish their discussion with some helpful tips.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[01:10] Influences and attitudes from culture/media
[02:45] The pandemic factor; example from CoxHealth
[04:45] Prevalence of incivility
[06:23] Paying attention to the signs; observation skills to use; actions to take
[09:30] Give the situation the same importance that patients and families give it
[10:16] Tools clinicians can use – Marpe’s role in alleviating violence
[12:05] A symptom of the healthcare crisis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
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Hermes award-winner!
In a special re-air of this award-winning episode, we discuss how the hospital is increasingly becoming a hostile environment, with clinicians facing verbal abuse and physical violence from patients and their families. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. If calming hostilities is not possible, they need to know what to do in the face of violent confrontation. Tomas discusses patient hostility with a leading expert on the topic.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[02:15] Patient hostility on the rise
[03:16] Verbal violence is most prevalent, and the most unreported
[04:05] Cleveland Clinic: violence four times more prevalent in health care
[04:40] Health care workers more exposed than prison guards and police officers
[05:12] Higher risk of assaults for nurses
[05:59] Biggest risk in high-acuity settings – ambulances, EDs, ICUs, psych units
[06:44] Reasons/origins
[09:25] Patient families as source of conflict
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
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This episode of our award-winning podcast finishes our discussion on the state of research today. Despite proven benefits, enrollment in clinical trials is sparse across the country, but participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guests:
Dylan Steen, MD, MS
Chief Executive Officer and Co-founder
High Enroll
Cardiologist, UC Health
Adjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmD
Medical Director, Oncology Research
Hematologist/Oncologist
St. Elizabeth Healthcare
Show Notes:
[01:32] Market research at St. Elizabeth Healthcare
[02:58] Benefits and advantages of clinical research to practices and organizations
[04:50] Background for High Enroll and the program’s value: opportunities offered
[06:20] Getting High Enroll started
[08:39] Vision for research at St. Elizabeth Healthcare – approaching a cure
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Steen’s email: steendy@gmail.com
Dr. Flora’s email: daniel.flora@stelizabeth.com
High Enroll website: https://www.highenroll.org
(513) 993-0330
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Despite proven benefits, enrollment in clinical trials is sparse across the country. This episode of our award-winning podcast continues our discussion on the state of research today and how participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guests:
Dylan Steen, MD, MS
Chief Executive Officer and Co-founder
High Enroll
Cardiologist, UC Health
Adjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmD
Medical Director, Oncology Research
Hematologist/Oncologist
St. Elizabeth Healthcare
Show Notes:
[01:31] Lack of inclusivity in trials – need for “real-world” participants
[04:05] Research organizations give standard of care that is lacking elsewhere
[04:50] Background for High Enroll and the program’s value: opportunities offered
[07:40] Latest generation of technology and information availability
[08:20] Improvement over other research sites (such as clinicaltrials.gov)
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Steen’s email: steendy@gmail.com
Dr. Flora’s email: daniel.flora@stelizabeth.com
High Enroll website: https://www.highenroll.org
(513) 993-0330
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The truth is: patients enrolled in clinical trials fare better than patients who are not. Participating in research can be a boon to a practice or organization and its patients. Yet, enrollment in clinical trials is still sparse across the country and part of the reason is organizations don’t realize the value research can bring. On the next three episodes of this award-winning podcast, two experts in research lay out the benefits in participating in clinical trials.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guests:
Dylan Steen, MD, MS
Chief Executive Officer and Co-founder
High Enroll
Cardiologist, UC Health
Adjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmD
Medical Director, Oncology Research
Hematologist/Oncologist
St. Elizabeth Healthcare
Show Notes:
[02:16] Research marketing
[03:20] Background: how High Enroll got started
[04:05] Number one problem in research
[05:20] Problem is still unsolved
[07:07] Need for cancer research at community level
[08:18] Look at research as a valuable product for the organization/practice
[09:03] Moving medicine forward: the value of clinical trials to the patient
[09:52] How to boost research participants for an organization
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Steen’s email: steendy@gmail.com
Dr. Flora’s email: daniel.flora@stelizabeth.com
High Enroll website: https://www.highenroll.org
(513) 993-0330
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On this episode of our award-winning podcast, we continue discussing the impact and benefits of the latest generation of single-use endoscopes, which promise a revolutionary role in surgery.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Andrew Bruenderman, MHA
Category Manager
Surgical Services
Vizient
Show Notes:
[00:44] Circumstances calling for single-use scopes
[03:19] Financial considerations
[04:37] ROI possibilities
[06:05] Environmental impact
[07:17] Final thoughts to consider
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Andrew’s email: andrew.bruenderman@vizientinc.com
Vizient TechWatch article on single-use ureteroscopes:
Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf
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The latest generation of single-use endoscopes promises a revolutionary role in surgery. On this episode of our award-winning podcast, we discuss the impact and benefits of single-use ureteroscopes.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Performance Improvement Consulting
Vizient
Guest:
Andrew Bruenderman, MHA
Category Manager
Surgical Services
Vizient
Show Notes:
[01:48] Early models were lacking; new models are advanced and improved
[02:49] Cross-contamination and adverse events from multiuse scopes
[04:15] Safety approaches with single-use scopes
[05:21] Wave of the future?
[06:20] Shelf life of single-use ureteroscopes and associated efficiencies
[07:37] Problems with early models may cause reluctance to use later models
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Andrew’s email: andrew.bruenderman@vizientinc.com
Vizient TechWatch article on single-use ureteroscopes:
Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf
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On this episode, we finish the discussion about the challenges and issues involving documenting elective surgeries in order to improve care and maximize reimbursement.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:37] Anticoagulation – often overlooked in documentation
[01:30] PSI 9
[02:20] Thrombocytopenia
[03:57] Antiplatelets and elective surgeries
[05:56] Every PSI reported means money lost to the practice
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
“Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here
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This episode continues the series on challenges and issues involving correctly documenting elective surgeries. A leading expert provides practical guidance and considerations that enable you to be correct in documenting these patients in order to improve care and maximize reimbursement.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:34] Dealing with preoperative infections
[01:56] Percentage of elective surgery patients who develop sepsis—with 25% mortality
[03:45] Accurately coding to avoid a PSI 13 being charged to your practice/organization
[05:34] Do not miss a Present on Admission case
[07:30] Need for CDI specialists to collaborate with quality (the “dotted line”)
[08:50] Issues around PSI 7
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
“Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here
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Elective surgeries are on the rise again following a downswing during the COVID era. Yet, with this rise in these procedures, there are challenges and issues involving correctly documenting elective surgeries that practices and organizations need to consider and address. On this episode, a leading expert on clinical documentation covers this difficult area.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[01:21] Planned surgeries
[02:26] Five most common elective surgeries and who has them
[04:15] Why elective surgeries are unique
[05:44] What you need to document – examples
[09:13] Obesity and documentation—capturing a CC
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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A safe culture is a key factor in developing a highly reliable organization, or HRO, and ensuring a healthy workplace. It means fostering psychological safety in that culture. On this episode, we continue our discussion on psychological safety and a healthy workplace.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Kristina Kelada, PHR, CHRE, CHRS
Associate Principal, Reliability and Management Systems
Vizient
Elizabeth Mack, MD, MS
Principal, Reliability and Management Systems
Vizient
Show Notes:
[00:47] Psych safety and fostering recruitment and retention
[03:33] What to do to develop safety in the workplace
[04:35] Culture of safety and return on investment: what the data shows
[06:17] Bad culture: a “thief in the night”
[09:09] Design systems that make sense for patients and families
Links | Resources:
How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Mack’s email: elizabeth.mack@vizientinc.com
Kristina Kelada’s email: kristina.kelada@vizientinc.com
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A healthy culture is a key factor in developing a highly reliable organization, or HRO. For a culture to be healthy depends on the existence of psychological safety in that culture. In this new series of our award-winning podcast, we discuss how to develop a healthy workplace as we continue our examination of HROs and the practices that lead to them.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Kristina Kelada, PHR, CHRE, CHRS
Associate Principal, Reliability and Management Systems
Vizient
Elizabeth Mack, MD, MS
Principal, Reliability and Management Systems
Vizient
Show Notes:
[02:28] Importance of building a culture on trust and respect
[03:38] Psych safety defined
[05:30] It is dangerous when employees are quiet
[07:18] How to know you have psych safety in your practice
[09:19] What leaders can do
[10:14] We’re in healthcare, for goodness sakes!
Links | Resources:
How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Mack’s email: elizabeth.mack@vizientinc.com
Kristina Kelada’s email: kristina.kelada@vizientinc.com
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On this episode, we continue our discussion about the need to provide a transition for advanced practice providers (APPs – nurse practitioners, physician assistants) from the academic setting to clinical practice, similar to the residencies and fellowships provided to physicians. You’ll learn how this transition can be a huge benefit to your practice or organization.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Christen Hunt, DNP, FNP-C, CPNP-AC
Associate Vice President, Workforce Consulting
Vizient
Show Notes:
[00:41] Fitting organizational needs – no cookie-cutter
[02:25] Provide a safe space; provide what the organization needs
[03:37] Not a burden but an opportunity
[04:42] Bringing APPs fully into the organization for greater productivity
[05:51] Example: ROI and a cost avoidance of over $2 million
[06:52] More ROI examples
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Christen Hunt’s email: christen.hunt@vizientinc.com
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Advanced Practice Providers, or APPs, have taken on an increasingly important role in patient care over the years. Comprised of nurse practitioners and physician assistants, APPs receive advanced education and clinical training for performing a wide range of care services, many of which were traditionally carried out by physicians. Yet, there are no residencies or fellowships to transition APPs from the academic to the clinical realm. On the next two episodes, this award-winning podcast examines how organizations and practices can address this gap.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guest:
Christen Hunt, DNP, FNP-C, CPNP-AC
Associate Vice President, Workforce Consulting
Vizient
Show Notes:
[02:02] Residencies and fellowships and what they mean for APPs
[04:41] APPs and orientation – need for a deeper dive
[05:13] Growth of APP positions and necessity for new care models
[06:44] Fostering the business side of healthcare
[07:14] Integrating APPs into the team
[08:13] Bringing APPs into the culture
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Christen Hunt’s email: christen.hunt@vizientinc.com
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On this final episode of a three-part series, Tomas finishes his discussion with two experts on high-reliability organizations who examine the crucial role of learning areas in the success of top performers. High-performing organizations take care of not only their patients but their staff and indeed enable staff to be at their best.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:54] Need for change-ready units in the organization
[01:32] Overcome the perception “this is one more thing”
[03:17] Example: skeptical ICU nurse – “This is going to fail”
[04:56] Taking a phased approach
[05:37] Measuring success of learning areas: the benchmarks to use
06:22] Excited staff members
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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On this episode, Tomas continues his discussion with two expert guests about learning areas and how they are proving effective and essential in developing high-reliability organizations.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:41] Who engages in learning areas?
[03:17] A flood of kudos in the ED – an example of lifting morale
[05:10] Team participation in barcode scanning – an example of improving compliance
[07:02] A resource for senior leaders
[07:55] A safety concern that, once identified, was quickly corrected
[08:44] Real-time nature of rounding and issue resolution
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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Learning areas have become an effective aspect of high-reliability organizations in healthcare. Employing floor or departmental huddles as the focal point for these learning areas, the experience of the huddles has been augmented and reinforced by bulletin boards and whiteboards. Even more effective is the newest wrinkle in the experience – LENS (Learning & Engagement System) boards, which are dynamic, digitally-based visual boards that can transmit messaging on a 24/7 basis in a designated learning area. On the next three episodes, Tomas discusses learning areas with two expert guests, who will share the rationale behind them and how to make them work for you.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Suzanne Miller, MSN, RN
Senior Consulting Director, Reliability and Management Systems
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[01:58] Developing and sustaining learning areas
[03:02] Elements employed in a learning area
[05:00] The cornerstone of high reliability
[06:07] The visual management role
[07:37] Advantages of the LENS board
[09:07] Selecting a unit to be a learning area
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: suzanne.miller@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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This episode finishes our discussion on how organizations can tackle persistent quality, safety and workplace challenges on the way to becoming high reliability organizations (HROs). Tomas engages with two expert guests on what constitutes an HRO and how to make that journey to better performance.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guests:
Allan Frankel, MD
Executive Principal, Safe and Reliable Healthcare
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:42] Dealing with burnout
[02:51] Culture and high reliability
[05:06] Assessing organizations
[08:25] Just Culture
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Allan’s email: allan.frankel@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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On this episode, we continue our discussion on how organizations can tackle persistent quality, safety and workplace challenges on the way to becoming high reliability organizations (HROs). Tomas discusses with two expert guests on what constitutes an HRO and how to make that journey to better performance.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guests:
Allan Frankel, MD
Executive Principal, Safe and Reliable Healthcare
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[00:46] Areas to address and challenges to meet
[01:52] Examples of challenges to high reliability
[03:47] Complex processes that can undermine reliability
[05:20] Sustaining improvement
[07:49] Vizient’s Safe and Reliable Healthcare: a force multiplier
[11:41] Burnout
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Allan’s email: allan.frankel@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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Reducing patient harm, team burnout and waste in healthcare requires organizations to tackle persistent quality, safety and workplace challenges. This work is what leads to becoming a high reliability organization (HRO). On the next three episodes, Tomas discusses with two expert guests on what constitutes an HRO and how to make that journey to better performance.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guests:
Allan Frankel, MD
Executive Principal, Safe and Reliable Healthcare
Vizient
Katerie Chapman, MHA
Senior Principal, Safe and Reliable Healthcare
Vizient
Show Notes:
[02:37] High reliability defined five key practices
[06:22] Origins of high reliability
[07:49] Combining complexity and human cognition
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Vizient Safe and Reliable Healthcare site Click here
Allan’s email: allan.frankel@vizientinc.com
Katerie’s email: katerie.chapman@vizientinc.com
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This episode of our award-winning podcast continues our examination of the complexities of cardiac surgery patients and the challenges in understanding them and in assessing and documenting their status.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:38] Cardiac complications post-op
[04:04] Renal issues
[06:11] Respiratory issues
[08:03] Transcatheter aortic valve replacement (TAVR) and heart failure
[11:15] Issues involving major comorbid conditions (MCCs)
[12:35] The biggest take-away
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
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On this episode, we continue our examination of cardiac surgery with its unique challenges and risks for patients, with a focus on accurate and thorough documentation of these procedures.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:31] Cardiac surgery patients: post-op and readmissions
[01:24] “Volume overload,” i.e., heart failure
[01:47] Five-day readmission stays!
[03:34] Story – cardiac patient on the move
[04:49] Common cardiac surgeries
[08:22] Vasopressors do not always indicate shock
[09:24] Encephalopathy and dementia
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
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Cardiac surgery poses unique challenges with its risks for patients, its potential complications and the difficulty in capturing the details in thorough documentation. On this episode, we discuss those challenges and how to approach them effectively.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:04] Uniqueness of cardiac surgery
[01:30] Cardiopulmonary bypass and extracorporeal circulation
[02:27] Postoperative issues
[05:08] Cardiac surgeons and documentation
[06:13] Intra-aortic balloon pumps and cardiogenic shock
[07:50] Cardiogenic acute renal failure
[08:31] Arrythmias and pacing
[09:10] The end of the road in intervention
[11:08] Document the reason for a patient’s deterioration
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
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The healthcare workforce is in a state of crisis: shortages of healthcare workers, rampant burnout, schedules in flux and outbreaks of violence in the workplace. On this episode, Tomas continues his discussion with a leading expert on the healthcare workforce on steps organizations can take to alleviate this crisis.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Eric Burch, MBA, RN, FACHE
Executive Principal
Operations and Workforce Services
Vizient
Show Notes:
[00:32] Need for collecting and leveraging data
[02:12] Reflecting the community in recruiting and retention
[03:28] Addressing regulatory issues
[06:10] Unions
[07:06] Taking the pulse
[07:35] Expanding the pipeline
[09:23] Fostering wellness and resilience
[10:52] Short- and long-term strategies
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Eric’s email: eric.burch@vizientinc.com
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Before the Covid outbreak, the healthcare workforce was already in a state of crisis. Covid made it much worse. On this new series of our award-winning podcast, we examine the varied causes behind workforce challenges and shortages of nurses, physicians and other related disciplines. We’ll also explore steps we can take to alleviate this crisis. Joining is us a leading workforce expert to provide an overview.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Eric Burch, MBA, RN, FACHE
Executive Principal
Operations and Workforce Services
Vizient
Show Notes:
[01:21] The workforce issue and the pandemic
[02:04] Drivers of the crisis
[04:19] Changing the traditional model
[05:48] Potential technology role in alleviating the crisis08:
[08:47] Recruitment and retention approaches
[11:22] Leadership and retention
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Eric’s email: eric.burch@vizientinc.com
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On this episode, Tomas continues examining an area often overlooked in documentation – chronic fatigue and debilities. Joining him is a leading expert on clinical documentation improvement. She will demonstrate how crucial this area is to reimbursement and patient care, affecting as it does mortality, length of stay and other indicators.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:37] Additional conditions in the Vizient variable
[04:57] Impact on direct costs
[05:46] SDOH Coding guidelines and subsequent reluctance to document
[04:50] Under-documented medical conditions and their ramifications
[09:08] Barriers to capturing this Vizient variable and use of queries
[11:10] How correct documentation can benefit patient care down the line
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
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An area often overlooked in documentation can be crucial to reimbursement and efficacious care, and that is the realm of chronic fatigue and debilities. Joining Tomas is a leading expert that will explain the importance of accurate coding for these patients..
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:07] Defining chronic fatigue and debilities
[02:27] G, R and Z codes
[03:19] Codes that capture Vizient variable for chronic fatigue and debilities
[04:50] Under-documented medical conditions and their ramifications
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
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This episode of our award-winning podcast continues an examination of the recent updates to the coding guidelines released by the Centers for Medicare and Medicaid Services (CMS). Knowing these guidelines is crucial to practices and healthcare organizations for accurate reporting and reimbursement. Two leading clinical documentation experts join Tomas in this critical discussion.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Sheila Bowlds, MBA
Associate Principal
Clinical Documentation Improvement
Vizient
Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIP
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:35] Increase to DRG relative weights and to reimbursement`
[02:54] Changes to coding guidelines
[05:37] Codes involving social determinants of health (SODH)
[07:06] Documenting SDOH
[08:48] Other changes
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila’s email: sheila.bowlds@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
ICD-10-CM Official Guidelines for Coding and Reporting: https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines.pdf
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Every year, the Centers for Medicare and Medicaid Services (CMS) makes revisions, additions and deletions to the coding guidelines that healthcare organizations and practices use for reporting, billing and reimbursement. The guidelines for 2024 include a number of new guidelines dealing with social determinants of health (SDOH) issues. It is crucial for practices to fully understand all the guideline updates for accurate reporting and maximized reimbursement. In the next two episodes, Tomas discusses the latest coding guidelines with two leading clinical documentation experts.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Sheila Bowlds, MBA
Associate Principal
Clinical Documentation Improvement
Vizient
Jim Tamburini, BS, RHIT, CCS, CSS-P, CDIP
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:39] Background and explanation of CMS coding updates
[03:19] When changes go into effect
[03:37] Impact on providers and hospitals
[04:42] Number of diagnosis and procedure codes added, deleted and revised
[06:48] Specificity drives the documentation
[07:26] Changes to complications/comorbidities (CCs) and Major complications/comorbidities (MCCs)
[11:58] Changes to DRGs and MS-DRGs
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila’s email: sheila.bowlds@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
ICD-10-CM Official Guidelines for Coding and Reporting: https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines.pdf
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On this episode of our award-winning podcast, we finish our feature on an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system. We will discuss the phenomenal results of the initiative so far and what is planned for the near future at Sanford Health.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[00:39] Use of data in managing PSI reduction
[03:14] Results of a successful program
[04:05] Lessons learned
[08:15] Expanding and standardizing throughout the enterprise
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
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On this episode of Modern Practice, we continue highlighting an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[01:06] Managing PSI notifications to staff – keeping it non-punitive
[03:46 Escalation process versus peer review – addressing practice variation
[05:12] Keys to achieving collaboration
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
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This episode of our award-winning podcast continues the success story of how Sanford Health has reduced PSIs through a concerted, multifaceted effort throughout the organization. Tomas interviews members of the clinical team that guided the way.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[00:34] Surgeon’s perspective
[02:04 Role of nurse reviewer
[03:18] Necessities for success
[04:05] Importance of executive leadership; need to be non-punitive (the “gold nugget”)
[06:37] Reliable software and establishing the stop bill process
[08:15] Involving HIM, coding and the CDI team
[10:36] Engaging the clinical staff
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
Subscribe Today!
