Atrium Health and Wake Forest Baptist Health complete merger

Atrium Health and Wake Forest Baptist Health complete merger

Atrium Health, Wake Forest Baptist Health and Wake Forest School of Medicine completed their merger, the North Carolina-based not-for-profit organizations announced Friday.

The combined entity is comprised of 70,000 employees, 42 hospitals and around 1,500 care locations that generate more than $11 billion in annual operating revenue. Executives aim to bolster their pipeline of medical professionals with a second Wake Forest School of Medicine campus in Charlotte as well as expand their population health efforts, among other goals.

“As the healthcare field goes through the most transformative period in our lifetime, in addition to a new medical school, our vision is to build a ‘Silicon Valley’ for healthcare innovation spanning from Winston-Salem to Charlotte,” Eugene Woods, president and CEO of Atrium Health, said in prepared remarks. “We are creating a nationally-leading environment for clinicians, scientists, investors and visionaries to collaborate on breakthrough technologies and cures. Everything we do will be focused on life changing care, for all, in urban and rural communities alike. And we will create jobs that provide inclusive opportunities to enhance the economic vitality of our entire region.”

Dr. Julie Ann Freischlag, CEO of Wake Forest Baptist Health and dean of Wake Forest School of Medicine, has been named the chief academic officer of Atrium Health. Edward Brown, the current board chair of the Charlotte Mecklenburg Hospital Authority, will lead the 16-member board appointed by the CMHA and Wake Forest University Baptist Medical Center, which will oversee the newly formed not-for-profit corporation, Atrium Health, Inc.

“Through our combined, nationally recognized clinical centers of excellence in multiple specialties, we will be able to expand our research in signature areas, such as cancer, cardiovascular, regenerative medicine and aging, and target bringing research breakthroughs to the community in less than half the time of the national average,” Freischlag said in prepared remarks.

The combined institution plans to build a new eye institute and construct a new critical care, emergency department and surgery tower at Wake Forest Baptist Medical Center.

Atrium will also expand its virtual care and behavioral health capacity and grow its research related to Alzheimer’s disease, high blood pressure, diabetes, obesity, hypertension and vascular disease.

Through the first half of the 2020 fiscal year, Atrium reported a $225 million operating loss on $2.96 billion of operating revenue, although that was offset by nearly $232 million in federal COVID-19 relief grants, according to Modern Healthcare’s financial database. That compared to a $168.3 million operating income on $3.21 billion of operating revenue in the same prior period.

Atrium reported $386.4 million of operating income on $7.48 billion of revenue in the 2019 fiscal year.

Through the fiscal year ended June 30, Wake Forest Baptist reported $40.6 million of operating income on $3.61 billion of operating revenue, up from a $1.84 million loss on $3.38 billion of operating revenue the prior year.

Atrium

Source: Atrium Health and Wake Forest Baptist Health complete merger

HHS orders Nevada to revoke ban on nursing homes using antigen tests

HHS orders Nevada to revoke ban on nursing homes using antigen tests

Federal health officials have ordered Nevada to allow nursing homes to use two rapid antigen tests after a review showed a majority of positive results were false, saying the action violated federal law and endangered lives. HHS

Nevada’s Department of Health and Human Services banned Quidel Corp.’s Sofe and Becton Dickinson and Co.’s Veritor antigen tests from long-term care facilities after receiving anecdotal reports questioning their validity. Those point-of-care tests’ positive results contradicted negative readings from reverse-transcriptase polymerase chain reaction tests, which are considered more accurate.

HHS Assistant Secretary Dr. Brett Giroir on Friday said the agency would take “swift and appropriate steps” if Nevada’s Department of Health and Human Services didn’t reverse course.

“The letter from Nevada officials can only be interpreted as reflecting a fundamental lack of basic knowledge about testing and interpreting results,” Giroir said. “Not just COVID testing but clinical testing in general.”

Nevada’s agency said spot checks of antigen tests found that only 40% were considered true positives; 23 of the 39 tests reviewed were false positives. Twelve skilled-nursing facilities performed more than 3,700 antigen tests with 60 positive results.

The state reported that Becton Dickinson tests had a 50% accuracy rate, and only one of the nine reviewed Quidel tests was a true positive.

