Knowledge on the Go

Identifying Ambulatory and Post-Acute Care Strategies to Reduce Readmissions

Transitions of care can be arduous for clinicians and confusing to patients. Often, clinicians and patients alike face unreal expectations as to the level of care that results. As an answer, NYU Langone Health fostered better communication between clinicians in the acute-care areas and clinicians in the post-acute facilities to improve on the inefficiencies and drawbacks involved in care transitions.
 
Ana Mola, PhD, ANP-BC
Director
Care Transitions and Population Health Management
NYU Langone Health.
 
Adrienne Goldberg, MPT
Director
Post-acute Innovation and Special Projects
NYU Langone Medical Center
 
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Behavioral Response Team

Hospitals all over the country are overwhelmed by an increasing number of patients with behavioral health issues. Many use the emergency department to access care and end up staying in the hospital for a more extended time.  These patients jeopardize health care workers safety and impede their own ability to receive necessary care. The University of Kansas Health System developed a Behavioral Response Team to intervene with these patients that has shown positive results for the organization and their patients.
 
Guests:
Teresa Long, MD
Associate Professor for Psychiatry and Internal Medicine
University of Kansas Health System
 
Heidi Boehm
Quality Outcome Coordinator
University of Kansas Health System
 
Show Notes:
[00:00 – 01:17]  Beginnings of the Behavioral Response Team
[01:18 – 02:36]  Recognizing the need for safety and improving the care of patients
[02:37 – 03:39]  Specific skillsets of Response Team
[03:40 – 04:39]  Training and partnering with police department
[04:40 – 05:57]  Prevention intervention
[05:58 – 06:42]  Importance of Documentation
[06:43 – 08:16]  Challenges and changes
[08:17 – 09:42]  Setting up for success
 
Links | Resources:
Watch the Vizient Behavioral Response Team webcast here for additional details.
For more information, email knowledgetransfer@vizientinc.com
 
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Improving Sepsis Early Recognition

Sepsis is a life-threatening infection that kills nearly 270,000 Americans annually.  Another 1.7 million people develop sepsis but survive the experience.  In this podcast, we dive into the work of patient and family advisory councils and why the collaboration between patients, families and their providers can mean the difference between life and death.
 
Guests:
Armando Nahum, Director, Center for Engaging Patients as Partners, MedStar Institute for Quality and Safety
Jeanne DeCosmo, BSN, MBA, CPHQ, Director, Clinical Quality, MedStar Health
For more information, email knowledgetransfer@vizientinc.com
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Emergency Medicine of the Future, Part 3

Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. Dr Tomas Spiegel from the University of Chicago and Dr. Martin Lucenti from Vizient return for part 3 of this series summarizing factors that shape emergency medicine today and offer their thoughts on what will be different in the future. In this episode they examine how emergency departments can adjust scope of care and use social determinants of care to help shape their future.
 
Guests:
Thomas Spiegel, MD, MS, BA, ED
Medical Director
University of Chicago Medicine
 
Martin Lucenti, MD, PhD
SVP & CMO, Solution Architecture
Vizient
 
For more information, email knowledgetransfer@vizientinc.com
 
Show Notes:
[00:00-08:13] Switching scope of care model in emergency department away from convenient care and making it easier for patients to access care.
 
[08:14-09:36] Training providers differently for the change in scope of care in emergency department.
 
[09:37-12:36] Role of specialists in emergency department when changing to a new care model.
 
[12:37-15:30] The transition of the emergency department to point of access for all service lines an organization.
 
[15:31-18:24] Role of community in helping emergency medicine in the future.
 
[18:25-26:56] Taking strain off emergency medicine by tapping into the resources of the community.
 
[26:57-29:43] What’s on the horizon for emergency medicine.
 
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Addressing Pharmaceuticals in High Cost Service Lines

Escalating drug costs along with decreasing reimbursement have increased pressure for the pharmacy departments to oversee cost effective medication management. Becky Sillaman, System Director, Clinical Pharmacy Services for Premier Health, discusses how her team collaborated with Premier’s Anesthesiologists on specific strategy that reduced inpatient spend on one drug while continuing to provide high-quality care for patients.
 
Guest:
Becky Sillaman, PharmD
System Director, Clinical Pharmacy Services
Premier Health
 
Show Notes:
[00:00 - 00:57]   Comparing Cost of IV Acetaminophen vs Oral Acetaminophen
[00:58 - 02:32]    Building the case for the initiative to use less IV Acetaminophen
[02:33 - 03:03]      Getting Anesthesiologists to buy into the initiative
[03:04 - 05:15]       Changing culture to make positive change in cost savings
[05:16 - 07:41]       Getting key stakeholders on board and workflow adjustments
[07:42 - 09:33]       Results and how to define success
 
For more information, email knowledgetransfer@vizientinc.com
 
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Emergency Medicine of the Future, Part 2

Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. Dr. Tomas Spiegel from the University of Chicago and Dr. Martin Lucenti from Vizient return for part two of this three-part series. They explore factors shaping emergency medicine today and tomorrow. In this episode, they outline how operational strategies and payer models could evolve to better support emergency medicine in the future.
 Guests:
Thomas Spiegel, MD, MS, BA, EDMedical DirectorUniversity of Chicago Medicine
Martin Lucenti, MD, PhDSVP & CMO, Solution ArchitectureVizient
For more information, email knowledgetransfer@vizientinc.com
Show notes:
00:00-3:58     The Emergency Room as an independent, immediate care service line.
03:58-07:57   Positioning the Emergency Department to serve as a support system to route patients towards other service lines.
07:58-14:30 Helping providers shift to take on different roles and address patient satisfaction.
14:31-18:19   Changes to payment reimbursement models and how they affect the emergency department.
 