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Developed by the Agency for Healthcare Research and Quality (AHRQ), Patient Safety Indicators, or PSIs, represent measurements of adverse events that enable healthcare organizations to gauge how they compare to others regarding patient safety. In addition, CMS looks at PSIs in scoring and penalizing organizations. In this series, Tomas talks with members of a clinical team that has seen great results in reducing PSIs throughout the organization.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Rachel Leyk, RN, CMSRN, CPHQ
Improvement Advisor
Quality and Safety – Fargo
Sanford Health
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Khaled Zreik, MD
Director, Critical Care
Acute Care Surgeon
Sanford Health
Show Notes:
[02:00] Patient Safety Indicators (PSIs) defined
[02:46] PSI-90 and individual PSIs
[03:43] Hospital Acquired Conditions Reduction Program (HACRP)
[05:06] Documentation and the “dotted line” to quality
[05:44] Benchmarking with the Vizient Clinical Data Base
[06:23] Focused objectives for the PSI reduction program
[07:34] Steps in building the program structure
[09:35] Addressing gaps in education – once clinicians know what to do, they don’t fail
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Leyk’s email: rachel.leyk@sanfordhealth.org
Dr. Mannuru’s email: devendranath.mannuru@sanfordhealth.org
Dr. Zreik’s email: khaled.zreik@sanfordhealth.org
PSI ACS Poster: PSI ACS Poster Final.pdf
2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx
Subscribe Today!
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Physical violence in the healthcare workplace is on the rise. Healthcare workers are more in danger of violence than are police officers or prison guards. Looking at the labor force in general, healthcare workers have five times the likelihood of facing violence than workers across all other industries. And that doesn’t include the verbal abuse. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. On this episode, Tomas and Cecilia finish their discussion with some helpful tips.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[00:39] Influences and attitudes from culture/media
[02:14] The pandemic factor; example from CoxHealth
[04:15] Prevalence of incivility
[05:53] Paying attention to the signs; observation skills to use; actions to take
[09:00] Give the situation the same importance that patients and families give it
[09:46] Tools clinicians can use – Marpe’s role in alleviating violence
[11:35] A symptom of the healthcare crisis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
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The hospital is increasingly becoming a hostile environment, with clinicians facing verbal abuse and physical violence from patients and their families. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. If calming hostilities is not possible, they need to know what to do in the face of violent confrontation. On this episode, Tomas discusses patient hostility with a leading expert on the topic.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Cecilia Cruz, MD, MPH, CPCC, ACC
Founder and Chief Executive Officer
Marpe, LLC
Board-certified emergency medicine physician
Former co-chair of Quality
Division of Emergency Medicine
NorthShore University HealthSystem
Show Notes:
[01:41] Patient hostility on the rise
[02:43] Verbal violence is most prevalent, and the most unreported
[03:19] Cleveland Clinic: violence four times more prevalent in health care
[04:08] Health care workers more exposed than prison guards and police officers
[04:39] Higher risk of assaults for nurses
[05:26] Biggest risk in high-acuity settings – ambulances, EDs, ICUs, psych units
[06:10] Reasons/origins
[08:52] Patient families as source of conflict
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page: Click here
MARPE, LLC website: Click here
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Screening for colorectal cancer (CRC) has seen a lot of innovations, but there is still the conventional gold standard. On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, and the options available to patients.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Abdul Aziz Aadam, MD
Interventional Gastroenterologist
Director, Interventional Endoscopy
Medical Director, International Patient Services
Northwestern Medicine
Show Notes:
[01:05] CRC screening options
[02:40] Colonoscopy advantages and disadvantages
[03:35] Virtual colonoscopies
[04:14] Artificial intelligence enhancement
[04:54] Improvements in the future
[07:10] No tests are foolproof
[07:50] Need to improve access
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Aadam’s email: abdul.aadam@northwestern.edu
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In this episode of the award-winning podcast Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, which drastically increases the rate of survival, and how improvements in CRC screening are giving patients better options.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Abdul Aziz Aadam, MD
Interventional Gastroenterologist
Director, Interventional Endoscopy
Medical Director, International Patient Services
Northwestern Medicine
Show Notes:
[01:11] Endoscopic submucosal dissection
[02:10] Prevalence of colorectal cancer
[02:38] Risk factors
[05:10] Reason for the need of early detection
[06:35] Challenges for screening
[07:56] Rise in younger patients
[09:11] Screening of the elderly
[09:54] Increasing screening rates
[11:09] Additional screening options
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Aadam’s email: abdul.aadam@northwestern.edu
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This episode of the award-winning podcast examines the importance of risk adjustment. Dr. Tomas Villanueva leads the discussion on the impact of this crucial aspect of documentation that can affect hospital outcomes.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Erica Braun, MS, RN, CCDS
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:29] Defining risk adjustment – maintaining an apples to apples comparison
[02:41] Capturing comorbid conditions to the highest level of specificity
[04:08] Capturing the low-hanging fruit
[05:47] Case mix index issues
[07:44] Severity of illness and risk of mortality
[08:52] Addressing query fatigue
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Erica Braun’s email: erica.braun@vizientinc.com
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On this episode, Dr. Tomas Villanueva and a leading clinical documentation expert finish their discussion on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike, and this episode will clear up what is needed to be successful in coding and documenting these procedures.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:31] Query opportunities and low-hanging fruit
[01:53] Blood loss and the whole clinical picture in querying
[02:50] Using that “magic word” can make a difference – coding to an MCC
[03:43] Other query opportunities
[10:36] When the documentation is wrong
[12:44] Reconciliation and feedback needed
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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On this episode, Dr. Tomas Villanueva continues his discussion with a leading clinical documentation expert on the need to correctly document everything involving spinal surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director Clinical Documentation Improvement Vizient
Show Notes:
[00:41] Rise in spinal surgeries
[01:23] Coding challenges and parameters
[01:53] Predicaments for coding and CDI specialists
[07:22] Common DRGs for spinal surgeries – the need to use the “magic words”
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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Spinal surgery represents a complex challenge for clinical documentation. Difficult to code and representing query situations that can be demanding, this is the area of focus for this episode of Modern Practice. Joining Dr. Tomas Villanueva is a leading expert returning to the podcast to talk about the challenges of spinal surgery documentation.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director Clinical Documentation Improvement Vizient
Show Notes:
[01:26] Around 1.62 million procedures per year
[02:22] Procedures on the increase (2.4 times the level of 15 years ago)
[03:54] The most common spinal diagnoses
[05:15] Often not caught by primary care
[06:20 Less common reasons for spinal surgery
[07:09] Reasons for planned surgeries—often a last resort
[08:45] Risks for avoiding surgery
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s email: rachel.mack@vizientinc.com
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In this episode, we continue our discussion about the value of diagnosing mental health and why it's important to make that diagnosis. Dr. Tomas Villanueva Welcomes back a leading expert who is well-versed in the documentation of mental health.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Connie Ryan, MBA, RN, CDIP
Consulting Director
Clinical Documentation Integrity
Vizient
Show Notes:
[01:14] Overcoming reluctance to diagnose mental health
[03:58] Mental well-being impacts physical well-being
[04:36] Chronic conditions, depression and mortality
[05:31] First steps in making mental health diagnosis a part of practice
[07:04 Don’t make assumptions about patient mental health
[08:31] Focus on education and keep lines of communication open with providers
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Connie Ryan’s email: connie.ryan@vizientinc.com
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In this episode, we discuss a topic that clinicians would rather avoid at times, diagnosing mental health. It can take clinicians out of their comfort zone and has little financial incentive. However, it's important to make that diagnosis when needed, and this podcast will examine why.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Connie Ryan, MBA, RN, CDIP
Consulting Director, Clinical Documentation Integrity
Vizient
Show Notes:
[01:14] No incentive
[02:39] Reasons beyond reimbursement to make a mental health diagnosis
[04:36] The value-based care angle
[05:02] Developing a plan: gathering data, prioritizing conditions, measuring
[06:13] Helping providers get comfortable; keep communication lines open
[07:31] Major depressive disorder: a starting point
[08:31] Monitor, evaluate, assess and treat
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Connie Ryan’s email: connie.ryan@vizientinc.com
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In this episode, we finish our three-part series updating therapeutic approaches in the field of electrophysiology. Joining us again is a leader in the field, who explains ablation therapies for atrial fibrillation, including the latest therapy to emerge: pulsed field ablation.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Thomas Munger, MD Chair, Heart Rhythm Division Associate Professor of Medicine Mayo Clinic
Show Notes:
[00:47] Recap of AF ablation
[02:08] Electroporation
[04:47] Research and specifications for pulsed field ablation
[06:33] Anticoagulation and pulsed field ablation
[07:41] Preparing for pulsed field ablation: staff readiness, pain, costs
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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On this episode of our award-winning podcast, a leading expert in electrophysiology explains the pathophysiology of atrial fibrillation and how therapies for it have evolved over the years, with pulsed field ablation emerging as the newest approach.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient Guest: Thomas Munger, MD Chair, Heart Rhythm Division Associate Professor of Medicine Mayo Clinic
Show Notes:
[00:50] Atrial fibrillation: pathophysiology and risk factors
[03:20] Treating rhythm and treating rate
[02:44] Electrophysiology and the only organ that moves constantly
[07:01] Efficacy of ablation and other treatments
[09:40] Pulsed field ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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Atrial fibrillation ablation therapies have progressed from rather primitive approaches to improved treatments that have emerged in recent years. In this series of our award-winning podcast, we discuss the history of the practice of electrophysiology and improvements that field has experienced.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Thomas Munger, MD Chair, Heart Rhythm Division Associate Professor of Medicine Mayo Clinic
Show Notes:
[01:06] History of electrophysiology
[01:55] Training to become an electrophysiologist
[02:44] Electrophysiology and the only organ that moves constantly
[04:22] Seizure of the heart
[05:22] The discipline of electrophysiology and evolving practice of ablation
[07:47) The types of ablation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Munger’s email: munger.thomas@mayo.edu
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Years of medical school, residency and fellowships have proven to do little in teaching physicians how to care for themselves. Physician burnout is at an all-time high. On this episode, a physician who is a leading expert on physician stress discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem
Show Notes:
[00:34] Physician suicide
[02:44] Need connection
[04:03] What organizations need to do
[06:20] A learned skill and resource
[06:37] Mental fitness
[08:20] The Marpe approach
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
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This episode of our award-winning podcast continues the discussion on why mental fitness is so crucial for physicians and other clinicians today and yet is a concept that physicians still tend to avoid or downplay. Physician training and medical school have not helped. Join us for this gritty discussion.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem
Show Notes:
[01:00] The in-box, EMR documentation and authorizations have only gotten worse
[01:40] If we don’t change, it’s all going to fall apart
[03:23] Examples from medical school and training—a lack of respect
[06:45] The EMR and the need for a 27-hour day
[08:05] Deficit of 40,000 primary care physicians by 2030 (AAMC)
[08:30] Emerging mental health issues and workplace violence
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
Though physicians spend years in medical school, residency and fellowships to learn how to care for patients, they spend little time learning how to care for themselves. Physician burnout, leading to physician turnover, is skyrocketing. On this episode, a physician who is a leading expert on physician stress, having gone through that stress herself, discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem
Show Notes:
[01:10] Physician heal thyself? Not happening!
[02:35] Weakness means not being the best
[03:31] An ingrained culture of perfectionism
[04:20] The burnout crisis
[06:40] Physician types affected the most
[07:30] Bigger burden on specialists
[09:13] Overcoming – awareness is only 20% of progress
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
Subscribe Today!
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Though physicians spend years in medical school, residency and fellowships to learn how to care for patients, they spend little time learning how to care for themselves. Physician burnout, leading to physician turnover, is skyrocketing. On this episode, a physician who is a leading expert on physician stress, having gone through that stress herself, discusses how to improve mental fitness in those who’ve given their lives to the care of others.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem
Show Notes:
[01:10] Physician heal thyself? Not happening!
[02:35] Weakness means not being the best
[03:31] An ingrained culture of perfectionism
[04:20] The burnout crisis
[06:40] Physician types affected the most
[07:30] Bigger burden on specialists
[09:13] Overcoming – awareness is only 20% of progress
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Cruz’s email: ceciliacruz@marpejourney.com
Dr Cruz’s Linkedin page:
Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website:
https://www.marpejourney.com/
Subscribe Today!
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This episode continues examining effective coding and documentation for sepsis cases and the impact accurate coding practices can have on clinicians and hospital operations. Paying attention to those who have sepsis present on admission (POA) is crucial to the process.
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Guest: Linda Wiseman, BSN, RN, CCDS Senior Consulting Director Clinical Documentation Improvement Vizient
Show Notes:
[00:50] Sepsis is one of the highest-denied DRGs; what documentation needs to include
[01:16] Coding guidelines to follow
[02:05] Is bacteremia sepsis?
[02:22] Present on admission (POA) – need to document even if sepsis only suspected
[03:51] Avoiding denials for sepsis
[04:58] Need to pay attention to “minimal” co-morbid conditions
[05:51] Sepsis due to graft or device
[07:12] Viral sepsis underdiagnosed
[08:37] Sepsis, expenses and fear of denial
[10:35] Need to link any organ involvement believed due to sepsis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
Subscribe Today!
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For decades, clinicians have known that effective intervention in sepsis cases relies universally on early diagnosis. Yet, despite this fact, sepsis remains a tough challenge. One in three patients dying in the hospital will have sepsis. Even more importantly for documentation, 87 percent of patients in the hospital with sepsis had it before admission. This episode examines ways to improve both diagnosis and documentation for sepsis patients in order to improve care and reduce the ill effects on clinicians and hospitals.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Linda Wiseman, BSN, RN, CCDS
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:16] Differing criteria
[01:48] Need to document early
[02:38] Two classifications
[03:10] SOFA/Sepsis-3
[03:36] SIRS criteria
[04:53] SOFA criteria
[06:13] What to document on admission
Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
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Simon Henley was on a video call with his manager when he suddenly disappeared from the screen. He had fallen to the floor with a cardiac arrest. Not to be confused with an acute myocardial infarction, cardiac arrest is usually fatal, requiring a defibrillator and immediate CPR to revive the patient. On this episode, Simon tells his harrowing story, one with a touch of the miraculous, in how he survived those crucial first minutes and embarked on the road to recovery.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Simon Henley, MBA, CMBB
Director, Global Market Growth
Defibrillator Solutions
Medtronic
Show Notes:
[00:34] Simon’s background
[01:08] An avid runner
[01:32] The call
[03:06] Every minute a cardiac arrest goes untreated drops survival rate by 10%
[04:06] No previous symptoms
[05:40] Rehabilitation
[06:38] Dealing with emotions and with recurring cardiac events
[10:02] Changed perspective
[10:55] No guarantees
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Simon’s email: simon.henley@medtronic.com
Sudden cardiac arrest: symptoms and causes (Mayo Clinic): Click here
Heart attack and cardiac arrest (American Heart Association): Click here
Cardiac care management (Medtronic): Click here
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On this episode, Tom completes his discussion with a physician leader whose team has developed a tool for an oncology floor that has improved communication among clinicians. Based on the SBAR approach (Situation – Background – Assessment – Recommendation), the tool has seen phenomenal results.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Show Notes:
[00:40] Challenges
[01:48] A clarification that improved participation
[02:18] Metrics of success
[04:25] Improving care means supporting the care delivery system rather than outcomes
[05:08] Expanding the model to the whole hospital
[06:00] With focus on quality, everything else falls into place
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dev’s email: mannuru.devendranath@sanfordhealth.org
Oncology Nursing SBAR – Final Copy (Sanford Hospital): Click here
Nursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click here
Interact and impact framework (Vizient presentation): Click here
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For the first time on this award-winning podcast, a faithful listener is sitting in the guest seat as he shares an exciting tool his team has developed to improve communication on an oncology floor. Join Tom as he continues his discussion with Dr. Dev Mannuru on this SBAR-based tool (Situation – Background – Assessment – Recommendation) that has produced phenomenal results.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Show Notes:
[00:55] Outcomes from the project – several metrics showing progress and success
[02:56] Effect on nursing turnover and morale
[04:10] Benefits of geographical/team rounding and use of tool
[04:51] Better questions asked during rounding – clarity for physicians and clinicians
[06:00] Whole team engaged
[07:28] Focus: length of stay vs team clarity
[08:58] Improved team approach to patient care
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dev’s email: mannuru.devendranath@sanfordhealth.org
Oncology Nursing SBAR – Final Copy (Sanford Hospital): Click here
Nursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click here
Interact and impact framework (Vizient presentation): Click here
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This episode features a physician who is a long-term listener to the podcast and developed an exciting process with his clinical colleagues. He joins the program to discuss the tool that has improved communication among staff and patients on the oncology floor.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
Show Notes:
[01:30] The Interact and Impact Project
[02:10] Rationale behind the initiative
[03:25] Gap analysis on the floor
[04:48] Assessment
[05:57] A unique tool
[06:44] Benefits of geographical rounding
[08:17] Engaging the team
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dev’s email: mannuru.devendranath@sanfordhealth.org
Oncology Nursing SBAR – Final Copy (Sanford Hospital): Click here
Nursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click here
Interact and impact framework (Vizient presentation): Click here
Subscribe Today!
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This edition of our award-winning podcast finishes the discussion on how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation. This can then improve patient care and reimbursement.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Amber Sterling, RN, BSN, CCDS
Senior Consultant
Clinical Documentation Improvement
Vizient
Show Notes:
[00:53] Copying and pasting – the need for editing
[03:40] Meaningful data as an effective motivator – measuring success
[08:06] Developing a relationship virtually versus onsite communication
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click Here
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On this episode, we continue examining how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation, which can then improve patient care and reimbursement.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Amber Sterling, RN, BSN, CCDS
Senior Consultant, Clinical Documentation Improvement
Vizient
Show Notes:
[00:42] Imprecise documentation and the need for partnership
[02:04] Communication about accurate DRG documentation
[02:36] Managing the utilization review process
[03:54] Outpatient documentation
[05:57] Breaking through silos with technology beyond in-boxes
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click here
Subscribe Today!
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Counteracting errors in clinical documentation can improve care for the patient and reimbursement for the health care organization by giving a true picture of the care offered. On this episode, we discuss how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Amber Sterling, RN, BSN, CCDS
Senior Consultant, Clinical Documentation Improvement
Vizient
Show Notes:
[01:31] Importance of working with other departments – silos have increased
[03:08] Working with the quality department
[04:23] Working with clinical teams
[05:53] Effect on revenue cycle
[06:48] Inadequate reimbursement and denial trends
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click here
Subscribe Today!
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This episode of our award-winning podcast continues examining the impact of risk adjustment models and methodologies. Knowing the models and their updates is crucial to full reimbursement for the patient’s care.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIP
Senior Consulting Director, Clinical Documentation Improvement and Coding
Vizient
Show Notes:
[00:47] Variables and POA
[03:03] Heart failure
[04:00] Changes in the COVID model and pediatric COVID model
[04:57] Document completely; MEAT (monitor, evaluate, assess, and treat)
[06:28] Clearly delineate POA conditions from conditions acquired after admission
[07:01] The Problem List
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
Vizient clinical documentation improvement site: Click here
Subscribe Today!