“If the use of the outlined antigen tests continues within a SNF, the Bureau of Health Care Quality and Compliance will take necessary corrective action to ensure the safety of staff and residents within the facility,” state health officials wrote to nursing homes.

The conflicting tests results may have stemmed from inadequate training, complpiance issues or false negatives from the RT-PCR tests, according to state health official. Nevada said it would update its antigen testing guidance after it received more data.

Giroir said all tests are expected to have some false positives, especially when screening a patients with a low infection prevalence. Nevada has reported 84,593 confirmed cases as of Friday, with 766 new cases over the last day.

Across the country, nearly 246,000 nursing home residents have tested positive for COVID-19, with another 141,444 suspected cases, according to CMS.

In August, CMS started requiring long-term care facilities to routinely screen both residents and staff for COVID-19 or face financial penalties. The agency hoped the effort would help stem coronavirus outbreaks in nursing homes.

Giroir declined to elaborate on the actions HHS could take if Nevada health officials don’t comply with the demand, but noted there were several enforcement mechanisms at their discretion. He said he was confident they would comply after reviewing the facts.

“There really is no scientific reason, no medical reason to not comply with this and not to allow lifesaving testing,” Giroir said.

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Source: HHS orders Nevada to revoke ban on nursing homes using antigen tests

White House sticks to Jan. 1 hospital price transparency deadline

White House sticks to Jan. 1 hospital price transparency deadline

The Trump administration has no plans to delay implementation of its hospital price transparency rule on Jan. 1, a White House official said.

Hospitals have implored the Trump administration to delay the January 2021 implementation of hospital price transparency requirements, but the White House does not appear to be backing down.

A White House official said that the administration already delayed implementation when HHS published the final rule and pushed the deadline to Jan. 1.

“As of right now we have no plans to delay implementation further,” the official said.

Hospital groups including the American Hospital Association, Federation of American Hospitals, Association of American Medical Colleges and Children’s Hospital Association in June wrote to HHS Secretary Alex Azar arguing the rule would be burdensome for hospitals to adhere to amid the COVID-19 pandemic and asked HHS to delay implementation until after the rule’s legality is settled by the courts.

“Even attempting to comply with the rule will require a significant diversion of financial resources and staff time that hospitals and health systems cannot afford to spare as they prepare to or care for patients with COVID-19,” the hospital groups wrote.

Oral arguments before the U.S. Court of Appeals for the District of Columbia Circuit are set for Oct. 15. A District Court judge upheld the rule in June.

Instead of acceding to hospitals’ demands for a delay, President Donald Trump signed an executive order that requires CMS to make data on compliance with the price transparency rule publicly available in March.

“At this point hospitals have shown they want to fight us tooth and nail in court and we think the statutory grounding is sound,” the White House official said.

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Source: White House sticks to Jan. 1 hospital price transparency deadline

COVID-19 tests remote work capacity

COVID-19 tests remote work capacity

CCM Health, a medical center based in Montevideo, Minn., shares continual COVID-19 updates from management and caregivers; daily emails to all employees about census, staffing, access and other stats; bi-weekly organizational updates from the CEO; and marketing communications that include facility updates as well as monthly department meeting recordings. tests

“We feel the key is through extensive and continuous communication,” said Kelly Johnson, CCM’s human resources manager.

Even though CereCore, which supports providers’ IT needs, initially saw its business decline, it kept more staff on than needed to help people transition to the new working environment, said Curtis Watkins, CereCore’s CEO.

They doubled down on personal check-ins, but managers had to strike a balance between checking in periodically and not overwhelming employees, he said.

“From an HR perspective, we try to treat people with grace and understanding,” Watkins said. “We were careful not to overdo it because people don’t want to feel like they always have somebody over their shoulder. So we made it personal, asking about their family or kids and had to be clear that this is about staying connected, not micromanaging.”

Ultimately, COVID-19 accelerated the Nashville-based company’s move to more remote work. Watkins expects about an 80%-to-20% ratio of remote to in-person work over the long term, up from around 60% to 40%. It will likely downsize its real estate footprint by about a third, Watkins said.

“It has been an interesting journey, and it is something we will try to figure out and get better at,” he said, adding that the biggest long-term challenge is around the void of face-to-face interaction between its senior level administrative team. “We need to find ways to build that teamwork and trust.”