 

Emergency Medicine of the Future, Bonus Edition

Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. In this bonus edition to the Emergency Medicine of the Future three-part series, Dr. Thomas Spiegel from the University of Chicago summarizes factors shaping emergency medicine today and offers his thoughts on what will be different in the future.  The broad-ranging discussion covers everything from emergency room current challenges, to implementing operational efficiency, operations management and functioning as a diagnostic center and COVID-19 patient hub for the organization.
 
Guest:Thomas Spiegel, MD, MS, MBAED Medical DirectorUniversity of Chicago Medicine
 
For more information, email knowledgetransfer@vizientinc.com
 
Show Notes:
[00:00 – 01:33]  Adjusting to COVID-19 in the Emergency Department
[01:34 – 02:33]  Caring for COVID patients in the Emergency Department
[02:34 – 03:46]  Separating patients into care spaces
[03:37 – 05:44]  Identifying and treating COVID-19 cases
[05:45 – 06:05]  Guideline: The 5 liters of oxygen
[06:06 – 09:55]  Ventilators vs. high-flow nasal cannula approach
[09:56 – 12:02]  High-flow nasal cannula differs from oxygen delivered though the standard nasal cannula
[12:03 – 15:57]  Continuous Positive Airway Pressure Helmets or CPAP
[15:58 – 16:54] Contraindications for co-morbidity patients
[16:55 – 17:42] Drawbacks for treatment options
[17:43 – 18:39] Lessons learned – Prevent the vent
[18:40 – 20:25] Future of Emergency Medicine
 
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Maternal Mortality

Dr. Carol Solie and Jennifer Gallagher from the Wyoming Medical Center knew they needed better staff training for maternal mortality by post-partum hemorrhage and hypertension. They decided on the obstetrical training simulation process and the results were astounding. They join us on this program to discuss their decision, including the challenges and benefits.
 
Guests:
Jennifer Gallagher
Clinical Educator for Obstetrics
Wyoming Medical Center 
 
Dr. Carol Solie
Vice President of Quality and Medical Safety
Wyoming Medical Center 
 
Resources:
Watch the Vizient Reducing Maternal Mortality collaborative webcast for additional details.
 
For more information, email knowledgetransfer@vizientinc.com
 
Show Notes:
[00:00 – 02:40]  Recognize the need for better training
[02:41 – 03:39]  Bedside simulation program with hands on training
[03:40 – 04:15]  Doctor education
[04:16 – 05:25]  Simulation pre-briefing scenarios and objectives
[05:26 – 06:05]  Identifying roles and scripting
[06:06 – 06:59]  Team building and positive experiences
[07:00 – 09:50]  Simulation challenges and benefits
[09:51 – 11:29]  Setting up for success
 
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Emergency Medicine of the Future, Part 1

Even before the COVID-19 pandemic, emergency medicine departments faced a myriad of challenges. In the first of a three-part series, Dr. Thomas Spiegel from the University of Chicago and Dr Martin Lucenti from Vizient summarize factors shaping emergency medicine today and offer their thoughts on what will be different in the future.  Their broad-ranging discussion covers everything from emergency room current challenges, to implementing operational efficiency, operations management and functioning as a diagnostic center and patient hub for an organization.
 
Guests:
Thomas Spiegel, MD, MS, BA, ED
Medical Director
University of Chicago Medicine
 
Martin Lucenti, MD, PhD
SVP & CMO, Solution Architecture
Vizient
 
For more information, email knowledgetransfer@vizientinc.com
 
Show Notes:
[00:00 – 03:15]  Current state of Emergency Medicine
[03:29 – 06:14]  Emergency Room efficiency model and its effect on overcrowding and finances
[06:31 – 07:27]  Challenges with behavioral health patient needs
[07:27 - 08:00]  Challenges with geriatric population
[08:00 - 08:31]  Challenges with workforce issues
[08:49 - 10:54]  What lies ahead: flattening of low acuity patient and growth in higher acuity patients
[10:55 – 14:13]  Operational efficiency, adopting operations management, system reliability
[14:21 - 16:41]  Emergency department functioning as a diagnostic center and patient hub
 
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Implementation of an Opioid Stewardship Program

Health care organizations across the country are implementing opioid stewardship programs to address the opioid crisis. BJC HealthCare joined the Vizient performance improvement collaborative hoping to discover best practices to improve the mortality rates for their system. The collaborative suggests participants inventory your current efforts as a first step in the process. And right at square one, BJC uncovered one of its hospitals had a unique program that was saving—and transforming—patients’ lives.
 
Guests:
Amanda Hays, PharmD, MHA, BCPS, CPHQ, System Pharmacy and Outcomes Manager. Center for Clinical Excellence – BJC HealthCare
Jordan Shapiro, Business Process Consultant, Healthcare Informatics, Center for Clinical Excellence – BJC HealthCare
 
Resources:
Watch the Vizient Opioid Stewardship Program collaborative webcast for additional details.
 
For more information, email knowledgetransfer@vizientinc.com
 
Show Notes:
[00:00 – 01:26] BJC singles out the opioid problem as a focus area and describes the impact on the community
[01:26 – 02:14]  A potential solution is uncovered within their system: EPICC –engaging patients in care coordination
[02:14 – 03:10] The ED provides a key opportunity for connecting patients in need
[03:10 – 04:09] Finding the secret sauce to the opioid addiction recovery efforts
[04:09 – 05:14]  Challenges to efforts
[05:14 – 06:25] Anticipating and overcoming addiction stigma
 
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