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This episode of our award-winning podcast examines the impact of risk adjustment models and methodologies. Knowing the models and their updates is crucial to full reimbursement for the patient’s care.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIP
Senior Consulting Director
Clinical Documentation Improvement and Coding
Vizient
Show Notes:
[00:58] The importance of risk models
[01:35] Reflecting how sick your patients are
[01:54] Variables and need for correct documentation
[02:43] Vizient methodology to help documentation
[03:19] Palliative care codes
[03:57] Present on Admission (POA)
[04:19] Obesity
[04:50] Malnutrition: average hospital patient only eats 1200 calories/day
[06:32] Cardiac device variables
[07:57] Oncology models
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim’s email: james.tamburini@vizientinc.com
Vizient clinical documentation improvement site:
https://www.vizientinc.com/what-we-do/operations-and-quality/clinical-documentation-improvement
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This episode of our award-winning podcast continues an examination of the CMS Star mortality rating, its significance and what clinical practices and organizations can do to improve their mortality scores.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Linda Wiseman, BSN, RN, CCDS
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[00:37] How to improve on mortality scores
[02:07] Risk adjusting and variable condition categories
[04:18] NIHSS scores (stroke)
[06:13] “Sludge” and the need to copy, paste and edit
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Fact sheet on CMS Stars Ratings:
10.6.22 FACT SHEET - 2023 Medicare Star Ratings.pdf
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This episode of our award-winning podcast begins a two-part series on the CMS Star Rating. The Centers for Medicare and Medicaid Services (CMS) provide the star rating system to evaluate health and drug services for the benefit of patients, enabling them to make informed care decisions. The next two episodes will examine the star mortality rating specifically, its significance and what clinical practices and organizations can do to improve their mortality ratings.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Linda Wiseman, BSN, RN, CCDS
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:30] CMS Star Ratings defined
[01:58] CMS Star mortality rating explained
[03:27] Mortality condition categories
[03:59] Exclusion criteria
[06:58] Non-compliance example with heart failure – how to code correctly
[07:55] Coding to the correct principal diagnosis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Fact sheet on CMS Stars Ratings:
10.6.22 FACT SHEET - 2023 Medicare Star Ratings.pdf
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On this episode of our award-winning podcast, Tom continues his discussion with two leading pharmacy experts on what medications and classes of medications are in expedited approval and what this means for patients in overall efficacy and safety, the benefits and the drawbacks.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guests:
Jeni Hayes, PharmD, MSPharm, BCPS
Senior Clinical Manager, Pharmacy Outcomes
Center for Pharmacy Practice Excellence
Vizient
Steven Lucio, PharmD, BCPS
Senior Principal, Pharmacy Solutions
Center for Pharmacy Practice Excellence
Vizient
Show Notes:
[00:44] Recap of approval pathways
[01:33] Examples of accelerated approval drugs and effect of delays
[03:59] Only 50 percent of accelerated approvals converted to full approval
[05:32] Challenge in keeping track of drugs in the process
[06:13] Huge cost of ineffective drugs that win approval
[07:02] Huge cost of developing drugs that end up not working
[09:55] Need for providers to look at evidence on approved drugs
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steven’s email: steven.lucio@vizientinc.com
Jeni’s email: jeni.hayes@vizientinc.com
FDA’s accelerated approval update page:
https://www.fda.gov/drugs/nda-and-bla-approvals/accelerated-approval-program
Vizient Pharmacy Market Highlights – Dec. 2022:
PMO322_PharmacyMarketOutlook_Highlights.pdf
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During the COVID pandemic, the vaccine approval process went from eight years to a few months. In addition, the FDA has used several expedited approval pathways, starting in the 1990s with HIV treatments and continuing today. On the next two episodes, Tom talks with two leading experts on these various approval pathways, what medications are on the approval fast track, and other considerations regarding expedited approval today.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guests:Jeni Hayes, PharmD, MSPharm, BCPSSenior Clinical Manager, Pharmacy OutcomesCenter for Pharmacy Practice ExcellenceVizient
Steven Lucio, PharmD, BCPSSenior Principal, Pharmacy SolutionsCenter for Pharmacy Practice ExcellenceVizient
Show Notes:
[01:32] Vaccine approval path before and after COVID
[02:59] Rationale for accelerated approval; reducing preapproval research
[05:14] Examples of expedited approval recently – reducing the eight-year duration
[07:32] Rundown of various approval routes
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steven’s email: steven.lucio@vizientinc.com
Jeni’s email: jeni.hayes@vizientinc.com
FDA’s accelerated approval update page:
https://www.fda.gov/drugs/nda-and-bla-approvals/accelerated-approval-program
Vizient Pharmacy Market Highlights – Dec. 2022:
PMO322_PharmacyMarketOutlook_Highlights.pdf
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On this episode of our award-winning podcast, we continue to examine the importance of social determinants of health (SDOH), the conditions in which patients are born and live. This discussion will provide ways organizations and practices can address SDOH and improve crucial patient outcomes.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient
Connie Ryan, MBA, RN, CDIPConsulting DirectorClinical Documentation ImprovementVizient
Show Notes:
[00:41] Barriers in capturing SDOH
[01:15] ICD-10 codes now include SDOH codes
[02:45] Z codes and payment
[03:35] Powerlessness
[04:25] Need to educate non-physicians on ICD-10 codes and SDOH
[05:35] At least 50 percent of inpatient clinical documentation may contain errors
[08:45] Clinical documentation in outpatient setting and assessment tools to use
[09:23] Role of Vizient in addressing SDOH
[12:10] Capturing SDOH in the future: how this can happen
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Connie’s email: connie.ryan@vizientinc.com
Advancing Health Equity website (Vizient):
https://www.vizientinc.com/what-we-do/health-equity
Vizient SDOH programs/podcasts:
https://knowledgeonthego.podbean.com/e/social-determinants-of-health/
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“In the long run, housing may be more important to health than hospitals.” This surprising quote points out the fact that only 20 percent of the nation’s health is the result of clinical care. Social determinants of health (SDOH), the conditions in which individuals are born and live, drive over 50 percent of a patient’s health. SDOH include circumstances such as socioeconomic status and physical environment. Addressing these factors improves crucial patient outcomes, and on this episode, we’ll discuss how documenting and reporting SDOH can help a clinical practice or organization address these factors.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guests:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient
Connie Ryan, MBA, RN, CDIPConsulting DirectorClinical Documentation ImprovementVizient
Show Notes:
[02:04] Inequities existing in health care
[02:55] Example of care inequity – a lack of specialized care due to location
[04:18] “In the long run, housing may be more important to health than hospitals.”
[04:35] Over 50 percent of the nation’s health due to SDOH
[05:23] A formal definition and how coding can make an impact
[07:00] Not a new concept
[08:05] Social inequities affect care inequities
[08:50] Need for clinical documentation integrity in addressing SDOH
[09:53] Mandates are coming
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel’s email: rachel.mack@vizientinc.com
Connie’s email: connie.ryan@vizientinc.com
Advancing Health Equity website (Vizient):
https://www.vizientinc.com/what-we-do/health-equity
Vizient SDOH programs/podcasts:
https://knowledgeonthego.podbean.com/e/social-determinants-of-health/
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This episode of the award-winning podcast continues examining major changes in E/M coding guidelines for this year. There are a number of key revisions and deletions that could impact your practice.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Sheila Bowlds, MBA
Senior Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:39] Emergency department E/M Codes
[01:44] Effects of changes in emergency department E/M Codes
[02:44] Impact of social determinants of health on E/M Codes
[03:14] Shared services
[04:34] Prolonged services codes
[05:04] Summary
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila’s email: sheila.bowlds@vizientinc.com
CPT E/M coding guideline changes in 2023 (AMA pdf): 2023-e-m-descriptors-guidelines.pdf
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For around a quarter of a century, E/M coding guidelines had few revisions, but that has all changed in the last couple of years. This year, E/M codes have a number of key revisions, with 25 deleted codes and many code changes in five categories. On this episode, we review key E/M coding changes important to you and your practice.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Sheila Bowlds, MBA
Senior Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[00:58] Professional fee E/M Codes
[01:30] Overview of changes involving E/M Codes in 2023
[02:00] Observation codes
[03:36] Rationale behind changes
[04:16] Potential results; focus on cognitive effort of provider
[05:33] Patients still in observation status
[05:47] Effect on consultation codes
[06:41] Simplification
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila’s email: sheila.bowlds@vizientinc.com
CPT E/M coding guideline changes in 2023 (AMA pdf): 2023-e-m-descriptors-guidelines.pdf
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Pharmacy Benefit Managers (PBMs) have emerged as a powerful player in healthcare today, and their role has brought value but also controversy. They have become a negative challenge for many provider practices Yet, there is a different approach that is more provider-friencly, and on this episode, we explore the approach of Alluma as an alternative to PBMs.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Priyesh Patel, PharmD, MBAVice President and General Manager, AllumaVizient
Show Notes:
[00:51] Role of PBMs: value and controversy
[02:53] Alluma: a different PBM approach
[05:33] PBMs and lagging rebates: a disconnect for health plans
[06:58] Best practice: a provider-led solution
[09:27] PBMs and thwarted access to preferred medications
[10:44] A limited PBM appeals process
[11:19] Alluma’s approach: working more closely with providers
[11:40] Addressing regional prescribing patterns
[15:20] The future: more government regulation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Priyesh Patel’s email: priyesh.patel@allumaco.com
“PBM Impact on Employers & Risk to Health Systems” (Alluma white paper):
https://www.allumaco.com/news/whitepaper-pbm-impact-on-employers-risk-to-health-systems
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As patients take on more of their medication costs through higher deductibles and coinsurance, Pharmacy Benefit Managers (PBMs) are becoming more and more crucial to the process. PBMs are key to determining the medications available to patients and what patients have to pay for them. Yet, there can be an alternative to PBMs, and on this episode, we explore how health care organizations can find alternative solutions for skyrocketing drug costs, solutions that are at the level of the individual patient and the provider and not at the macro level taken by PBMs.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Priyesh Patel, PharmD, MBAVice President and General Manager, AllumaVizient
Show Notes:
[01:07] Addressing skyrocketing drug costs – the Alluma solution
[02:04] Pharmacy Benefit Managers (PBMs)
[03:07] 75% of Vizient member organizations are self-employed insurers (8M lives)
[03:51] Health care workers are not healthy
[05:21] PBMs are not health providers – they manage lives at a macro level
[06:42] Working at a clinical level
[09:55] Complex issues around new, complex drugs
[11:21] Controversy around PBMs: the extravagant profits and the rebate issue
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Priyesh Patel’s email: priyesh.patel@allumaco.com
“PBM Impact on Employers & Risk to Health Systems” (Alluma white paper):
https://www.allumaco.com/news/whitepaper-pbm-impact-on-employers-risk-to-health-systems
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The past couple of years revealed issues that had to be faced and glaring needs that hac to be addressed. On this episode, Tom continues his review of the issues and challenges of the past year and what we can do to improve on them.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[00:23] Increase of addiction, suicides and accidental overdoses
[01:34] Addiction treatment needed
[02:30] Resilience revealed
[03:22] Doing more with less and using better documentation processes
[04:45] Community is essential
[05:09] If you don’t make time for your wellness, you’ll be forced to make time for your illness
[07:02] Be kind to one another and ourselves
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
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Nearly three years ago, COVID-19 struck and changed the healthcare landscape. It created issues but also pushed issues to the surface that needed to be addressed. On this episode, Tom recaps the issues and challenges of the past year and what we can do to face them and make improvements.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[00:54] The use of masks
[02:23] Vaccines
[03:37] Booster fatigue is common
[05:09] Be kind to yourself
[06:10] Not everyone is treated equally in healthcare
[07:47] Take mental health seriously – anxiety has nothing to do with character
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
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This final episode of a three-part series on clinical quality focuses on documentation and the impact correct documentation can make on improving care. Also featured is a discussion on what needs to happen in the future to improve quality.
Guest speakers:Angela Hunt, RN, MBA, CCDSPrincipalClinical DocumentationVizient
Rick May, MDSenior PrincipalClinical Quality ImprovementVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[00:38] Documentation requires critical thinking
[01:37] Providers and documentation
[05:25] What needs to happen in the next few years
Links | Resources:
Advance clinical operations and quality (Vizient)
Click Here
AHA Leadership Roundtable: The Future of Health Care Quality (Aug 3, 2022)
Click Here
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This episode continues a three-part series on clinical quality: why it is still elusive and what practices and organizations can do to overcome the massive challenges around quality improvement. This program focuses on those challenges but also the benefits in the drive toward quality in health care.
Guest speakers:
Angela Hunt, RN, MBA, CCDS
Principal, Clinical Documentation
Vizient
Rick May, MD
Senior Principal, Clinical Quality Improvement
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Show Notes:
[00:38] Issues affecting quality
[01:37] Documentation issues – not just finance
[02:55] Thinking differently – prime importance of quality, reduced patient days
[05:06] Other benefits
[06:11] Effect on private payers
[07:07] Workforce – a brewing catastrophe
Links | Resources:
Advance clinical operations and quality (Vizient) Click here
AHA Leadership Roundtable: The Future of Health Care Quality (Aug 3, 2022) Click here
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Angela Hunt: angela.hunt@vizientinc.com
To contact Dr. Rick May: rick.may@vizientinc.com
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Since the publication of “To Err Is Human” over 20 years ago, focus on healthcare quality has intensified. Yet, progress has been halting at best, with hospital-acquired conditions, medication errors, and many other issues still prevalent. This episode begins a three-part series on clinical quality: why it is still elusive and what are recommended actions that clinical practices and organizations can take to attain quality improvement.
Guest speakers:Angela Hunt, RN, MBA, CCDSPrincipal, Clinical DocumentationVizient
Rick May, MDSenior Principal, Clinical Quality ImprovementVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Show Notes:
[01:22] The status of clinical quality today
[02:49] The impact of the workforce shortage
[03:42] Areas of concern
[04:54] Process and training issues
[05:43] The impact of financial issues
[08:06] Clinical documentation issues
Links | Resources:
Advance clinical operations and quality (Vizient) Click Here
AHA Leadership Roundtable: The Future of Health Care Quality (Aug 3, 2022) Click Here
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Angela Hunt: angela.hunt@vizientinc.com
To contact Dr. Rick May: rick.may@vizientinc.com
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This episode of our award-winning podcast finishes the three-part series on the various drug shortages occurring today and what organizations and practices can do about them.
Guest speaker:Mittal Sutaria, PharmDSenior Vice PresidentContract and Program Services, PharmacyVizient
Steven Lucio, PharmD, BCPSSenior PrincipalPharmacy SolutionsVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[00:40] Challenges of dealing with China and the impact of COVID
[03:14] Partnerships to help providers deal with shortages
[07:12] Months of disruption
[07:40] Employing different sourcing strategies and building inventory
[08:38] Recommendations for next steps and a new alliance
[10:00] Need for enduring management to minimize shortages
Links | Resources:
“The one thing you need to know about drug shortage stewardship” (Vizient, Oct 25, 2022): Click Here
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Sutaria: mittal.sutaria@vizientinc.com
To contact Dr. Lucio: steven.lucio@vizientinc.com
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On this episode of our award-winning podcast, we continue our series on the various drug shortages occurring today and what organizations and practices can do about them.
Guest speaker:Mittal Sutaria, PharmDSenior Vice PresidentContract and Program Services, PharmacyVizient
Steven Lucio, PharmD, BCPSSenior PrincipalPharmacy SolutionsVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[00:33] Challenges dealing with shortages
[01:58] Using shortages as a care opportunity
[04:06] “Anticipatory purchasing”
[06:16] Problem knowing where drugs originate
[08:44] Originating drugs in the US and Europe: pros and cons
Links | Resources:
“The one thing you need to know about drug shortage stewardship” (Vizient, Oct 25, 2022): Click Here
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Sutaria: mittal.sutaria@vizientinc.com
To contact Dr. Lucio: steven.lucio@vizientinc.com
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For a long time, drug shortages have made a tremendous impact on clinical practice, but now, because of the pandemic and its aftermath, those shortages are acute. This new series will cover the various shortages that are occurring today and what we can do about them.
Guest speaker:Mittal Sutaria, PharmDSenior Vice PresidentContract and Program Services, PharmacyVizient
Steven Lucio, PharmD, BCPSSenior PrincipalPharmacy SolutionsVizient
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Show Notes:
[01:20] Shortages have expanded beyond drugs
[02:20] Shortages occurring today
[03:40] The “Swiss Cheese” approach to addressing shortages
[06:00] COVID
[07:02] Why recovery from shortages takes time
[07:56] Causes of shortages
Resources:
“The one thing you need to know about drug shortage stewardship” (Vizient, Oct 25, 2022): https://newsroom.vizientinc.com/en-US/releases/the-one-thing-you-need-to-know-about-drug-shortage-stewardship
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Sutaria: mittal.sutaria@vizientinc.com
To contact Dr. Lucio: steven.lucio@vizientinc.com
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After a short hiatus, by and large, during the COVID outbreak, influenza is returning, with severe outbreaks in South America and other areas. This episode updates this situation and examines the preventions and treatments best for combating the flu.
Guest speaker: Stacy Lauderdale, PharmD, BCPS Senior Director, Drug Information Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:53] The return of the flu
[01:44] Children and the immunity debt
[02:04] Flu vaccine choices
[04:50] Tamiflu and other flu treatments: indications, dosages, comparisons
[07:35] Tamiflu side effects
[08:05] When to use Tamiflu – treatment and prophylaxis
[09:40] Tamiflu, vaccines and pregnancy
[10:25] Contraindications
[11:33] Final thoughts: getting ready for flu season
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Lauderdale: stacy.lauderdale@vizientinc.com
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This episode concludes an examination of a new platform using artificial intelligence to identify patients at risk for a cardiac event. Two physician leaders discuss how this approach can support and revolutionize physician practice.
Guest speakers:
Sanjaya Gupta, MD, MBA
Cardiologist, Electrophysiologist
St. Luke’s Mid-America Heart Institute
Alan Cheng, MD, MBA
Chief Medical Officer, Cardiac Rhythm Management
Medtronic
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:35] Reaching the most vulnerable at-risk patients
[02:10] Using AI for heart failure patients and to keep track of medications
[03:06] Accessible data
[03:32] AI and triaging patients
[05:28] Return on investment
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Gupta: sgupta@saint-lukes.org.
To contact Dr. Cheng: alan.cheng@medtronic.com
Sudden cardiac arrest avoidance through collaboration and AI (aptitude release)
A case study: MDT SFH Mpirik Case Study
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On this episode of our award-winning podcast, two physician experts continue examining how artificial intelligence can identify patients at risk for a cardiac event.
Guest speakers: Sanjaya Gupta, MD, MBA Cardiologist, Electrophysiologist St. Luke’s Mid-America Heart Institute
Alan Cheng, MD, MBA Chief Medical Officer, Cardiac Rhythm Management Medtronic
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Show Notes:
[01:04] Rationale for the Mpirik artificial intelligence platform in clinical decision-making
[02:19] Eliminating disruptive alerts
[02:58] Six months of data
[04:22] The need for the new technology
[05:10] Predictive analytics in decision support
[06:03] Not a fad
[07:25] Mimicking physician decision-making
[08:19] The clinical team members
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Dr. Gupta: sgupta@saint-lukes.org
To contact Dr. Cheng: alan.cheng@medtronic.com
Sudden cardiac arrest avoidance through collaboration and AI (aptitude release)
A case study: MDT_SFH_Mpirik Case Study.pdf
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Cardiac arrest has a fatality rate approaching 100%, and this episode of our award-winning podcast will examine ways artificial intelligence can identify at-risk patients before an event happens.
Guest speakers: Doug Beinborn, MA Associate Principal Vizient
Logan Brigman, BS Chief Executive Officer Mpirik
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:17] Sudden cardiac arrest and its impact
[01:43] The role of AI in assisting the identification of cardiac arrest
[02:58] Meeting the criteria and key phrases in the patient notes
[04:12] Ejection fraction as an indicator
[05:05] Screening and physician discussion need formalizing
[06:50] Process in using the screening tool
[08:35] Who and what needs to be in place for the process to work
[10:31] Sites involved in the protocol
[11:18] Other applications in the future
[12:14] AI used to meet the challenges in healthcare today
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
To contact Doug Beinborn: douglas.beinborn@vizientinc.com
Mpirik website: www.mpirik.com
A case study: MDT_SFH_Mpirik Case Study.pdf
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This episode of our award-winning podcast continues an examination of medication safety and how health care organizations can maintain it during this time of shortages, both in supplies and workforce. Two leading pharmacy experts join Tom to explore strategies organizations can use to keep medication safety in the forefront of their care.
Guest speakers: Gretchen Brummel, PharmD, BCPS Consulting Solutions Director Pharmacy Vizient
Carina Dolan, PharmD, MS, BCOP Senior Director Pharmacy Services Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:14] Factors contributing to medication errors
[02:09] Management strategies to prevent medication errors
[05:25] Populations at risk
[06:02] Oncology patients
[06:34] Looking to the future
[08:33] Pharmacists in ambulatory centers
[09:32] Medication reconciliation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Gretchen Brummel’s email: gretchen.brummel@vizientinc.com
Carina Dolan’s email: carina.dolan@vizientinc.com
Swiss Cheese Model of Patient Safety (IHI): IHI- Swiss Cheese Model.pdf
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On this two-part series of our award-winning podcast, we discuss medication safety and how the COVID-19 pandemic has impacted it. Because of the pandemic, health care has experienced shortages of medications and challenges in the workforce. Yet, the rigors and framework of maintaining patient safety are just as crucial now as ever before. Leading pharmacy experts join Tom in this series to examine how health care organizations can manage scarce resources and keep medication safety in the forefront of their care.
Guest speaker: Gretchen Brummel, PharmD, BCPS Consulting Solutions Director Pharmacy Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:23] Impact of medication errors
[02:21] Major causes of medication errors
[02:48] The Swiss Cheese Model
[03:20] Status of medication safety today
[04:25] Shift away from a punitive culture
[05:54] Standardization
[06:19] Dosage errors and involving pharmacists
[07:13] Contribution of staff shortages and stress factors
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Gretchen Brummel’s email: gretchen.brummel@vizientinc.com
Swiss Cheese Model of Patient Safety (IHI): IHI- Swiss Cheese Model.pdf
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On this episode of our award-winning podcast, we conclude our examination of the recent outbreak of polio in New York and its ramifications for the healthcare system. Dr. Martin Lucenti joins Dr. Tom Villanueva for this comprehensive discussion.
Guest speaker: Martin Lucenti, MD, PhD Chief Medical Officer and Senior Vice President Product Strategy and Innovation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient
Show Notes:
[00:28] Polio carriers
[01:07] Asymptomatic carriers and herd immunity
[02:29] Diagnosing
[03:13] Treatment options
[04:35] Importance of hand hygiene
[05:16] Check with pediatrician
[06:15] Vaccination rates declined during COVID pandemic
[07:08] Background for New York outbreak
[09:08] The world is small
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Lucenti’s email: martin.lucenti@vizientinc.com
Why New York’s polio outbreak has put global experts on high alert (The Telegraph): Click Here
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On this episode of our award-winning podcast, we discuss the recent outbreak of polio in New York and its ramifications for the healthcare system. On this two-part series, Dr. Martin Lucenti joins Dr. Tom Villanueva in a comprehensive discussion of polio, covering its origins, pathophysiology and the preventative measures available for it, including an overview of vaccines.
Guest speaker: Martin Lucenti, MD, PhD Chief Medical Officer and Senior Vice President Product Strategy and Innovation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:14] Polio before the 1960s – a devastating disease
[01:45] The eradication of polio
[02:05] Resurgence, transmission and symptoms
[02:56] Risk factors
[03:29] Vaccines: oral vs. injectable
[07:26] Outbreak in New York
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Lucenti’s email: martin.lucenti@vizientinc.com
Why New York’s polio outbreak has put global experts on high alert (The Telegraph): Click Here
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This episode continues our discussion on the important new COVID treatment Paxlovid. Covered in this program are issues such as resistance, drug-to-drug interactions, the recommended course of treatment and impact on patient care.
Guest speaker: Stacy Lauderdale, PharmD, BCPS Senior Director, Drug Information Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:49] Resistance to Paxlovid
[01:38] Patient candidates for Paxlovid
[03:09] Contraindications and drug interactions
[02:47] Whether or not to get flu vaccines
[06:00] Latest studies/trials
[07:04] Prescribing issues
[08:43] “Paxlovid Mouth”
[09:10] Stop dispensing Paxlovid like Pez
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Stacy’s email address: stacy.lauderdale@vizientinc.com
13 Things to Know about Paxlovid, the Latest COVID-19 Pill (Yale Medicine) Click here
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This episode continues our discussion on the important new COVID treatment Paxlovid. Covered in this program are issues such as resistance, drug-to-drug interactions, the recommended course of treatment and impact on patient care.
Guest speaker: Stacy Lauderdale, PharmD, BCPS Senior Director, Drug Information Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:49] Resistance to Paxlovid
[01:38] Patient candidates for Paxlovid
[03:09] Contraindications and drug interactions
[02:47] Whether or not to get flu vaccines
[06:00] Latest studies/trials
[07:04] Prescribing issues
[08:43] “Paxlovid Mouth”
[09:10] Stop dispensing Paxlovid like Pez
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Stacy’s email address: stacy.lauderdale@vizientinc.com
13 Things to Know about Paxlovid, the Latest COVID-19 Pill (Yale Medicine) Click here
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Available through an FDA Emergency Use Authorization (EUA), Paxlovid could be a approach to more effective treatment of the COVID-19 virus. On this episode, we begin a two-part discussion about the evidence from clinical trials of Paxlovid.
Guest speaker: Stacy Lauderdale, PharmD, BCPS Senior Director, Drug Information Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:09] Defining Paxlovid
[01:53] Paxlovid vs Tamiflu – comparison of effectiveness and impact
[02:50] Two randomized control trials
[04:42] Effectiveness with Omicron variant
[07:19] Age as a risk factor
[08:23] The issue of rebound
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Stacy’s email address: stacy.lauderdale@vizientinc.com
13 Things to Know about Paxlovid, the Latest COVID-19 Pill (Yale Medicine) Click here
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Available through an FDA Emergency Use Authorization (EUA), Paxlovid could be a approach to more effective treatment of the COVID-19 virus. On this episode, we begin a two-part discussion about the evidence from clinical trials of Paxlovid.
Guest speaker: Stacy Lauderdale, PharmD, BCPS Senior Director, Drug Information Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:09] Defining Paxlovid
[01:53] Paxlovid vs Tamiflu – comparison of effectiveness and impact
[02:50] Two randomized control trials
[04:42] Effectiveness with Omicron variant
[07:19] Age as a risk factor
[08:23] The issue of rebound
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Stacy’s email address: stacy.lauderdale@vizientinc.com
13 Things to Know about Paxlovid, the Latest COVID-19 Pill (Yale Medicine) Click here
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This episode continues our discussion on the new bivalent COVID boosters that target the original virus and also Omicron subvariants BA.4 and BA.5.
Guest speaker: Azra Behlim, PharmD, MBA Associate Vice President, Pharmacy Sourcing and Program Services Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:30] Is the booster safe?
[00:48] Efficacy
[01:32] How long to wait after previous vaccine
[02:47] Whether or not to get flu vaccines
[05:58] Feasibility of using the booster as an initial vaccine in a series
[07:52] Novavax
[09:05] Nasal vaccines and mucosal immunity
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To contact Modern Practice: modernpracticepodcast@vizientinc.com
FDA announcement on new vaccine boosters (8-31-22): Click here
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This episode continues our discussion on the new bivalent COVID boosters that target the original virus and also Omicron subvariants BA.4 and BA.5.
Guest speaker: Azra Behlim, PharmD, MBA Associate Vice President, Pharmacy Sourcing and Program Services Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:30] Is the booster safe?
[00:48] Efficacy
[01:32] How long to wait after previous vaccine
[02:47] Whether or not to get flu vaccines
[05:58] Feasibility of using the booster as an initial vaccine in a series
[07:52] Novavax
[09:05] Nasal vaccines and mucosal immunity
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
FDA announcement on new vaccine boosters (8-31-22): Click here
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Just this week, the CDC and FDA gave the green light to distribute updated bivalent COVID boosters that target the original virus and also Omicron subvariants BA.4 and BA.5. On this episode, we begin a two-part discussion over the science and rationale behind the new vaccines.
Guest speaker: Azra Behlim, PharmD, MBA Associate Vice President, Pharmacy Sourcing and Program Services Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:54] How the new vaccine type is different
[01:45] Shorter vaccine approval and turnaround
[02:45] COVID virus mutations and immunity
[04:50] Rationale for alternating vaccines
[05:53] Upcoming human studies
[07:47] Vaccine eligibility
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
FDA announcement on new vaccine boosters (8-31-22): Click here
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Just this week, the CDC and FDA gave the green light to distribute updated bivalent COVID boosters that target the original virus and also Omicron subvariants BA.4 and BA.5. On this episode, we begin a two-part discussion over the science and rationale behind the new vaccines.
Guest speaker: Azra Behlim, PharmD, MBA Associate Vice President, Pharmacy Sourcing and Program Services Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:54] How the new vaccine type is different
[01:45] Shorter vaccine approval and turnaround
[02:45] COVID virus mutations and immunity
[04:50] Rationale for alternating vaccines
[05:53] Upcoming human studies
[07:47] Vaccine eligibility
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
FDA announcement on new vaccine boosters (8-31-22): Click here
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This episode continues the discussion of the monkeypox outbreak, highlighting symptoms, preventive measures, and treatment approaches.
Guest speaker: Martin Lucenti, MD, PhD Chief Medical Officer and Senior Vice President Product Strategy and Innovation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:22] Symptoms
[00:44] When someone is contagious
[03:22] The monkeypox vaccine
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Lucenti’s email: martin.lucenti@vizientinc.com
Vizient clinical resource guide on monkeypox: ccsr_monkeypox.pdf
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Cases of the monkeypox virus continue to rise in the United States, creating concerns and even fears, much of those concerns due to lack of information or misinformation. On this two-episode series, Dr. Martin Lucenti joins Dr. Tom Villanueva in a comprehensive discussion of monkeypox, covering its origins and pathophysiology and the preventative measures and therapies available to combat it.
Guest speaker: Martin Lucenti, MD, PhD Chief Medical Officer and Senior Vice President Product Strategy and Innovation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:11] Origins – a virus more related to smallpox than COVID-19
[01:59] Smallpox vaccination
[02:55] Number of cases
[03:26] Strains of monkeypox and the current strain
[03:56] Symptoms
[06:43] Mechanisms of spread
[08:19] Preventative hygiene practices
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. Lucenti’s email: martin.lucenti@vizientinc.com
Vizient clinical resource guide on monkeypox: ccsr_monkeypox.pdf
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According to a recent report by Reuters, health care is one of the most dangerous fields of work, and the American Hospital Association backs this up by saying 75 percent of all episodes of workplace violence occur in health care organizations. On this episode, the discussion focuses on how to recognize and prevent these occurrences before they happen.
Guest speaker: Diana Scott, MHA, RN, CPHQ Principal, Regulatory/Accreditation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:38] Pending legislation on workplace violence
[04:03] Where organizations can start to curb workplace violence
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Diana Scott’s email: diana.scott@vizientinc.com
Fact sheet: Health Care Workplace Violence and Intimidation (AHA) Click Here
Navigating the hazard of rising violence in health care facilities (Reuters) Click Here
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According to a recent report by Reuters, health care is one of the most dangerous fields of work, and the American Hospital Association backs this up by saying 75 percent of all episodes of workplace violence occur in health care organizations. On this episode, the discussion focuses on how to recognize and prevent these occurrences before they happen.
Guest speaker: Diana Scott, MHA, RN, CPHQ Principal Regulatory/Accreditation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:58] Physician and emotional impact
[01:59] Ripple effect, low morale and financial toll
[03:32] Where violence can occur
[05:40] Behavioral health and the value of connection
[06:43] Red flags to watch for
[08:08] Actions to mitigate violence
[10:33] Policies to address violence
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Diana Scott’s email: diana.scott@vizientinc.com
Fact sheet: Health Care Workplace Violence and Intimidation (AHA) Click Here
Navigating the hazard of rising violence in health care facilities (Reuters) Click Here
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In the emergency room, the spouse of a drug-seeker verbally threatens the physician who refuses to provide opioids. A nurse endures a physical assault and wants to leave the field. These true instances of workplace violence are all-too-common in health care, and today’s episode focuses on why violence is happening and the toll it takes on health care workers.
Guest speaker: Diana Scott, MHA, RN, CPHQ Principal, Regulatory/Accreditation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:01] Defining workplace violence
[02:18] Four categories of violence
[03:25] Seriousness of the problem – deaths from violence in health care
[04:25] Universal experience among health care workers
[05:43] A lack of reporting
[06:57] Building awareness
[07:50] Portrayal in entertainment
[08:42] Consequences
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Diana Scott’s email: diana.scott@vizientinc.com
Fact sheet: Health Care Workplace Violence and Intimidation (AHA) Click Here
Navigating the hazard of rising violence in health care facilities (Reuters) Click Here
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Getting to the clinical truth is the real purpose of coding, according to our two experts on this episode of our award-winning podcast. We’ll continue our discussion on avoiding defensive coding practices and improving clinical data and reimbursement.
Guest speakers: Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIP Senior Consulting Director Vizient
Sheila Bowlds, MBA Senior Consulting Director Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:15] Fear of denials: the basis of conservative coding practices
[01:55] Proactive coding
[02:32] Getting to the true clinical story
[04:11] Physician involvement in getting to the truth
[06:22] Dealing with patient safety indicators (PSIs) and hospital-acquired conditions (HACs)
[08:47] Vizient’s support
[10:38] Clinical language vs. coding language
[12:08] Issues around copying and pasting
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim Tamburini’s emaill: james.tamburini@vizientinc.com
Sheila Bowlds’ email: sheila.bowlds@vizientinc.com
Are you prepared to defend your coding? (AAFP) Click Here
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“If that physician documentation isn't there to support how sick that patient really is, number one, the hospital's reimbursement will suffer. But number two, the physician will appear that they're treating healthier patients than they actually are.” This quote from our guest on today’s Modern Practice highlights the fact that conservative coding or defensive coding can be costly. On this episode of our award-winning podcast, we’ll discuss how to code correctly to provide a true picture of patient severity, leading to better data and reimbursement.
Guest speaker: Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIP Senior Consulting Director Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:13] Importance of physician documentation
[02:00] Coded data needed to show severity of patient condition
[03:00] Role of coding professional
[04:27] Communicating in the medical record decides perception and reimbursement
[07:37] Denials fuel defensive coding
[08:29] Impact of conservative coding
[09:57] Correcting a coding entry
[12:30] Vizient’s robust education and mentoring program for coding
[14:04] Where to start changing defensive coding practices
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Jim Tamburini’s emaill: james.tamburini@vizientinc.com
Are you prepared to defend your coding? (AAFP) Click Here
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On this episode of our award-winning podcast, we conclude a three-part series on how to focus on areas that will bring comprehensive quality transformation to your practice. Developing a culture that embraces this focus is a key to sustaining your efforts.
Guest speakers: Rick May, MD Senior Principal, Clinical Quality Improvement Vizient Orthopedic Surgeon
Tod Baker, BS Principal, Clinical Quality Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:35] Streamline what your organization measures
[01:02] Too much data
[01:50] Talk with the folks on the front line
[02:18] What good data should include – success with one indicator
[04:15] Just start and make it simple
[04:43] Transforming culture – one unit or department as a starting point
[06:44] The perfect approach – from a surgeon’s standpoint
[08:26] The perfect approach – from an analyst’s standpoint
[09:27] The future
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
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Dr. Rick May, one of the guests on today’s episode, has this to say about a good many quality improvement initiatives, “What we see, which is unfortunately, all too common these days, hospitals just flail. They do one thing, they try another, nothing sustains. At the end of the day, they look back after a year or two of work and they just haven't gained any ground at all.” Today, on Modern Practice, we discuss a more focused and lasting approach to improvement initiatives that will bring comprehensive quality transformation to your practice.
Guest speakers: Rick May, MD Senior Principal, Clinical Quality Improvement Vizient Orthopedic Surgeon
Tod Baker, BS Principal, Clinical Quality Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:32] Elements for a robust quality program
[02:09] When analytics are not aligned across the organization
[03:00] Need to set priorities – an example
[04:54] Physician involvement
[05:15] Measuring a leading indicator and a lagging indicator – an example
[07:02] Goal-setting: focus on a short list and make sure everyone is looking at it
[09:07] Engaging patients and families
[10:02] The data needs
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
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Today, it’s not enough to just pick a few quality initiatives to work on each year and hope for the best. Complex systems like hospitals need a comprehensive approach: an interlinked series of people, programs, and analytics to consistently improve and sustain quality. This episode of Modern Practice covers comprehensive and sustained quality transformation.
Guest speakers: Rick May, MD Senior Principal, Clinical Quality Improvement Vizient Orthopedic Surgeon
Tod Baker, BS Principal, Clinical Quality Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:30] Comprehensive clinical quality transformation program
[03:03] When initiatives run out of steam
[04:25] Quality is the great impactor, the holy grail, the fixer and differentiator
[05:44] Readmissions in a new light
[07:00] Why there is no sustainability
[08:36] Mistaken emphasis on lagging instead of leading metrics
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
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Practices have just to the end of the year to prepare for and adjust to the new CMS billing guidelines that include rules around split/shared visits between physicians and advanced practice providers (APPs). On this episode of Modern Practice, we’ll continue our discussion about these 2023 guidelines and examine tactics you can use to improve your performance under them.
Guest speakers: Christen Hunt, DNP, NP-C, CPNP-AC Senior Director Clinical Team Insights Vizient
Jennifer Sarno, MSN, ACNP-BC, CPHQ Programmatic Advisor Director Clinical Team Insights Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:45] A laundry list for getting prepared
[02:43] Need for awareness among providers
[03:10] Need for organizational assessment
[03:46] Areas covered by the new ruling
[04:27] No blueprint
[05:43] An opportunity for efficiency
[07:04] Importance of documentation
[08:09] Modifier required
[08:40] Challenging the status quo
[09:00] Vizient’s role to help organization’s prepare
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Christen Hunt’s contact email: christen.hunt@vizientinc.com
Jennifer Sarno’s contact email: jennifer.sarno@vizientinc.com
Calendar Year (CY) 2022 Medicare Physician Fee Schedule Final Rule (CMS) – includes information on 2023 split/shared visits Click Here
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Six months left. That’s how long practices have to adjust to the new CMS billing guidelines that include rules around split/shared visits between physicians and advanced practice providers (APPs). Once it happens, it will be a huge disruption to how split/shared patient care is delivered and reported. On this episode of Modern Practice, we discuss the impact of these new guidelines and how practices can get prepared and respond effectively.
Guest speakers: Christen Hunt, DNP, NP-C, CPNP-AC Senior Director Clinical Team Insights Vizient
Jennifer Sarno, MSN, ACNP-BC, CPHQ Programmatic Advisor Director Clinical Team Insights Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:29] New rule
[02:53] A huge disruptor for team-based practice
[04:16] The rationale behind the new guidelines
[05:00] Impact of the new guidelines
[06:36] Forcing the evolution to true reporting and metrics
[07:25] Tracking time
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Christen Hunt’s contact email: christen.hunt@vizientinc.com
Jennifer Sarno’s contact email: jennifer.sarno@vizientinc.com
Calendar Year (CY) 2022 Medicare Physician Fee Schedule Final Rule (CMS) – includes information on 2023 split/shared visits Click Here
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In the previous episode we covered how to optimize your national scorecard performance. On this episode we examine the data points that drive national scorecard performance. Ratings organizations track thousands of metrics on each hospital, attempt to run these through analytic programs and then spit out grades. It is a confusing jumble, and in this discussion, we share how to focus on the metrics that matter.
Guest speaker: Rick May, MD Senior Principal Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:40] Making sense of the metrics
[02:42] Limitations to the data
[03:53] More than just “end-of-the-trail” metrics
[06:39] Trend toward quality and how to achieve ROI
[08:20] Re-examining your approach to quality
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
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There are dozens of national scorecards and hundreds of metrics to track the performance of health care organizations. Yet, it is a challenge to use these metrics to improve care. From deciding on which scorecard to use to figuring out how to best employ scorecard metrics, the choices can be bewildering. On this episode, we’ll discuss how you can address these issues and optimize your organization’s national scorecard performance.
Guest speaker: Rick May, MD Senior Principal Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:54] Evolution of national scorecards
[02:54] The move away from paying for bad outcomes
[03:40] Recognizing the value of scorecards
[04:43] Reliability of the scoring systems
[05:57] Who looks at scorecards, and how scorecards affect their choices
[07:25] Drawbacks and limitations
[08:24] The Vizient approach
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
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As health care organizations expand into international markets, reimbursement for clinical services offered involves the use of international Diagnosis Related Groups (DRGs). How these differ from Medicare Severity Diagnosis Related Groups (MS-DRGs) and what they include is the topic of this episode of Modern Practice.
Guest speaker: Linda Wiseman, RN Senior Consulting Director Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:53] Various DRG systems and their uses
[01:46] Government oversight in other countries, including IR-DRGs
[03:32] Diagnostic categories by country
[04:48] Focus on three main areas
[06:26] ICD-11 issues
[08:26] Need to understand procedural coding when working overseas
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda Wiseman’s contact email: linda.wiseman@vizientinc.com
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“Bad data leads to $3.1 trillion in lost revenue opportunity,” says Tod Baker, quoting from a recent IBM study. Yet, good data empowers organizations, providing strategic direction and market advantage. On this episode, we continue our discussion on the imperatives for health care organizations to improve their business intelligence capabilities and the use of good data.
Guest speaker: Tod Baker, BS Principal, Clinical Quality Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:24] Empowering the success of an organization
[00:41] Bad data leads to $3.1T in lost revenue opportunities
[00:52] Three stages in evolution of analytics
[02:51] The need for focus and leadership
[03:28] How to prepare for the conversation with the CFO
[04:56] Characteristics of successful organizations
[05:49] Steps to success
[07:00] Getting started
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
Business intelligence in healthcare (Villanova) Click Here
Vizient’s Clinical Data Base (CDB) platform Click Here
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Business intelligence empowers organizations, providing strategic direction and market advantage. Yet, health care is lagging behind other industries in analytics capabilities, and on this episode of Modern Practice, we take a look at the challenges and opportunities health care organizations face to evolve in this area.
Guest speaker: Tod Baker, BS Principal Clinical Quality Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:44] Defining business intelligence
[01:08] Common functions
[01:40] Data is the DNA
[02:07] Health care needs to evolve
[02:30] The Amazon experience
[03:50] 95% of hospitals are behind
[05:37] Staffing opportunities
[06:33] Challenges
[07:52] Decreasing variation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
Business intelligence in healthcare (Villanova) Click Here
Vizient’s Clinical Data Base (CDB) platform Click Here
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The mid-2000s saw a strong move toward quality in surgical procedures, with the emergence of the Surgical Care Improvement Project (SCIP), various initiatives to reduce surgical site infections (SSIs) and the National Surgical Quality Improvement Program (NSQIP) developed by the American College of Surgeons (ACS). Yet, the passing years have revealed the need to get actionable data around surgery care and outcomes for improvement efforts to succeed. Actionable data is critical to drive optimal quality and financial performance. Also needed is to provide surgeons with a system in place that fosters improvement. In this episode, we continue our discussion on these and other ways to improve surgical quality.
Guest speaker: Rick May, MD Senior Principal Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:28] Surgery and the hospital’s financial success
[01:14] Payers and surgical costs
[02:07] Surgical quality and national scorecards
[02:45] Surgery impacts many metrics
[03:23] Surgeon compensation for quality
[04:20] Need to have system in place that fosters surgical quality
[04:56] The rise of ambulatory surgery and the effect on quality
[06:33] The ROI for improving surgical care
[08:00] The future of surgical improvement
[09:05] Start now. Don’t wait.
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
ACS National Surgical Quality Improvement Program (NSQIP) Click Here
Developing a Surgical Quality Improvement Program for Resource-Limited Settings (JAMA Surgery) Click Here
Vizient Operations and Quality Click Here
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“Surgeons don’t actually care that much about mortality.” So says orthopedic surgeon Dr. Rick May, a Senior Principal at Vizient. This may seem surprising, but in this episode, Dr. May goes on to explain how other metrics around surgery are much more important and valuable. In this interview, you’ll hear his explanation and learn a lot more about the current move toward quality in surgical procedures.
Guest speaker: Rick May, MD Senior Principal Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:03] NSQIP: value and drawbacks
[01:56] Biggest challenges to surgical quality
[02:35] “The surgeons actually don’t care that much about mortality”
[03:12] Documentation need
[04:16] What surgeons need to see: a focus on complications
[05:42] The captain of the ship
[06:20] Role of medical complications
[06:48] Perioperative focus is essential
[07:50] Variance of focus among surgeons and where they need to focus
[09:03] Anecdotally, 60% to 70% of opportunities for quality improvement happen before the OR
Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
ACS National Surgical Quality Improvement Program (NSQIP) Click Here
Developing a Surgical Quality Improvement Program for Resource-Limited Settings (JAMA Surgery) Click Here
Vizient Operations and Quality Click Here
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This episode concludes a three-part series with the co-founders of Phrase Health. Their discussion continues on the insights Phrase Health’s technology provides Vizient members. Reducing variation in clinical practice is a key issue covered in this discussion, as well as reducing unnecessary alerts in the electronic health record (EHR).
Guest speaker: Marc Tobias, MD Chief Executive Officer and Co-founder Phrase Health
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:22] The EHR: a window into clinical workflows and variation
[01:34] Alerts: seeing their usefulness and addressing their drawbacks
[02:55] Benefit to clinicians
[07:52] Metrics needed from order sets
[10:02] Reducing the burden of unnecessary alerts and clicks
[10:50] Case study – Virtua Health System
[11:33] Clinical informatics
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Contact email for Dr. Tobias: marc@phrasehealth.com
Contact email for Mike Zeidlhack: mike.zeidlhack@phrasehealth.com
Reducing Clinical Variation to Drive Success in Value-Based Care (HFMA): Click Here
Phrase Health website: Click Here
Vizient announces strategic partnership with Phrase Health: Click Here
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This episode is part two of a three-part series with the co-founders of Phrase Health. It will continue their discussion on the insights Phrase Health’s technology provides Vizient members. Reducing variation in clinical practice is the key function.
Guest speaker: Mike Zeidlhack, MBA Chief Operating Officer and Co-founder Phrase Health
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:34] Reducing clinical variation
[01:43] Helping all health systems
[02:50] “We practice what we preach”
[04:06] CDB and Phrase Health technology are complementary
[04:49] The technology at work: case studies
[08:08] Value to Vizient members
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Contact email for Dr. Tobias: marc@phrasehealth.com
Contact email for Mike Zeidlhack: mike.zeidlhack@phrasehealth.com
Reducing Clinical Variation to Drive Success in Value-Based Care (HFMA): Click Here
Phrase Health website: Click Here
Vizient announces strategic partnership with Phrase Health: Click Here
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Reducing variation in clinical practice is ongoing in health care, and Vizient members have used the Clinical Data Base (CDB) to focus on areas for improvement by identifying variation across the care continuum. However, the CDB does not provide detail on the source of variation. It does not provide attribution. The new partnership with Phrase Health will empower members to find that information. This episode begins a three-part series with the co-founders of Phrase Health, and they will go into detail on insights Phrase Health’s technology provides Vizient members.
Guest speakers: Marc Tobias, MD Chief Executive Officer and Co-founder Phrase Health
Mike Zeidlhack, MBA Chief Operating Officer and Co-founder Phrase Health
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[01:43] Effects of clinical variation across the care spectrum
[02:39] Finding the ordering patterns driving variation
[03:18] Pinpointing provider behavior: no longer seeing outcomes without explanation
[04:28] Capabilities of other programs and tools to produce the same granularity
[07:32] Attribution for physicians in training and for APPs
[08:21] There aren’t “a lot of ways to skin a cat” – outcomes and decreasing variation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Contact email for Dr. Tobias: marc@phrasehealth.com
Contact email for Mike Zeidlhack: mike.zeidlhack@phrasehealth.com
Reducing Clinical Variation to Drive Success in Value-Based Care (HFMA): Click Here
Phrase Health website: Click Here
Vizient announces strategic partnership with Phrase Health: Click Here
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“Splitters” are a challenge for hospital surgery departments, as more and more options outside the hospital facility are available to surgeons. Often, these options, such as ambulatory surgery centers, are more attractive with faster OR turnover times and fewer requirements on surgeons in preoperative and postoperative care. Losing these cases is a blow to hospital operations and finance. This episode provides several approaches that can encourage these surgeons to make your hospital a destination of choice.
Guest speaker: Rick May, MD Senior Principal Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:55] “Splitters”
[01:41] Factors behind the trend—the core issues
[02:38] Working with ambulatory surgical centers (ASCs)
[03:12] Time and money are the same
[03:32] What surgeons are looking for
[04:38] How hospitals can compete; what hospitals can do
[06:49] The special sauce: quality
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
Ambulatory Surgery Centers Versus Hospital-based Outpatient Departments: What’s the Difference? (AAOS) Click here
Can your hospital survive the growing dominance of ASCs? (Thomas A. Blasco, MD, MS) Click here
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Not too long ago, hospitals got paid much more for bad outcomes than good, but those days are long gone. Just surgical complications alone can add $25,000 on average to a hospital’s direct costs. Of those complications, only 10 percent are procedure-related (technical) and 90 percent are due to medical conditions. This is just one reason for health care organizations to have a robust preoperative program. On this episode, you’ll hear about all the benefits of developing a great preoperative clinic.
Guest speaker: Rick May, MD Senior Principal, Clinical Quality Improvement Vizient Orthopedic Surgeon
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:49] The drive to surgical quality and rise of perioperative medicine
[01:11] Defining perioperative medicine
[01:55] What drives better surgical outcomes
[02:24] Technical and medical complications – the need for pre-operative evaluation
[04:39] The pre-operative clinic process
[05:50] The need for perioperative training
[06:17] Turf wars
[07:04] Staffing
[08:11] Three characteristics of a great pre-operative clinic
[09:11] Benefits of creating a pre-operative program
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. May’s contact email: rick.may@vizientinc.com
Preoperative evaluation clinics proving their worth (Becker’s) Click here
Preoperative Evaluation Before Noncardiac Surgery (Mayo) Click here
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On this episode, Dr. Madeleine McDowell returns for a look back at lessons learned from the COVID pandemic, insights we can apply in the future. The discussion ranges from the viability of lockdowns, countries that were the best prepared, the role of new treatments, the need for mental health approaches and how the pandemic has affected clinical training.
Guest speakers: Madeleine McDowell, MD Senior Principal Intelligence Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:23] Do lockdowns work?
[03:11] Huge cost in mental health
[07:04] Improvements in testing, treatment and vaccines
[07:26] Economic hardship
[09:00] Changes in mental health care
[10:14] Changes in medical and clinical training
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. McDowell’s contact email: madeleine.mcdowell@vizientinc.com
“What will it be like when COVID-19 becomes endemic?” (Interview with Yonatan Grad for Chan School of Public Health at Harvard) Click here
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On this episode, two leading experts continue their discussion of whether or not we are approaching a COVID endemic and lessons learned from the pandemic. The value of mass closures, restrictions, masking and the emergence of valid testing are some of the crucial issues considered in this compelling podcast.
Guest speakers: Madeleine McDowell, MD Senior Principal Intelligence Vizient
Martin Lucenti, MD, PhD Senior Vice President and Chief Medical Officer Solution Architecture Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:31] Mass closures: do they work?
[03:54] The factor of acute care capacity
[07:03] The chance of a more lethal variant in the future
[08:22] Factors for reaching the endemic state
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Dr. Lucenti’s contact email: martin.lucenti@vizientinc.com
“What will it be like when COVID-19 becomes endemic?” (Interview with Yonatan Grad for Chan School of Public Health at Harvard) Click here
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On this episode, two leading experts join Tom to discuss reaching an endemic state with COVID-19. Points of consideration are the role of vaccines, which one expert describes as “the cornerstone for reaching an endemic state,” dealing with variants, vaccinating children, the challenge of asymptomatic COVID and other issues.
Guest speakers: Madeleine McDowell, MD Senior Principal Intelligence Vizient
Martin Lucenti, MD, PhD Senior Vice President and Chief Medical Officer Solution Architecture Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:36] Vaccines and the endemic state
[01:38] Controlling variants through vaccinations
[03:54] Vaccinating children
[07:49] Herd immunity, asymptomatic COVID and the effect of variants
[10:16] Therapeutics
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Dr. Lucenti’s contact email: martin.lucenti@vizientinc.com
“What will it be like when COVID-19 becomes endemic?” (Interview with Yonatan Grad for Chan School of Public Health at Harvard) Click here
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As the COVID-19 pandemic reaches the two-year mark, there is discussion about moving into the endemic stage, living with COVID and any future variants as we have learned to live with the flu. On this episode, leading experts cover whether or not COVID is here to stay, national attitudes about living with it and the possibility of eradicating it in the future.
Guest speakers: Madeleine McDowell, MD Senior Principal Intelligence Vizient
Martin Lucenti, MD, PhD Senior Vice President and Chief Medical Officer Solution Architecture Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal Clinical Operations and Quality Vizient
Show Notes:
[00:54] Pandemic vs. endemic
[01:36] Two considerations in moving from pandemic to endemic
[04:58] Possibility of eradicating COVID
[06:04] What data shows about getting to endemic state
[07:38] Most COVID public health policies came from Spanish Flu era
[08:41] Synergies between public health agencies and health care providers
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dr. McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Dr. Lucenti’s contact email: martin.lucenti@vizientinc.com
“What will it be like when COVID-19 becomes endemic?” (Interview with Yonatan Grad for Chan School of Public Health at Harvard) Click here
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We continue our discussion on quality and safety. We talk about always improving on messaging and telling the patient story which connects back to what the data shows. We also talk about value based purchasing and connecting the quality story to the financial impact. We touch on strategic plans and quality metrics while taking into account national scorecard priorities. We also talk about creative initiatives for physicians, having shorter meetings, and effective safety huddles.
Guest speaker: Charlene Sanders, MHA, CPHQ, RHIT, CCDS Senior Consulting Director Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:41] Gaining executive buy-in for your quality agenda
[02:36] Quality reputation and connecting the story with the financial impact
[03:46] Measures to include in a leadership dashboard and a service line dashboard
[04:36] Communicating with physicians and showing results to move the dial
[05:11] Creatively engaging physicians in quality initiatives and meeting them where they’re at
[07:50] Having effective patient safety huddles driven and led by the executive team
[09:41] Being nimble and creative while still dealing with daily clinical challenges
[10:46] The quality agenda should be top of mind
[11:26] It's important to support each other
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Charlene Sanders contact email: charlene.sanders@vizientinc.com
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Now more than ever, it is critical that health care organizations advance quality while operating efficiently. This episode explores best practices for quality department structure, governance and priorities, while looking ahead to the opportunities new technologies may bring.
Guest speaker: Charlene Sanders, MHA, CPHQ, RHIT, CCDS Senior Consulting Director Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:51] Quality department reporting structure
[03:30] Quality governance
[04:42] Getting buy-in from and information to clinicians
[05:24] Optimal FTE mix for quality
[06:37] Determining priorities
[07:10] Impact of COVID on quality initiatives
[09:40] Impact of new technology
[10:49] Quality scorecards
[11:57] Data overload
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Charlene Sanders contact email: charlene.sanders@vizientinc.com
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It has been a year since the American Medical Association released new guidelines for Evaluation and Management (E&M) codes, revising and replacing guidelines issued back in 1995 and 1997. This episode reviews the impact of these changes, which are intended to make the codes more relevant in today’s practice and easier for documentation.
Guest speaker: Sheila Bowlds, MBA Senior Consulting Director, Clinical Documentation Improvement Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[01:10] Changes to outpatient clinic codes only so far
[02:00] Process meant to be easier
[02:49] Codes that were dropped
[03:34] History and physical do not go into level determination but still needed
[04:34] Medical decision-making
[07:16] Time includes face-to-face and non-face-to-face: examples of what’s included
[08:33] What isn’t included in time component
[09:51] Intent of the new rules
[10:14] Prolonged services
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Sheila Bowlds’ contact email: sheila.bowlds@vizientinc.com
2021 Office Visit Evaluation and Management (E/M) Changes (ACOG) Click here
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A robust and effective clinical documentation program needs a strong partnership between clinical documentation specialists and coders. Yet, rifts can occur between those two groups, and this episode examines how those differences happen, why it is important to cultivate and encourage this vital partnership.
Guest speaker: Rachel Mack, MSN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:39] Story of a rift between clinical documentation specialists and coders
[03:55] Conflict is common
[04:17] Value of cooperation
[05:01] Miscoding a helicopter ride to the hospital
[06:48] Taking the time
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s contact email: rachel.mack@vizientinc.com
What is CDI and how does it impact you? (AAPM) Click here
Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here
Vizient’s CDI App Click here
What Does a Clinical Documentation Specialist Do Day-to-Day? Click here
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This episode continues an examination of CDI software, considering how best to use the technology and take into account the need for critical thinking beyond it. Cutting-edge automation does not replace the skills of CDI specialists and coders.
Guest speaker: Rachel Mack, MSN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Principal, Clinical Operations and Quality Vizient
Show Notes:
[00:49] Essentials to keep in mind when using CDI software technology during concurrent review
[02:10] Origins of CDI technology
[03:30] Virtual versus in-person
[04:13] Interrelationship of CDI specialists and coders
[06:10] The perfect marriage
[07:22] Keys to success
[09:04] Partnering with physicians
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s contact email: rachel.mack@vizientinc.com
What is CDI and how does it impact you? (AAPM) Click here
Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here
Vizient’s CDI App Click here
What Does a Clinical Documentation Specialist Do Day-to-Day? Click here
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Clinical documentation improvement (CDI) is crucial for full and accurate reimbursement and reduced compliance risks. Many software programs provide automation to assist coding and prioritization. However, clinical documentation specialists (CDSs) and coding professionals need to use these enhanced software tools along with critical thinking skills to take advantage of query opportunities. On this episode, we’ll discuss how to effectively use CDI technology.
Guest speaker:
Rachel Mack, MSN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal, Clinical Operations and Quality
Vizient
Show Notes:
[01:40] Each physician document holds importance for the patient
[02:10] Origins of CDI technology
[03:21] CDI technology today: advantages and drawbacks
[06:28] Example: when there’s a need to avoid technology dependence
[07:43] Need for critical thinking apart from the technology
[09:48] Choose the software well
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Rachel Mack’s contact email: rachel.mack@vizientinc.com
What is CDI and how does it impact you? (AAPM) Click here
Addressing Provider Clinical Documentation Challenges: New Technology Solutions Improve Accuracy (Vizient) Click here
Vizient’s CDI App Click here
What Does a Clinical Documentation Specialist Do Day-to-Day? Click here
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This episode is the final in the series on the final MACRA Rule for 2022. An excerpt from the recent Medical Leadership Series webcast, the discussion on this episode focuses on MIPS Accountable Care Organizations (ACOs), Business Associate Agreements (BAAs) , new performance category percentages, the Outpatient Prospective Payment System (OPPS) and other issues.
Guest speakers:
Valinda Rutledge, MBA, MSN
Senior Advisor, Sg2
Vizient
Madeleine McDowell, MD
Principal and Medical Director, Sg2
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:30] MIPS Accountable Care Organization changes and the CMS web interface
[04:41] Need to look at Business Associate Agreements (BAAs)
[05:09] Standard performance of ACOs – changes and the new threshold
[07:11] Chance that some ACOs may not achieve savings at all
[07:41] Issues around the Outpatient Prospective Payment System (OPPS)
[10:20] Key insights overall
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Maddie McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Valinda Rutledge’s contact email? valinda.rutledge@vizientinc.com
Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here
Link to December 8 webcast: Click here
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This episode, an excerpt from the recent Medical Leadership Series webcast, continues the discussion of the final MACRA Rule for 2022, focusing on challenges providers now face as MACRA progresses into next year and the serious consideration providers should give to joining an Alternative Payment Model (APM). Also part of the discussion are MIPS Value Pathways (MVPs) and Advanced Alternative Payment Models (aAPMs).
Guest speakers:
Valinda Rutledge, MBA, MSN
Senior Advisor, Sg2
Vizient
Madeleine McDowell, MD
Principal and Medical Director, Sg2
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:27] Uncontrollable circumstance exemption for COVID-19
[02:22] Changes to the final score
[03:36] “The juice ain’t worth the squeeze anymore”
[03:56] The only way to do well
[04:33] The heavy lift: the reporting burden
[05:46] MIPS Value Pathways (MVPs)
[07:41] Advanced Alternative Payment Models (aAPMs)
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Maddie McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Valinda Rutledge’s contact email? valinda.rutledge@vizientinc.com
Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here
Link to December 8 webcast: Click here
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For physician and clinician leaders, this episode provides the latest information on the final MACRA Rule for 2022, including regulatory activities impacting reimbursement. We will discuss the Merit-based Incentive Payment System (MIPS), Alternative Payment Models (APMs), telehealth reimbursement, split visit payment rules and other information crucial to physicians and clinicians.
Guest speakers:
Valinda Rutledge, MBA, MSN
Senior Advisor, Sg2
Vizient
Madeleine McDowell, MD
Principal and Medical Director, Sg2
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:58] Concerning changes to payments
[04:31] Split visits
[07:56] Telehealth coverage
[09:10] MACRA—details and ramifications
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Maddie McDowell’s contact email: madeleine.mcdowell@vizientinc.com
Valinda Rutledge’s contact email? valinda.rutledge@vizientinc.com
Program handout from December 8, 2021 Vizient Medical Leadership Series webcast: Click here
Link to December 8 webcast: Click here
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Patient Safety Indicators, or PSIs, provide insight into safety events that occur during care delivery. Health care organizations can use PSIs to assess potential complications and events to improve their care. Today, we define PSIs and their importance. We also discuss how health care organizations can use Present on Admission data to alleviate being unfairly compared to other organizations regarding care outcomes.
Guest speaker:
Terry Golde, MBA, RN, CCDS
Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:53] Definition
[01:14] Importance of PSIs
[01:44] What PSIs measure
[03:07] Development of PSIs
[03:36] What lower PSI rates mean for hospital performance
[04:14] How PSI data is collected
[07:10] Hospital Rate in PSIs
[08:07] Calculating PSI rates
[09:13] Adjust for patient characteristics – so hospitals will compare fairly
[10:01] Using Present on Admission (POA) data
[11:08] Effect of PSIs on reimbursement and performance ranking
[11:49] PSIs as a useful measure
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Terry Golde’s contact email: teresa.golde@vizientinc.com
Patient Safety Indicators (AHRQ) Click here
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When a clinical diagnosis or procedure is not validated in the medical record, resulting in a claim denial, the health care organization loses reimbursement, the physician or clinician involved may come under scrutiny and the reputations of both clinician and hospital may suffer. Errors in documentation needlessly contribute to this problem. On this episode, we discuss what clinicians and organizations can do to avoid claim denials.
Guest speaker:
Erica Braun, MS, RN, CCDS
Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:11] Clinical validation denial
[01:31] Implications for denials: downgraded DRGs and lower reimbursement
[02:31] Avoiding denials
[03:25] When diagnoses are at high risk for denial
[03:59] Examples of disputed diagnoses
[04:30] Establishing criteria for diagnoses
[05:15] What physicians can do to help improve documentation
[06:17] What to do when a denial occurs
[07:29] Negotiating and coordinating with payers
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Erica Braun’s contact email: erica.braun@vizientinc.com
Fact sheet on Vizient’s clinical documentation improvement services: Click here
Clinical Validation: The Next Big Challenge in Inpatient Coding (American Academy of Professional Coders, AAPC): Click here
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A strategy to achieve regulatory and accreditation compliance is important more than ever, especially in the wake of COVID-19 when regulatory agencies ramp up their efforts again. On this episode, we’ll discuss how health care organizations can face the challenges they face in achieving compliance.
Guest speaker:
Diana Scott, MHA, RN, CPHQ
Associate Vice President
Accreditation and Regulatory Services
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:37] Challenges are not new, with infection prevention at the forefront
[02:48] Cleanliness of ice machines
[03:25] Dialysis: orders, water management, disinfecting equipment
[04:23] Behavioral health: suicide risk
[05:31] Medication management
[06:26] Perinatal standards
[07:27] New requirements/developments
[09:24] Vizient resources
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Diana Scott’s contact email: diana.scott@vizientinc.com
Vizient Accreditation Services: Click here
The Joint Commission: www.jointcommission.org
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Health care organizations need a comprehensive strategy to achieve regulatory and accreditation compliance. At stake are crucial certification and approval ratings and, more crucial, patient and workplace safety. On this two-part series, we’ll examine the current status of regulatory and accreditation organizations and the latest challenges organizations face in their efforts to reach compliance.
Guest speaker:
Diana Scott, MHA, RN, CPHQ
Associate Vice President
Accreditation and Regulatory Services
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:17] Status on accreditation and surveys
[02:38] Update on survey methods: the hybrid model
[05:38] Impact of decreasing COVID infection rates
[06:39] Surveyor expectations
[07:32] Clinical workforce issues and expectations
[09:40] Water management, fire safety/sprinkler systems and workplace safety
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Diana Scott’s contact email: diana.scott@vizientinc.com
Vizient Accreditation Services: Click here
The Joint Commission: www.jointcommission.org
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The last episode of this two-part series covered why readmissions occur. This episode explores those causes in more depth – the clinical and social issues underneath readmissions—and what health care organizations can do to prevent these from happening.
Guest speaker:
Tod Baker, BS
Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:40] Addressing clinical issues
[02:59] Addressing social issues
[04:38] Best practices/new approaches in risk stratification
[09:00] Engaging the family or community to manage the patient
[10:11] Where to start
[12:17] Post-acute care
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
Designing and Delivering Whole-Person Transitional Care (AHRQ) Click here
Vizient’s Clinical Data Base (CDB) and readmissions Click here
CMS Hospital Readmissions Reduction Program Click here
Amy Boutwell, MD, MPP, presents six videos on Multi-visit Patients (MVPs) and readmissions Click here
Contact Dr. Amy Boutwell at: amy@collaborativehealthcarestrategies.com
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The value of reducing readmissions to the hospital has been well-established: lowering health care costs, eliminating wasted resources, improving quality and increasing patient satisfaction. However, organizations still wrestle with the causes for readmissions, whether it is poor care coordination or poor patient follow-up after discharge. This next two-part series will examine why readmissions occur and what organizations can do to improve on them.
Guest speaker:
Tod Baker, BS
Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:11] Defining readmissions
[01:48] Issues resulting from readmissions
[02:17] Misaligned incentives and compartmentalization
[03:27] New energy for reducing readmissions
[04:46] Getting started
[05:49] Effective risk-stratification
[07:13] Impact of social issues
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Tod Baker’s contact email: tod.baker@vizientinc.com
Designing and Delivering Whole-Person Transitional Care (AHRQ) Click here
Vizient’s Clinical Data Base (CDB) and readmissions Click here
CMS Hospital Readmissions Reduction Program Click here
Amy Boutwell, MD, MPP, presents six videos on Multi-visit Patients (MVPs) and readmissions Click here
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On this episode, we continue our discussion on mortality by addressing hospice and palliative approaches as a way to provide improved care for patients and improve hospital mortality scores.
Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Executive Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:35] Hesitancy in leveraging palliative and hospice care
[01:08] A success story with palliative care
[01:51] Vizient Clinical Data Base analytic can pinpoint use of palliative and hospice care in an organization
[02:22] The advanced directive process: everyone’s responsibility
[03:04] Surgeons and the medical record
[04:05] Triggering palliative care consults
[05:28] Patients discharged to hospice do not factor into hospital mortality index
[06:02] Mortality review – best practice
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Aman Sabharwal’s contact email: aman.sabharwal@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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On this episode, we continue our discussion with a physician executive on addressing mortality as a key quality indicator. We focus on using the correct coding and documentation scores for a more accurate representation. We examine the under-use of palliative care, and we discuss how to better work with transfer centers, patients and their families to improve patient experience and hospital mortality scores.
Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Executive Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:46] Role of documentation and coding
[01:52] Example from neurosurgery notes
[03:20] Gaming the system accusation
[04:12] Ignorance about coders and coding process
[05:10] Surgeons and the medical record
[06:27] Risk stratification and the transfer center in the academic medical center
[08:10] Patient-family involvement in the transfer
[09:16] Use of observation and of virtual care
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Aman Sabharwal’s contact email: aman.sabharwal@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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Mortality scores are increasingly an issue for many health care organizations across the country. Obviously, the pandemic had a major role in affecting these scores, but the truth is this was an issue before the pandemic and only rose to attention of the public and regulators from it. Despite the obvious reasons organizations need to address their mortality scores as a key quality indicator, these scores also are a major influence in national quality scores and reputation. Organizations can also use good scores as leverage in negotiations with payers. In earlier episodes, we addressed this issue with a data scientist and a documentation specialist. In this series, a physician executive gives his perspective.
Guest speaker:
Aman Sabharwal, MD, MHA, CPHM
Executive Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:32] Importance of mortality scores
[02:50] Putting the pandemic aside
[03:09] Mortality weighs heavily in rankings
[04:08] Mortality scores and payers
[04:30] The O/E Ratio
[06:11] Four workstreams to address mortality
[08:33] One single thing an organization can do to improve ranking
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Aman Sabharwal’s contact email: aman.sabharwal@vizientinc.com
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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This episode continues the discussion on Hierarchical Condition Categories, or HCCs, examining the impact of HCCs on reimbursement, approaches to risk-adjustment and changes in payment policies.
Guest speaker:
Angela Hunt, RN, MBA, CCDS
Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:43] RAF scores defined
[01:22] Importance of RAF scores for reimbursement
[03:40] Importance of understanding HCCs and their documentation
[04:07] Risk adjusting patients
[06:07] Payment structures in commercial policies
[06:49] Approach and input from the Vizient team – focus on documentation
[07:59] The future of HCCs and documentation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Angela Hunt’s contact email: angela.hunt@vizientinc.com
Hierarchical Condition Categories Coding (AAFP) Click here
HCC Fact Sheet (Vizient) Click here
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Hierarchical Condition Categories (HCCs) aren’t a new concept, but as more and more organizations shift to value-based care, there has been renewed issue in the subject. This is based on the recognition that without solid foundational knowledge of HCCs, health systems risk lower rates of reimbursement, or sometimes not getting paid at all.
On this program, we will explore the use of HCCs and their importance to medical practice.
Guest speaker:
Angela Hunt, RN, MBA, CCDS
Principal
Operations and Quality
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:36] Background and definition for HCCs
[02:24] Using HCCs
[02:54] Physicians and clinicians who use HCCs
[04:08] Importance
[05:34] Documentation approaches
[08:47] Deriving value through the HCC designation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Angela Hunt’s contact email: angela.hunt@vizientinc.com
Hierarchical Condition Categories Coding (AAFP) Click here
HCC Fact Sheet (Vizient) Click here
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On this episode, we conclude our series on mortality by examining palliative care, home care and hospice care. These are underused yet better and more beneficial for end-of-life situations than traditional inpatient approaches.
Guest speaker:
Steve Meurer, PhD, MBA, MHS
Executive Principal
Data Science and Member Insights
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:28] Risk adjusted mortality: examining the most relevant hospice care approaches
[01:35] Effective palliative care
[01:58] Bullish on palliative care: broadening beyond the dying population
[03:24] Leveraging home care and hospice approaches
[05:02] Challenge in caring for a dying patient
[06:06] Facing mortality: getting the patient in the right place at the right time
[08:14] Mortality review: not finding fault but improving performance
[09:35] Example from mortality review: care for multiple myeloma patients
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steve Meurer’s contact email: steve.meurer@vizientinc.com
To contact Tom regarding mortality reduction: tomas.villanueva@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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Reducing hospital mortality is crucial to improve care and meet stringent reporting and reimbursement requirements. Improvements involve a complex effort involving multiple areas in the organization. On this episode, we continue our series on mortality by focusing on transfer centers and admissions as factors in reducing mortality.
Guest speaker:
Steve Meurer, PhD, MBA, MHS
Executive Principal
Data Science and Member Insights
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:35] Risk adjusted mortality: focusing on one factor can make a difference
[02:13] Transferring patients
[02:40] Example: using telehealth instead of transfers for stroke patients
[03:16] Example: developing a co-management program
[04:08] Example: mini-ICU in the ER
[04:39] Example: in-hospital mortality for sepsis patients
[05:33] Supportive care for the dying patient
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steve Meurer’s contact email: steve.meurer@vizientinc.com
To contact Tom regarding mortality reduction: tomas.villanueva@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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“The longer you stay in the hospital, the higher chance that you have of dying in that hospital.” So says our guest in this crucial series on reducing hospital mortality. Mortality, always a leading quality indicator, is under increasing public scrutiny, with mounting pressure on health care organizations to reduce it. In this three-part series, we will discuss the multiple factors that affect hospital mortality and come into play when trying to lower mortality rates.
Guest speaker:
Steve Meurer, PhD, MBA, MHS
Executive Principal
Data Science and Member Insights
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:43] Tracking a quality indicator
[03:04] Improvement is multifactorial
[03:49] The longer the stay, the higher the chance of mortality
[04:38] Effective mortality review
[05:58] Effective clinical documentation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Steve Meurer’s contact email: steve.meurer@vizientinc.com
To contact Tom regarding mortality reduction: tomas.villanueva@vizientinc.com
Mortality Measures Hospital-Specific Reports (CMS) Click here
Selected Best Practices and Suggestions for Improvement – Mortality (AHRQ) Click here
Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic (JAMA Internal Medicine) Click here
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In this final episode of our series on the blood supply, our discussion goes beyond managing red blood cells to the management of every blood component. We examine hospital practices for conserving blood and using alternatives to transfusion.
Guest speaker:
Akiva Faerber
Senior Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:22] Extending management beyond red blood cells
[00:52] Platelets
[03:23] Other products and technologies for blood management
[04:21] More on platelets, other products/technologies and the need for platelet donors
[07:26] Vizient recommendations concerning platelets
[09:41] Avoiding transfusions
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Akiva Faerber’s contact email: akiva.faerber@vizientinc.com
Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here
Severe Blood Shortage (American Red Cross web page) Click here
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Because of the critical shortage of the blood supply across the nation, health care organizations are having to work with less. On this episode, part two of a three-part series, we discuss reducing the number of transfusions and other strategies that will help you manage a more limited blood supply.
Guest speaker:
Akiva Faerber
Senior Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:32] Not focusing on eight as the magical number
[01:37] Managing red blood cells (RBCs)
[03:53] “Why two? Why not one? Why one? Why not none?”
[05:11] Autologous transfusion
[07:26] RBC-stimulating drugs
[09:05] Financial issues
[09:34] Old blood vs new blood
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Akiva Faerber’s contact email: akiva.faerber@vizientinc.com
Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here
Severe Blood Shortage (American Red Cross web page) Click here
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In normal times in this country, only three percent of the population donates blood. Yet, the pandemic has worsened the situation even more, causing donor fatigue and lack of supply. In addition, more stringent guidelines have reduced the number of donors as well. On this episode, beginning a three-part series, we discuss the causes and effects of a shrinking blood supply and how to face this challenge.
Guest speaker:
Akiva Faerber
Senior Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:52] A grim situation
[02:26] Effect from an increased number of tests and guidelines
[03:41] Recruiting donors
[06:10] Changing clinical practice on use of blood
[07:50] Restrictive vs liberal blood use policies
[08:46] Vizient data to guide blood management
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Akiva Faerber’s contact email: akiva.faerber@vizientinc.com
Conservation of Blood Products (The Ohio State University Wexner Medical Center) Click here
Severe Blood Shortage (American Red Cross web page) Click here
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In this final episode of our series on HACs, we examine the challenge of Clostridium difficile infection (C. diff, or CDI) for clinicians and patients. Highly infectious and unsusceptible to alcohol, CDI is cause for concern, with infection rates rising after COVID-19, as they are for all HACs. Yet, a systematic approach according to new guidelines can curb and eliminate this condition.
Guest speaker:
Richard Beaver, B.S. Chem, MBB, CPHQ
Senior Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:31] New CDI guidelines
[01:21] Insight on major causes – and an example
[03:31] Benefit of early detection at hospital
[05:57] Issues with testing protocols, isolation practices and use of antibiotics
[09:21] A multi-faceted approach
Links | Resources:
Rick Beaver’s contact email: richard.beaver@vizientinc.com
New CDI guidelines (IDSA and SHEA) Click here
CMS Hospital-Acquired Condition (HAC) fact sheet Click here
CMS Hospital-Acquired Condition (HAC) reduction program Click here
Information on Vizient’s Clinical Data Base (CDB) Click here
AHRQ tools to reduce HACs Click here
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Surgical site infections (SSIs) are persistent and challenging, no more so than following the COVID-19 outbreak. Now that elective surgeries are ramping up again, it is more important than ever to prevent SSIs, and that is the focus for this episode in our series addressing HACs.
Guest speaker:
Richard Beaver, B.S. Chem, MBB, CPHQ
Senior Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:36] The upsurge in sepsis
[02:25] Limited SSI improvement in some cases
[03:39] A combination of causes
[04:50] Lack of compliance
[05:59] Prophylactic antibiotics
[08:35] Chlorhexidine
[10:33] Accurate metrics and analysis for key drivers of improvement
[11:35] 360-degree approach
Links | Resources:
Rick Beaver’s contact email: richard.beaver@vizientinc.com
CMS Hospital-Acquired Condition (HAC) fact sheet Click here
CMS Hospital-Acquired Condition (HAC) reduction program Click here
Information on Vizient’s Clinical Data Base (CDB) Click here
AHRQ tools to reduce HACs Click here
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The outbreak of COVID-19 exacerbated the occurrence of Hospital-Acquired Conditions (HACs) in health care organizations, and bringing infection rates back down is a struggle. This series examines the steps we can take to reduce HACs, and on this episode, we focus on catheter-associated urinary tract infections, or CAUTIs.
Guest speaker:
Richard Beaver, B.S. Chem, MBB, CPHQ
Senior Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:33] Occurrences of CAUTI
[01:11] Foley removal practice
[05:51] Other causes and managing the perineum
[08:25] Addressing the bundle components
Links | Resources:
Rick Beaver’s contact email: richard.beaver@vizientinc.com
CMS Hospital-Acquired Condition (HAC) fact sheet Click here
CMS Hospital-Acquired Condition (HAC) reduction program Click here
Information on Vizient’s Clinical Data Base (CDB) Click here
AHRQ tools to reduce HACs Click here
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Hospital-Acquired Conditions (HACs) have risen in frequency since the outbreak of COVID-19 after years when rates were falling. This series examines the reasons and steps we can take to reduce these infections. On this episode, we focus on central line-associated bloodstream infections, or CLABSIs.
Guest speaker:
Richard Beaver, B.S. Chem, MBB, CPHQ
Senior Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[00:31] Effect of placement on line management
[04:12] Impact of shaving
[06:18] Actions for preventing CLABSIs
[08:23] Engaging physicians and nurses – not dictating to them
Links | Resources:
Rick Beaver’s contact email: richard.beaver@vizientinc.com
CMS Hospital-Acquired Condition (HAC) fact sheet Click here
CMS Hospital-Acquired Condition (HAC) reduction program Click here
Information on Vizient’s Clinical Data Base (CDB) Click here
AHRQ tools to reduce HACs Click here
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Even before the pandemic, health care organizations struggled with Hospital-Acquired Conditions (HACs), and the outbreak of COVID-19 only worsened infection rates. In this five-part series, we will examine four leading HACs to discuss why their rates went up and proven approaches hospital staff can use to reduce them.
Guest speaker:
Richard Beaver, B.S. Chem, MBB, CPHQ
Senior Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Principal
Clinical Operations and Quality
Vizient
Show Notes:
[01:05] Situation today regarding HACs, as seen in the Vizient Clinical Data Base (CDB)
[01:45] Major HACs
[02:21] Effect of the pandemic
[03:17] Insights post-COVID
[07:15] Line placement: who owns the lines
[08:52] Impactful HACs
[10:06] Role of clinician resilience
[11:24] Financial implications/penalties
Links | Resources:
Rick Beaver’s contact email: richard.beaver@vizientinc.com
CMS Hospital-Acquired Condition (HAC) fact sheet Click here
CMS Hospital-Acquired Condition (HAC) reduction program Click here
Information on Vizient’s Clinical Data Base (CDB) Click here
AHRQ tools to reduce HACs Click here
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“We are seeing increased demand, lots of questions out there from people who’ve had COVID, and questions that, quite honestly, primary care physicians aren’t comfortable being able to answer.” So says Dr. Maddie McDowell of Sg2 about care for COVID long-haulers. She continues, “This is a field that’s very new, it’s evolving weekly, and so being able to provide expertise in this specific area is really important for all communities.” In this episode, we finish our examination of the COVID clinic at the University of Texas Medical Branch that does provide that expertise.
Guest speakers:
Madeline McDowell, MD
Principal, Intelligence
Sg2
Rex McCallum, MD
Chief Physician Executive
UTMB Health
Justin Seashore, MD
Director, Post Recovery COVID-19 Recovery Clinic
UTMB Health
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:40] Continuing COVID long-hauler clinics
[02:56] Getting started
[04:54] Patients with hypertension and diabetes
[05:40] Significant improvement
[07:15] Support of leadership and staff
[07:41] Telemedicine
[09:09] Post-COVID symptoms
[10:14] Dealing with vaccine hesitancy
[10:56] The future of the clinic after COVID
Links | Resources:
UTMB Health: Post COVID Recovery Clinic Click here
COVID “Long Haulers”: Long-Term Effects of COVID-19 Click here
Vizient webcast: Care approaches for COVID-19 long-haulers Click here
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In this episode, we continue our discussion on COVID long-haulers, those who contracted COVID-19 and cannot shake off the effects weeks or months later. We feature a clinic developed to care for long-haulers and examine treatment approaches.
Guest speakers:
Madeline McDowell, MD
Principal, Intelligence
Sg2
Rex McCallum, MD
Chief Physician Executive
UTMB Health
Justin Seashore, MD
Director, Post Recovery COVID-19 Recovery Clinic
UTMB Health
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:34] Developing the care plan
[01:35] Types of patients
[03:32] Defining post-COVID patients
[04:30] Leading symptoms
[06:53] Results of clinic care
[07:59] Getting paid
[10:07] Approach to imaging
[11:19] Significant improvement
[12:39] The fatigue component
Links | Resources:
UTMB Health: Post COVID Recovery Clinic Click here
COVID “Long Haulers”: Long-Term Effects of COVID-19 Click here
Vizient webcast: Care approaches for COVID-19 long-haulers Click here
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“Long-haulers” are those who contracted COVID-19 and cannot shake off the effects weeks or months later. These patients can experience continual impaired lung function, mental incapacity, dizziness, tiredness and other maladies lingering on from the disease. This podcast features excerpts from a recent webcast that discussed one health care organization’s clinic outreach to COVID long-haulers as well as Sg2 research into the various conditions represented.
Guest speakers:
Madeline McDowell, MD
Principal, Intelligence
Sg2
Rex McCallum, MD
Chief Physician Executive
UTMB Health
Justin Seashore, MD
Director, Post Recovery COVID-19 Recovery Clinic
UTMB Health
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[02:05] Conditions caused by long-term COVID
[02:20] Treating with multiple specialists
[02:54] The time is now
[04:36] Becoming aware of other symptoms associated with COVID
[06:39] Defining the post-COVID patient
[08:10] Getting the word to the community
[09:41] Referrals
[10:03] Patient assessments
Links | Resources:
UTMB Health: Post COVID Recovery Clinic Click here
COVID “Long Haulers”: Long-Term Effects of COVID-19 Click here
Vizient webcast: Care approaches for COVID-19 long-haulers Click here
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In this episode, we continue our discussion about a novel approach to alleviate the stress on health care workers. Developed for the US Army, Stress First Aid is proving beneficial to dealing with the ongoing crises and challenges faced in health care organizations every day, particularly during the pandemic.
Guest speaker:
Courtney Gidengil, MD, MPH
Senior Physician Policy Researcher
Director, Boston Office
The Rand Corporation
Associate Physician in Pediatrics
Boston Children’s Hospital
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:26] Stress First Aid model—the color code designations
[02:03] Seven Cs
[03:14] Benefits of participating
[04:24] First steps
[05:46] Individual participation
[06:53] The site champion
Links | Resources:
Vizient’s SFA Overview for Health Care Professionals Click here
Workplace Stress Impacts Health Care Workers (U of Michigan) Click here
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Already in a high-stress occupation, health care workers have been severely tested by the ongoing COVID-19 pandemic. While others have stayed at home, health care workers have been unable to practice isolation but have had to go into a workplace where they confront the sickest in the population, where staffing has often been inadequate and e. Burn-out is rife and finding a way to deal with stress a priority. Stress First Aid is a program developed to allow health care workers to use their peer-to-peer relationships to increase resilience and improve their well-being.
Guest speaker:
Courtney Gidengil, MD, MPH
Senior Physician Policy Researcher
Director, Boston Office
The Rand Corporation
Associate Physician in Pediatrics
Boston Children’s Hospital
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:05] Defining “Stress First Aid”
[02:24] Impact of COVID
[03:30] Clinical decisions and stress
[04:40] Using peer-to-peer connections
[06:30] The Stress First Aid program
Links | Resources:
Vizient’s SFA Overview for Health Care Professionals Click here
Workplace Stress Impacts Health Care Workers (U of Michigan) Click here
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On this episode, we continue our discussion on the reasons and remedies for COVID-19 vaccine hesitancy among the health care staff.
Guest speakers:
Michele Andrasik, PhD, EdM, MS, MA
Senior Staff Scientist
Fred Hutchinson Cancer Research Center
Clinical Assistant Professor
Department of Global Health
University of Washington
Tony Reed, MD, PhD, MBA
Executive Vice President and Chief Medical Officer
Temple University Health System
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:39] Issues around incentives
[02:30] Vaccine choice
[04:33] Issues around mandates
Links | Resources:
COVID-19 Vaccine Hesitancy: 12 Things You Need to Know (Johns Hopkins) Click here
How to Talk to Someone About Vaccine Hesitancy (Cleveland Clinic) Click here
Vizient webinar on addressing vaccine hesitancy among health care workers Click here
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Health care workers can be hesitant to take the COVID vaccines for a number of reasons. To address this challenge, organizations can take a number of approaches, from vaccine mandates to incentive payments, yet these tactics may not really address the strong, even deep-seated, concerns staff members may have about vaccination. On this episode, we continue our discussion about addressing vaccine hesitancy.
Guest speakers:
Michele Andrasik, PhD, EdM, MS, MA
Senior Staff Scientist
Fred Hutchinson Cancer Research Center
Clinical Assistant Professor
Department of Global Health
University of Washington
Tony Reed, MD, PhD, MBA
Executive Vice President and Chief Medical Officer
Temple University Health System
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:30] Temple University Hospital: vaccines not mandatory, all groups consulted
[06:00] Getting out the news and the staff voice
[09:28] Easy access: walk-in clinic
[11:06] Strategies for listening to those who are vaccine hesitant; vaccine “equity”
Links | Resources:
COVID-19 Vaccine Hesitancy: 12 Things You Need to Know (Johns Hopkins) Click here
How to Talk to Someone About Vaccine Hesitancy (Cleveland Clinic) Click here
Vizient webinar on addressing vaccine hesitancy among health care workers (Drs. Villanueva, Andrasik, Reed) Click here
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For a variety of reasons, from concerns about side effects to lack of trust of societal institutions, many health care workers are hesitant about taking COVID vaccinations. In this episode, Tom discusses this hesitancy with two leading experts in the health care field to examine why this response is occurring and what organizations can do to encourage staff members to have the vaccines.
Guest speakers:
Michele Andrasik, PhD, EdM, MS, MA
Senior Staff Scientist
Fred Hutchinson Cancer Research Center
Clinical Assistant Professor
Department of Global Health
University of Washington
Tony Reed, MD, PhD, MBA
Executive Vice President and Chief Medical Officer
Temple University Health System
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:50] Vizient survey results on vaccine hesitancy at member organizations
[03:09] A lack of trust in institutions and systems
[06:30] A different way of looking at side effects
[07:06] COVID and social determinants of health
[08:24] Health care staff who are often the most hesitant
Links | Resources:
COVID-19 Vaccine Hesitancy: 12 Things You Need to Know (Johns Hopkins) Click here
How to Talk to Someone About Vaccine Hesitancy (Cleveland Clinic) Click here
Vizient webinar on addressing vaccine hesitancy among health care workers (Drs. Villanueva, Andrasik, Reed) Click here
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On this episode, we continue our discussion about turning the corner on the COVID pandemic, examining the latest treatments and other developments and what they mean for the future.
Guest speaker:
Jayanta (Jay) Bhattacharya, MD, PhD
Professor of Medicine
Stanford University
Director
Stanford Center on the Demography of Health and Aging
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:40] Looking at COVID treatments: positive and negative
[01:22] Disappointing effort in research community regarding therapies
[02:25] Issues around access to treatments
[02:58] Mask-wearing and the fear and politics of COVID
[05:17] Masks and regular flu
[06:51] Wake-up call for health care
[08:25] Need for value-based services; paying for the outcomes
Links | Resources:
The CDC updated masking guidelines for fully vaccinated Americans – here’s what you need to know (USA Today—April 28, 2021) Click here
The Great Barrington Declaration Click here
How and when will this pandemic end? (World Economic Forum) Click here
“Implementing Optimal Team-Based Care to Reduce Clinician Burnout” (National Academy of Medicine discussion paper – September 17, 2018) Click here
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Living with a pandemic for over a year has strained resources in health care and the country as a whole. For months, the use of masks seemed the only mode of prevention, but with attendant limitations and even controversy. Now, the emergence of vaccines and new treatments has brought some hope. In this episode, we discuss whether or not we have turned a corner on COVID-19, and we examine the changes and issues the crisis has brought about in health care.
Guest speaker:
Jayanta (Jay) Bhattacharya, MD, PhD
Professor of Medicine
Stanford University
Director
Stanford Center on the Demography of Health and Aging
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:52] Impact of vaccines on turning the corner
[03:13] Finding the super-infectors
[05:04] Addressing vaccine hesitancy and herd immunity
[07:06] COVID and social determinants of health
[08:19] Addressing the COVID long-haulers
[09:51] Masking
[13:12] Innovations during COVID
[14:51] Needing health care professionals to work at the top of their licenses
Links | Resources:
The CDC updated masking guidelines for fully vaccinated Americans – here’s what you need to know (USA Today—April 28, 2021) Click here
The Great Barrington Declaration Click here
How and when will this pandemic end? (World Economic Forum) Click here
“Implementing Optimal Team-Based Care to Reduce Clinician Burnout” (National Academy of Medicine discussion paper – September 17, 2018) Click here
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Part three of this series concludes the discussion of exploring the need for health care organizations to excel in digital health. In this episode our guests discuss how to transition to digital health and how to help organizations with limited resources and expertise start the transition to providing digital health solutions.
Guest speakers:
Kenneth Holmen, MD
President and CEO
CentraCare Health
Crystal Mullis, RN, MBA, MHA
Vice President and General Manager
Digital, Virtual and Ventures
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:29] Making the necessary transition to digital health
[04:38] Ideas to help organizations with limited resources or expertise
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Part two of this series continues the exploration of the need for health care organizations to excel in digital health. In this episode our team addresses how health care fares as an industry in the digital ecosystem. They also discuss how to overcome barriers to providing digital health solutions, addressing provider push back, identify key stakeholders in an organization needed for the digital transition, and give some examples of companies that are already operating in the digital ecosystem.
Guest speakers:
Kenneth Holmen, MD
President and CEO
CentraCare Health
Crystal Mullis, RN, MBA, MHA
Vice President and General Manager
Digital, Virtual and Ventures
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:24] How health care fares as an industry in digital health
[02:39] Overcoming the disadvantages to providing digital health solutions
[05:51] Addressing provider push back
[10:20] Key stakeholders that need to be involved in the transition
[12:47] Companies already in the digital ecosystem
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In this episode, we explore the need for health care organizations to excel in the digital health space. Consumers are demanding that health care provide similar digital experiences as huge organizations such as Amazon and Walmart. Hospitals and clinical practices excel in delivering care by nature but are challenged to keep pace with digital solutions to their patients.
Guest speakers:
Kenneth Holmen, MD
President and CEO
CentraCare Health
Crystal Mullis, RN, MBA, MHA
Vice President and General Manager
Digital, Virtual and Ventures
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:38] Guest Introductions, Background on CentraCare
[02:30] Why digital transformation is crucial in today’s health care environment
[05:30] How consumerism is accelerating digital transformation in health care
[08:45] Overcoming generational barriers with digital technology
[11:04] COVID Pandemic as digital technology accelerator
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In this episode, we continue exploring the toll of the administrative burden on clinicians and on the care they deliver. As an answer, practices and organizations are finding well-being to be the leading quality indicator that drives outcomes. How practices have transitioned during COVID has only underscored that fact.
Guest speaker:
Nigel Girgrah, MD, PhD
Chief Wellness Officer
Ochsner Health System
Medical Director, Liver Transplantation
Ochsner Medical Center
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:30] Government intervention
[01:54] Success of recent efforts
[02:24] Actions following 2003 SARS outbreak in Toronto
[03:22] Agility of organizations during COVID
[04:14] How organizations can reduce burden on clinicians
[06:21] Work on well-being at Ochsner: four strategic pillars, efforts during COVID
[09:16] Need to destigmatize mental health issues
Links | Resources:
“Death by 1,000 Cuts” (Medscape) Click here
Craig McKinley article Click here
Reducing Administrative Waste in the US Health Care System (JAMA) Click here
Senator Cassidy and Dr. Lorna Breen Health Care Provider Protection Act Click here
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For every hour a physician or clinician spends with a patient, they will spend at least another half hour or more on documentation or other administrative work. More than that, around 25 percent of the dollars spent in health care are on wasteful administrative tasks. Such a burden leads to long hours and takes the clinician away from patient interaction and care, continuing education, clinical decision-making and personal and family time. It can lead to burnout and worse. On this episode, a leading expert discusses the challenge of administrative burden and what practices and organizations can do to remedy it.
Guest speaker:
Nigel Girgrah, MD, PhD
Chief Wellness Officer
Ochsner Health System
Medical Director, Liver Transplantation
Ochsner Medical Center
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:20] The administrative burden
[02:11] EHRs, burnout and “pajama time”
[03:51] Toll on female clinicians
[04:26] Where clinician burnout can lead
[05:19] Craig’s story and the high risk of physician burnout
[07:14] A systems approach to well-being
[09:14] Drivers of professional fulfillment
[09:34] The Fourth Aim: caring for the caregivers
Links | Resources:
“Death by 1,000 Cuts” (Medscape) Click here
Craig McKinley article Click here
Reducing Administrative Waste in the US Health Care System (JAMA) Click here
Senator Cassidy and Dr. Lorna Breen Health Care Provider Protection Act Click here
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On this episode, we conclude our three-part series detailing patient and family concerns as the pandemic heads into its second year. Based on Vizient’s extensive and ongoing assessments, we have learned how patients and families feel about COVID testing and vaccines, from where they prefer receiving their tests to whether or not they plan to take a vaccine at all. This information will be valuable for bringing patient and family desires into your care planning and care approaches in the near future.
Guest speaker:
Kellie Goodson, MS, CPXB
Performance Improvement Program Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:20] Patient and family attitudes toward testing
[01:26] Attitudes toward testing locations
[02:15] COVID Vaccines
[03:56] Vaccine locations
[05:58] Trust in providers
[08:42] Value in listening to patients and families
Links | Resources:
Summary Report – Connecting with Patients During COVID-19: Perspectives on Safety Click here
AAMC-Vizient White Paper on patient-centered care Click here
Patient and Family-Centered Care: A Systematic Approach (AMA Journal of Ethics) Click here
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In this episode, we continue our discussion on patient and family engagement (PFE) and concerns as the pandemic continues. We will focus on accessing care, on the care settings patients and families prefer—whether virtual visits, urgent care, the ER or the caregiver’s office—and on their attitudes toward going in for preventative screenings, such as colonoscopies or mammograms. The extensive and ongoing assessment of patients and families by Vizient and Sg2 will yield valuable information for your clinical practice.
Guest speaker:
Kellie Goodson, MS, CPXB
Performance Improvement Program Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:33] Preferences as to care settings
[02:20] Concerns for the next six months
[03:27] Preferences as to care after the pandemic
[05:17] Categories of patient and family respondents
[05:38] An opportunity for providers
[06:09] Preferences as to preventative screenings
[07:09] A personal example
Links | Resources:
Summary Report – Connecting with Patients During COVID-19: Perspectives on Safety Click here
AAMC-Vizient White Paper on patient-centered care Click here
Patient and Family-Centered Care: A Systematic Approach (AMA Journal of Ethics) Click here
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Two of the most significant challenges facing clinical practices today, to increase patient satisfaction and to meet patient demands, involve connecting with patients and families. Recognizing patient and family engagement (PFE) as a critical aspect of care, especially as COVID-19 has overhauled and overwhelmed care delivery models, Vizient and Sg2 have conducted ongoing assessments of patients and families to learn their attitudes during this crisis. In this episode, part one of a three-part series, we will discuss those patient-family assessments and what they reveal.
Guest speaker:
Kellie Goodson, MS, CPXB
Performance Improvement Program Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:02] Rationale for PFE
[02:34] New assessment approach for PFE through 2020-2021
[03:57] The main patient and family concern
[05:25] Attitudes toward elective procedures: a change for the worse
[09:21] Need for provider engagement
Links | Resources:
Summary Report – Connecting with Patients During COVID-19: Perspectives on Safety Click here
AAMC-Vizient White Paper on patient-centered care Click here
Patient and Family-Centered Care: A Systematic Approach (AMA Journal of Ethics) Click here
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Drastic forces unleashed by COVID-19 have transformed everything, including health care. Clinical care delivery has changed. Health policies have changed. Regulation and payment have changed. Whether or not these changes will last is up in the air as the pandemic enters a second year. On this episode, part two of a series, Modern Practice brings back an expert who will look at what has happened and address questions and concerns about what will happen.
Guest speaker: Celina Burns Principal Financial Performance Solutions Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
Show Notes: [00:23] Acquisition, compensation and productivity [02:27] Hospital-physician engagement [03:59] Care access in the future and Walmart “health hubs” [05:55] Health insurance trends and the payor role [08:38] Head winds in the work force [10:18] Redesign and Social Determinants of Health
Links | Resources:
Practice and Policy Reset Post-COVID-19 Click here
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The COVID pandemic has transformed all of health care, from the way patients access care to the way clinicians conduct it. In this episode, the first of a two-part series, we will examine how health policies and clinical practice have taken on never-before-seen aspects and where these changes might lead in the future.
Guest speaker: Celina Burns Principal Financial Performance Solutions Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
Show Notes: [00:54] Care moving toward virtual/ambulatory and lower-cost sites [01:53] Changes in financial landscape [02:48] Bringing secrets to light [04:33] Consolidation and mergers; move to regionalized care [05:27] Relieving the pressure [08:06] Value-based payments
Links | Resources:
Practice and Policy Reset Post-COVID-19 Click here
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In Part 3 of this series on monoclonal antibody therapies for COVID-19, our expert panel continues their discussion on concerns about the efficacy and distribution of these treatment options. They respond to the FDA’s recent Emergency Use Authorization (EUA) for monoclonal antibodies.
Guest speakers: Azra Behlim, PharmD, MBA Senior Director Pharmacy Sourcing and Program Services Vizient
Stacy Lauderdale, PharmD Senior Director Drug Information Vizient
Steve Rudner, PharmD, MS Director Pharmacy Network Contracting Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
Show Notes: [00:37] Identifying the right patients – best practices [03:10] The access challenge [05:54] Plenty of availability [06:10] COVID vaccination and use of monoclonal antibody therapy [06:37] Post-infusion management
Links | Resources:
Press release and information from FDA Click here
Information from FDA on EUA for monoclonal antibody therapy Click here
ASPR’s portfolio of COVID-19 medical countermeasures (HHS site) Click here
[ For more information, contact: ASPRstakeholder@HHS.gov ]
JAMA article: “An EUA for Bamlanivimab—A Monoclonal Antiboey for COVID-19” (Dec. 11, 2020) Click here
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Last November, the FDA released an Emergency Use Authorization (EUA) for the use of monoclonal antibody therapy for adult and pediatric patients with mild to moderate COVID-19. Currently, there is some confusion about the availability and access issues to these treatment options.
In this episode, part two of a three-part series, we will address questions and concerns about the distribution and availability of these therapies.
Guest speakers: Azra Behlim, PharmD, MBA Senior Director Pharmacy Sourcing and Program Services Vizient
Steve Rudner, PharmD, MS Director Pharmacy Network Contracting Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
Show Notes: [02:05] Access to the monoclonal antibody therapies [03:51] No lack of supply [05:07] Infusion options [09:59] Misconceptions and challenges around distribution [11:40] Every idea worth exploring
Links | Resources:
Press release and information from FDA Click here
Information from FDA on EUA for monoclonal antibody therapy Click here
ASPR’s portfolio of COVID-19 medical countermeasures (HHS site) Click here
[ For more information, contact: ASPRstakeholder@HHS.gov ]
JAMA article: “An EUA for Bamlanivimab—A Monoclonal Antiboey for COVID-19” (Dec. 11, 2020) Click here
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COVID-19 vaccines have dominated the headlines. Not garnering the same attention, but just as important, is last November’s US Food and Drug Administration Emergency Use Authorization (EUA) allowing monoclonal antibody therapy for adult and pediatric patients with mild to moderate COVID-19.
This episode, beginning a three-part series on this treatment option, will address questions and concerns about the administration of monoclonal antibody therapy.
Guest speaker:
Stacy Lauderdale, PharmD
Senior Director
Drug Information
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:05] Science behind the treatment
[02:09] Evidence is compelling but hypothesis-generating
[03:43] Choosing an option
[04:37] Role of COVID testing
[04:52] Inclusion and exclusion factors
[06:17] Risk of anaphylaxis
[06:54] Social determinants for treatment
[07:44] Patient risk factors
Links | Resources:
Press release and information from FDA Click here
Information from FDA on EUA for monoclonal antibody therapy Click here
ASPR’s portfolio of COVID-19 medical countermeasures (HHS site) Click here
[ For more information, contact: ASPRstakeholder@HHS.gov ]
JAMA article: “An EUA for Bamlanivimab—A Monoclonal Antiboey for COVID-19” (Dec. 11, 2020) Click here
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In this third and final episode of our series on building a team culture, we examine the role of scope of practice, training and fostering a psychologically safe environment to improve and sustain workforce capability.
Guest speakers:
Robert Dean, DO, MBA
Senior Vice President
Performance Management
Vizient
Katie Davis, RN, MS-HSM
Clinical Workforce Solutions Intelligence Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:20] Scope of practice and team-based care
[05:59] Core competencies
[08:44] Story from Northwestern Memorial Hospital
[09:38] A new timeline
[09:56] Attributes of a team-based culture
[10:51] The role of virtual health
[11:48] Story from Vidant Health
Links | Resources:
Vizient playbook: Advancing team culture for workforce effectiveness Click here
“Disruptive and Toxic Behaviors in Healthcare (Holloway, Kusy) Click here
Leading Frontline COVID-19 Teams: Research-Informed Strategies (Kerrisey, Singer—NEJM Catalyst, September 2020) Click here
What Healthcare Workers Need from Leaders in COVID-19 Crisis (Ratanjee, Foy – Gallup, April 2020) Click here
Diversity Still Matters (Dolan, Hunt, Prince, Sancier-Sultan—McKinsey & Company, May 2020) Click here
“Implementing Optimal Team-Based Care to Reduce Clinician Burnout” (National Academy of Medicine discussion paper – September 17, 2018) Click here
“Association Between Provider Engagement, Staff Engagement, and Culture of Safety” (Journal of Healthcare Quality, July/Aug 2020) Click here
Toxic Workplace!: Managing Toxic Personalities and Their Systems of Power (Kusy, Holloway). Book ordering information: Click here
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Despite the challenges COVID-19 has posed to health care teams, these teams have proved resilient and innovative during the crisis. However, sustaining and building on the improvements these teams have made means creating a lasting culture of teamwork. In part two of this three-part series, we consider the role of communication and conflict management in establishing this culture.
Guest speakers:
Robert Dean, DO, MBA
Senior Vice President
Performance Management
Vizient
Katie Davis, RN, MS-HSM
Clinical Workforce Solutions Intelligence Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[00:17] Nurturing the continued development of effective teams
[01:42] Importance of two-way communication to innovation
[02:53] Dealing with disruptive team members
[09:43] Building the foundation of a team-based culture: leadership
Links | Resources:
Vizient playbook: Advancing team culture for workforce effectiveness Click here
“Disruptive and Toxic Behaviors in Healthcare (Holloway, Kusy) Click here
Leading Frontline COVID-19 Teams: Research-Informed Strategies (Kerrisey, Singer—NEJM Catalyst, September 2020) Click here
What Healthcare Workers Need from Leaders in COVID-19 Crisis (Ratanjee, Foy – Gallup, April 2020) Click here
Diversity Still Matters (Dolan, Hunt, Prince, Sancier-Sultan—McKinsey & Company, May 2020) Click here
“Implementing Optimal Team-Based Care to Reduce Clinician Burnout” (National Academy of Medicine discussion paper – September 17, 2018) Click here
“Association Between Provider Engagement, Staff Engagement, and Culture of Safety” (Journal of Healthcare Quality, July/Aug 2020) Click here
Toxic Workplace!: Managing Toxic Personalities and Their Systems of Power (Kusy, Holloway). Book ordering information: Click here
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During the COVID-19 pandemic, the health care workforce has shown resiliency and agility in the face of unprecedented challenges. Yet, sustaining and improving on the advances made in the past year means building a culture of teamwork. In part one of our three-part series on workforce effectiveness, we examine what has hindered effective teamwork in the past, the challenges posed by COVID and how teams can sustain the efforts they have made and improve on those efforts in the future.
Guest speakers:
Robert Dean, DO, MBA
Senior Vice President
Performance Management
Vizient
Katie Davis, RN, MS-HSM
Clinical Workforce Solutions Intelligence Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:30] Inhibitions to team-based care
[04:07] Effect of the pandemic
[06:16] The team defined
[07:29] Characteristics of effective team-based care
[10:27] Benefits of team-based care
[11:34] Approaches that need to continue
Links | Resources:
Vizient playbook: Advancing team culture for workforce effectiveness Click here
“Disruptive and Toxic Behaviors in Healthcare (Holloway, Kusy) Click here
Leading Frontline COVID-19 Teams: Research-Informed Strategies (Kerrisey, Singer—NEJM Catalyst, September 2020) Click here
What Healthcare Workers Need from Leaders in COVID-19 Crisis (Ratanjee, Foy – Gallup, April 2020) Click here
Diversity Still Matters (Dolan, Hunt, Prince, Sancier-Sultan—McKinsey & Company, May 2020) Click here
“Implementing Optimal Team-Based Care to Reduce Clinician Burnout” (National Academy of Medicine discussion paper – September 17, 2018) Click here
“Association Between Provider Engagement, Staff Engagement, and Culture of Safety” (Journal of Healthcare Quality, July/Aug 2020) Click here
Toxic Workplace!: Managing Toxic Personalities and Their Systems of Power (Kusy, Holloway). Book ordering information: Click here
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This is Part 2 of our discussion on the latest MACRA Rule for 2021. Leading experts from Sg2 discuss the issues that affect reimbursement for medical and clinical practices, including Advanced APMs and what they could mean for you.
Guest speakers:
Valinda Rutledge, MBA, MSN
Fellow
Sg2
Madeleine McDowell, MD
Principal, Intelligence
Sg2
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:44] Advanced Alternative Payment Models (aAPMs)—descriptions, developments
[06:44] Outpatient Prospective Payment System (OPPS)—changes
[08:16] Accountable Care Organizations (ACOs)—changes, options
[11:19] Alternative Payment Model Performance Pathway (APP)—measures, options
[12:22] Ramifications of elimination of Inpatient Only (IPO) list
[14:06] Medicare Physician Fee Schedule—developments
[15:44] Three themes from CMS continuing
Links | Resources:
Program handout from December 9, 2020 webcast: Click here
Link to December 9 webcast: Click here
CMS website on MACRA and QPP Click here
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For physician and clinician leaders, this episode provides the latest information on regulatory activities, including the final MACRA Rule for 2021, that will impact reimbursement. We will discuss changes to the Quality Payment Program, E&M Codes and the Merit-based Incentive Payment System (MIPS), along with the MIPS Value Pathways (MVPs). This is information crucial to physicians and clinicians.
Guest speakers:
Valinda Rutledge, MBA, MSN
Fellow
Sg2
Madeleine McDowell, MD
Principal, Intelligence
Sg2
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:58] E&M Code changes: background, rationale, details—after years of development
[06:56] Virtual health changes
[10:38] Expanding scope of practice and team-based care
[12:21] The MACRA Rule—details and ramifications
[16:16] Uncontrollable circumstances – applying for adjustments
[16:45] Merit-based Incentive Payment System (MIPS) update
[20:47] MIPS Value Pathways (MVPs)
Links | Resources:
Program handout from December 9, 2020 Vizient Medical Leadership Series webcast: Click here
Link to December 9 webcast: Click here
CMS website on MACRA and QPP Click here
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Evaluation and Management Codes, used for physician billing, are crucial in capturing the precise level of care needed for accurate and full care reimbursement. In 2021, a number of changes in the rules for these codes will change how physicians bill for clinic visits. This episode will succinctly and comprehensively cover those crucial changes.
Guest speakers:
Aman Sabharwal, MD, MHA, CPHM
Senior Principal, Operational Effectiveness
Vizient
Sheila Bowlds, MBA, RHIA
Consulting Director
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:06] Function and importance of E&M Codes
[02:13] Outdated coding and documentation rules to be replaced
[03:16] Why now?
[04:02] Clinic/ambulatory E&M codes affected
[05:10] Only what is “clinically relevant”
[05:58] Components needed for the clinic codes
[06:33] Revisions
[08:33] Total Time for Office Visits
[09:44] Things included and not included
[12:15] Deleted code
[12:48] Main points to keep in mind
Links | Resources:
CMS Evaluation and Management Services Guide Click here
AMA E&M Codes web page Click here
AAFP E&M Codes web page Click here
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On this episode, experts from Vizient’s COVID-19 Vaccine Task Force continue their discussion on the latest details about vaccine distribution, storage, dosing and availability.
Guest speakers:
Azra Behlim, PharmD, MBA
Senior Director
Pharmacy Sourcing and Program Services
Vizient
Stacy Lauderdale, PharmD
Senior Director
Drug Information
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:30] Refrigeration and storage
[02:44] Dosing interval and immunity
[03:21] Distribution funding and government allocation
[05:59] Retail availability
[06:31] Addressing Social Determinants of Health
[06:57] Operationalizing the process; need for enrolling as administrator
[09:08] Vaccine administration supplies
Links | Resources:
Vizient COVID vaccine resource center Click here
CDC website on COVID vaccines Click here
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News about the emerging COVID-19 vaccines has electrified the world and fueled intense speculation. Finding the truth amid all the press releases and reports is challenging. Yet, clinicians, health care organizations and patients need to distinguish fact from fiction. On this episode, experts from Vizient’s COVID-19 Task Force will give you just that, providing the latest details and developments crucial to your decision-making.
Guest speakers:
Azra Behlim, PharmD, MBA
Senior Director
Pharmacy Sourcing and Program Services
Vizient
Stacy Lauderdale, PharmD
Senior Director
Drug Information
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:22] Vizient COVID-19 Vaccine Task Force
[01:53] Task force workstreams
[03:17] Vaccine platforms
[04:48] The data (apart from press releases)
[06:54] The dosing error and its ramifications
[07:46] Use with asymptomatic patients
[08:16] ADEs?
[09:47] Vaccines on deck
[11:29] Distribution plans and challenges
[13:41] Availability for children
[14:21] Engagement matters
Links | Resources:
Vizient COVID vaccine resource center Click here
CDC website on COVID vaccines Click here
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Patients and families are an untapped resource. As organizations make plans to ramp up elective surgeries and other clinical procedures, and as physicians and clinicians prepare to return to business as usual, they often fail to ask patients how they feel about it. In this episode, we examine the opinions of patients and families, captured in a recent Vizient study, on their preferences around accessing health care during COVID-19.
Guest speakers:
Kellie Goodson, MS, CPXP
Director, Programs
Vizient
Mark Larson, MBA
Principal
Sg2
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:26] Patient attitudes about virtual health
[02:18] Primacy of established patient-physician relationship
[04:49] Virtual health strategies and benefits
[06:39] How organizations and practices can alleviate patient and family concerns
[08:44] Need for physician leadership
[09:47] Organizations successful in engaging patients during COVID
[11:30] Health care is personal
Links | Resources:
Connecting with Patients During COVID-19: Perspectives on Safety (Sept. 2020 Vizient report) Click here
Key talking points from PFA webinar – May 1, 2020 Click here
Working with Patient and Families as Advisors (AHRQ Handbook) Click here
The role of Patient and Family Councils (PFACs) in resuming elective procedures (Modern Practice Podcast – May 13, 2020) Click here
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As health care organizations consider ramping up elective procedures and other clinical practices scaled back or stopped due to COVID, one voice usually absent from these considerations is that of the patient. Yet, patients and families ultimately determine if these procedures will even happen. On this episode, we discuss how to engage patients and families when you resume your procedures, learning the factors they deem crucial in their decisions to have elective surgery or even come in for routine visits.
Guest speakers:
Kellie Goodson, MS, CPXP
Director, Programs
Vizient
Mark Larson, MBA
Principal
Sg2
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:57] Need for the patient voice
[03:35] Conversations with patients on what they need to hear and see
[04:15] Patients accessing procedures in waves
[05:03] Survey results and patient perceptions
[08:04] Utilizing services: patient considerations
[09:56] Pulling the trigger
[11:03] Using patients and families as a resource
[13:40] Communication matters
[14:21] Engagement matters
Links | Resources:
Connecting with Patients During COVID-19: Perspectives on Safety (Sept. 2020 Vizient report) Click here
Key talking points from PFA webinar – May 1, 2020 Click here
Working with Patient and Families as Advisors (AHRQ Handbook) Click here
The role of Patient and Family Councils (PFACs) in resuming elective procedures (Modern Practice Podcast – May 13, 2020) Click here
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On this episode, we continue our discussion on high reliability and how it can transform the system failings that cause clinical errors. Two leading experts examine health care organizations that have used the principles of high reliability to reduce dangerous errors such as pressure ulcers and drastically improve their care over a number of clinical indicators.
Guest speakers:
David Munch, MD
Senior Principal
Vizient
Bradley Schultz, MBA
Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:17] Principles of high reliability
[05:10] Importance of having a team at work
[05:35] Reliability in the front lines
[07:17] Example of Northwestern Memorial Hospital
[08:11] Example of Nebraska Medicine
[08:49] Example of New Hanover Regional Medical Center
Links | Resources:
Evidence Brief: Implementation of High Reliability Organization Principles (NIH) Click here
HRO Development Services – Achieving a high reliability organization (Munch) Click here
The Future of Health Care (Vizient page) Click here
High Reliability (AHRQ) Click here
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Over twenty years ago, the landmark report To Err is Human shook all of health care with its focus on medical errors causing patient deaths. It cast a light on the systems that failed to ensure high-quality, safe clinical care. Yet, today, errors continue, and on this episode of Modern Practice, two leading experts discuss the principles of high reliability that address system failures and the errors they cause.
Guest speakers:
David Munch, MD
Senior Principal
Vizient
Bradley Schultz, MBA
Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[01:26] Costs of medical errors – to hospitals, patients and caregivers
[02:47] Overall costs to the health system
[03:52] Need to sustain efforts
[05:10] Applying high reliability to health care
[08:15] Need for standard work
[09:58] Staff roles in the high reliability organization
[13:04] The problem is not with the front-line staff
Links | Resources:
Evidence Brief: Implementation of High Reliability Organization Principles (NIH) Click here
HRO Development Services – Achieving a high reliability organization (Munch) Click here
The Future of Health Care (Vizient page) Click here
High Reliability (AHRQ) Click here
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On this episode, we continue our discussion on declining operating margins in health care and what we need to do in addressing the challenge through a phased strategic approach to improve margin optimization.
Guest speaker:
Celina Burns
Principal
Financial Performance Solutions
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:29] Operating margins
[01:37] Improving operating margins
[02:51] Stabilizing and preparation phase of growth strategy
[03:20] Managing your “portfolio”: having the right service-line mix
[03:49] Acquisition: not a strategy but a strategy enabler
[05:00] Focus on scaling
[07:06] Importance of analytics
[07:42] What should operations look like?
[09:13] Examples of organizations successfully optimizing margins
[10:34] Resist the urge to go back to “normal”
Links | Resources:
Creating a sustainable business model in an emerging value-based care market Click here
Hospital operating margins decline in 2019 (HFMA) Click here
Hospital margins fell 174% in April Click here
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Before the COVID outbreak, decreasing margins and other challenges were bringing health care to a tipping point, and after the pandemic, health care passed that tipping point. Hospitals and hospital systems were experiencing a fundamental shift in their business models. On this episode, we discuss how health care organizations can address the financial headwinds they face in this new era.
Guest speaker:
Celina Burns
Principal
Financial Performance Solutions
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[01:33] Landscape of health care today
[02:58] Passing the tipping point
[04:19] Five critical areas of opportunity
[05:42] Hospital-physician partnership
[06:26] Need for urgency
[06:55] A different business model
[07:54] Depletion of Medicare funds driving innovation
[08:53] What the recovery period looks like
[10:31] Radical transformation
[11:22] A necessary change in attitude
Links | Resources:
Creating a sustainable business model in an emerging value-based care market Click here
Hospital operating margins decline in 2019 (HFMA) Click here
Hospital margins fell 174% in April Click here
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This episode continues our discussion of artificial intelligence, or AI. We examine how to overcome the common pitfall of bias, both statistical and social, and how to use AI innovatively. We describe what AI, which encompasses machine learning and other functions, can do in chronic care management. Finally, we’ll detail how you can help make it more viable in your organization.
Guest speaker:
Shannon Sims, MD, PhD
Vice President
Data Intelligence and Interoperability
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:25] Bias in AI
[02:32] Perpetuating bias
[02:58] Mitigating bias
[04:04] Does AI inhibit innovation?
[04:43] Changing provider behavior
[05:55] Changing patient behavior
[06:36] Chronic care management: where AI shines
[07:53] Developing AI capability in the organization
Links | Resources:
Machine Learning in Medicine (NEJM—April 4, 2019) Click here
HYPE Randomized Clinical Trial Click here
Potential Biases in Machine Learning Algorithms Using Electronic Health Record Data (JAMA Internal Medicine—Nov 2018) Click here
On Deep Learning for Medical Image Analysis (JAMA—Sept 18, 2018) Click here
Artificial Intelligence in Health Care: Will the Value Match the Hype? (JAMA—June 8, 2019) Click here
Artificial Intelligence in Health Care: A Report from the National Academy of Medicine (JAMA—Feb 11, 2020) Click here
Artificial Intelligence: Promise, Pitfalls and Perspective (JAMA—June 23/30, 2020) Click here
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For years relegated to science fiction, as exemplified when the HAL 9000 had a speaking role in 2001: A Space Odyssey, artificial intelligence (AI) now has become practical reality and in medicine, a long-hoped-for remedy in areas from pathology to electronic medical records. Yet, artificial intelligence, which encompasses machine learning and other functions, has limitations. In this episode, learn about the current state of artificial intelligence and what it can realistically achieve for your practice.
Guest speaker:
Shannon Sims, MD, PhD
Vice President
Data Intelligence and Interoperability
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:56] Understanding concepts around AI
[02:28] Two main functions of AI
[03:33] Importance of prescriptive analytics
[04:26] Enabling clinicians make better decisions
[05:13] Machine learning and EMRs
[06:10] AI and the coronavirus
[07:52] Structural challenges
[09:01] AI and quality
[10:09] Role of clinicians in developing solutions
[11:04] Successes and limitations
Links | Resources:
Machine Learning in Medicine (NEJM—April 4, 2019) Click here
HYPE Randomized Clinical Trial Click here
Potential Biases in Machine Learning Algorithms Using Electronic Health Record Data (JAMA Internal Medicine—Nov 2018) Click here
On Deep Learning for Medical Image Analysis (JAMA—Sept 18, 2018) Click here
Artificial Intelligence in Health Care: Will the Value Match the Hype? (JAMA—June 8, 2019) Click here
Artificial Intelligence in Health Care: A Report from the National Academy of Medicine (JAMA—Feb 11, 2020) Click here
Artificial Intelligence: Promise, Pitfalls and Perspective (JAMA—June 23/30, 2020) Click here
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For data to be effective, the information needs to be current. It needs to reflect what is truly significant in patient care. And it needs to encourage consistency in practice. On this episode, a leading analytics expert continues his discussion on how you and your organization can shape the wealth of data you collect to guide the care you deliver.
Guest speaker:
David Levine, MD, FACEP
Group Senior Vice President
Advanced Analytics and Project Management
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:23] The issue of data validity
[02:09] The issue of timeliness
[02:55] Data from the Wild, Wild West (ambulatory arena)
[04:03] Getting to the data—clinical data more valid than claims data
[05:10] Encouraging consistency
[06:22] Steps we can take now to better data
[06:46] Understand the data before refuting it
[08:12] The meaningless quest for an overall clinical score
[09:08] The sea of data
Links | Resources:
Transparency: A Critical Component in Advancing Health Care Improvement Click here
Leveraging the Power of Data and Collaboration to Change Healthcare Click here
Electronic Health Records and Meaningful Use (AHRQ) Click here
Public Health and Promoting Interoperability Programs (CDC) Click here
How hospitals can use data to improve efficiency Click here
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Big data has the potential to provide clinicians with the information they need to improve the value of their care. Yet, the challenges are in how to find the right metrics, out of all the information available, and then putting the metrics to the best use. On this episode, a leading expert in clinical analytics will discuss using data that provides a true picture of care and serves to improve care outcomes. He will also discuss what recent analysis is showing about trends during the COVID-19 outbreak.
Guest speaker:
David Levine, MD, FACEP
Group Senior Vice President
Advanced Analytics and Project Management
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[01:37] Elements of meaningful data
[03:06] The data will never be perfect
[03:34] Attribution challenge
[03:53] Hospitalist example
[04:53] Data from the pandemic
[07:28] Not a major investment but a major commitment
[08:52] Bringing clinicians to the table early
Links | Resources:
Transparency: A Critical Component in Advancing Health Care Improvement Click here
Leveraging the Power of Data and Collaboration to Change Healthcare Click here
Electronic Health Records and Meaningful Use (AHRQ) Click here
Public Health and Promoting Interoperability Programs (CDC) Click here
How hospitals can use data to improve efficiency Click here
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Lack of communication and fear of telling the truth are common pitfalls for leaders, and these pitfalls lead to the staff losing trust. In this episode, we continue our discussion on how leaders can develop and hone skills to keep staff engaged. Effective leaders are coaches and foster team-based care. Their actions lead to trust and resilience, in this time of crisis and beyond.
Guest speaker:
David Munch, MD
Senior Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes
[00:37] Need for leadership visibility where the work is done
[01:01] Need for inclusive communication: top-to-bottom and bottom-to-top
[02:37] Executives and middle managers average 65% of their time in meetings
[03:27] Leadership visibility in the surgical suite
[04:42] Give everyone the benefit of the doubt
[06:40] Make their job easier!
[07:45] What leaders can do today: four stages
[10:37] Having the right metrics
Links | Resources:
How to Succeed or Fail in Your Lean Improvement Efforts Click here
How Process Improvement Teams Can Help During the COVID-19 Crisis Click here
Lean Thinking during the COVID-19 Pandemic Click here
Resources to Support the Health and Well-being of Clinicians during the COVID-19 Outbreak Click here
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This time of ongoing crisis has severely tested the resilience of clinical staff, increasing the risk of burnout and emotional exhaustion. Health care leaders must address the issue of resilience right now or the problem will accelerate. Leaders that do not engage their staff, that do not have visibility or transparency and do not give and receive feedback are risking loss of trust and even staff turnover. On this episode, we’ll consider ways to foster resilience among staff and avoid pitfalls in leadership.
Guest speaker:
David Munch, MD
Senior Principal
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:30] Staff resilience during the pandemic
[02:23] Rounding as a leadership style
[04:25] Essential characteristics of leadership
[05:07] Dealing with staff emotions
[06:13] Addressing frustrations
[07:43] Accelerating trust
[08:59] Necessity of team-based care
Links | Resources:
How to Succeed or Fail in Your Lean Improvement Efforts Click here
How Process Improvement Teams Can Help During the COVID-19 Crisis Click here
Lean Thinking during the COVID-19 Pandemic Click here
Resources to Support the Health and Well-being of Clinicians during the COVID-19 Outbreak Click here
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This episode continues our discussion on the impact of COVID-19 on clinical practices by examining a new framework for health care, with the idea that it must be more adaptable, flexible and reliable than in the past. Practice data should reflect what we need to know about access, quality and even productivity. Finally, we explore the best approach for creating and developing new ideas and practices, one that originates from those involved in the care every day and not imposed from the top down.
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
[00:37] Future of the health care framework
[02:10] Using a nimble virtual care platform
[02:30] Leveraging practice data to look at access, quality and productivity
[03:42] Providers need options for developing new approaches
[04:06] How health care organizations should use practice data
[05:01] The Clinical Practice Solutions Center (CPSC): sharing data with clinicians
[05:27] Access and improvement insights
[06:19] Lessons learned from COVID-19
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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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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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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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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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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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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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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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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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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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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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, CPXP Director, Programs Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
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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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, CPXP Director, Programs Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President, Clinical Resources Vizient
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 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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This episode continues our discussion on the “weekend effect,” the phenomenon where the comprehensiveness and quality of hospital care drops off on weekends. Having established in Part 1 how this situation occurs, we devote this session to strategies that help you avoid it, including staffing accommodations and leadership focus. In addition to improving patient care and outcomes, health care organizations will find they will gain a significant competitive advantage in addressing this issue.
Guest speakers: Aman Sabharwal, MD, MHA, CPHM Senior Principal, Advisory Solutions Vizient
Eric Burch, RN, MBA Associate Principal, Advisory Solutions Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President, Clinical Resources Vizient
Show Notes: [00:25] The impact of “weekend effect” on quality of care [01:35] Impact on medical and surgical cases [02:12] Impact on community hospitals vs. academic medical centers [05:20] Procedures affected [07:05] Avoiding the weekend effect [08:09] Competitive advantage in addressing weekend effect [09:28] Example of health care organization that successfully dealt with the weekend effect
Links | Resources:
The Weekend Effect in Hospitals: Causes (Vizient Brief) Click here
The Weekend Effect in Hospitalized Patients: A Meta-Analysis (Journal of Hospital Medicine, Sept. 2017) Click here
“Who elects the weekend?” Click here
Sg2 Perspectives: A new podcast connecting you to Sg2 thought leadership … anytime, anywhere Click here
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Patients have good reason to fear staying at the hospital over the weekend. Studies have consistently demonstrated the weekend effect, where weekend admissions or stays cause increases in complications and higher mortality rates. This two-part series of Modern Practice examines the reasons behind the weekend effect and strategies for preventing it.
Guest speakers:
Aman Sabharwal, MD, MHA, CPHM
Senior Principal, Operational Effectiveness
Advisory Solutions
Vizient
Eric Burch, RN, MBA
Associate Principal
Advisory Solutions
Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Associate Vice President
Clinical Resources
Vizient
Show Notes:
[01:25] The “weekend effect” explained
[01:57] Multiple causes
[02:17] Data supporting the weekend effect
[07:29] Case management and care transitions
[08:40] Impact of COVID Pandemic
[09:22] Assessing the weekend effect
Links | Resources:
The Weekend Effect in Hospitals: Causes (Vizient Brief) Click here
The Weekend Effect in Hospitalized Patients: A Meta-Analysis (Journal of Hospital Medicine, Sept. 2017) Click here
“Who elects the weekend?” Click here
Sg2 Perspectives: A new podcast connecting you to Sg2 thought leadership … anytime, anywhere Click here
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This episode continues the series on valuable insights gained in the handling of the COVID-19 crisis. We will discuss skills clinical leaders and staff have developed to cope with new risks and responsibilities. Also, we will examine a renewed focus nationwide on patient and family engagement, how to remain competitive when having to shut down operations and how to plan for patient cohorting in the future.
Guest speaker: David DiLoreto, MD, MBA Consulting Principal Sg2
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President, Clinical Resources Vizient
Show Notes: [00:28] Staff and leadership resilience [02:06] Listening to the consumer voice [04:16] Importance of patient families [05:40] Financial impact on health care sector and fee-for-service [09:00] Changes in the competitive landscape [09:39] On remaining competitive [12:18] Impact of patients dying alone [13:28] Cohorting patients: the new norm?
Resources: Vizient COVID-19 webinar page, including May 27 webinar “Roundtable discussion: moving forward through lessons learned during COVID-19”: click here Vizient’s disaster-preparedness site: click here Sg2 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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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, MBA Consulting Principal Sg2
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President, Clinical Resources Vizient
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 here Vizient’s disaster-preparedness site: click here Sg2 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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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, PharmD Vice President Pharmacy Solutions Vizient
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
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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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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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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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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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, MBA Senior Vice President Performance Management Vizient
Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Associate Vice President Clinical Resources Vizient
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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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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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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