Advocate Aurora launched its first ever virtual professional development initiative. To Brady’s surprise, about 40% of its leadership team tuned in to some of the 30 sessions.

“It is part of how this whole process drove more innovation,” he said.

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Source: COVID-19 tests remote work capacity

Keeping frontline healthcare workers physically and psychologically safe is paramount during the COVID-19 pandemic

Keeping frontline healthcare workers physically and psychologically safe is paramount during the COVID-19 pandemic

Source image: Pixabay by Hilary Clark.
Care teams are asking for a safer work environment. But what does “safe” actually mean? frontline

Fall is here, and as many had feared and predicted, COVID-19 cases are on the rise again in many parts of the U.S. Just last week, 3,400 nurses at Brigham and Women’s Hospital in Boston, an area that’s been hit hard by the pandemic, urged executives to give them a safer environment with universal N95 masking, shuttle safety, communication about infections and effective quarantines.

The message was simple: To adequately care for coronavirus patients, care teams need to be able to care for themselves. That’s a tall order, given that nurses and caregivers on the front lines are more at risk of infection than the socially distanced populace. But the concern over healthcare worker safety is well-founded, and administrative teams need to ensure that equipment and processes are in place that can reduce the risk of transmission.

Enter “The Person Behind the Mask,” a campaign launched by patient safety company RLDatix. It was created to increase awareness about the importance of keeping frontline workers safe, and a key component of that effort is ensuring that caregivers remain physically and emotionally healthy in order to deliver better and safer care.

“When harm events happen in hospitals, it’s devastating for patients and families, but also for the care team,” said Dr. Tim McDonald, RLDatix’s chief patient safety and risk officer. “They feel terrible when harm events happen. Traditionally the response had been the wall of silence — don’t talk to patients and families openly, and often don’t talk to each other. It was a sign of weakness to ask for help. We needed to shatter the wall of silence.”

It’s a pressing mission for a number of reasons, not least of which is morale. Physician and nurse suicide has spiked in the past decade. McDonald works with the suicide prevention team at University of California San Diego and was distressed to learn that an emergency department physician recently committed suicide due to pandemic-related stress.

Even taking suicide out of the equation, there’s been a massive increase in burnout. Doctors and nurses are leaving the profession because of the impact, and that extends beyond their own lives to those of their families. Divorce rates are high among care teams, and also among patients and families who have lost loved ones to the coronavirus — implying some pretty troublesome collateral damage.

Yet with care teams asking for a safer work environment, it’s constructive to ask: What does “safer” mean, exactly?

A BETTER ENVIRONMENT

Broadly speaking, better safety encompasses both the physical and the psychological. Hospitals and health systems have tended to fare better on the physical side, which entails procuring the requisite personal protective equipment and getting it to the right people at the right time. Sanitation protocols also make an environment feel more physically safe.

Psychological safety, said McDonald, can be fostered when health leaders are transparent and report when things aren’t going the way they should be. Event reporting systems can capture unexpected events so teams can learn from them in the future, which created a psychologically safe environment for people to report and act upon the data, thereby buttressing the overall work environment.

“I’m encountering devastating things I’ve never seen before,” said McDonald. “Organizations can put in place ‘caring for the caregiver’ programs to provide support on a proactive basis. It’s analogous to what aviation does. Whenever there’s a mishap in aviation, there’s immediate outreach to the people involved in that. We need to be doing more of that in healthcare.”

Data is a big component of that approach, as it allows leaders to educate care teams about things like infection management and patient safety. Many electronic health records systems are able to analyze infection surveillance data, for example, to see whether there are pockets of infections the organization should know about, allowing the provider to take action.

It can also pick up on medication errors, which are the most common errors that occur in healthcare. EHRs and other software can analyze and collate events to look for patterns, allowing teams to take preventive action. An example of this is preventing central line and catheter infections, which are linked to ventilator-associated pneumonias.

“It changes the way we deliver care,” said McDonald. “We need to do more to identify safety scientists to help design cate that prevents events in a more rapid way.”

THE OPPORTUNITY

Executives have a challenge, but also an opportunity, to improve safety in a manner that lasts well beyond the end of the pandemic. One way is to examine the ways care has changed during the public health crisis and implement those changes permanently across all areas of care.

Change in process, said McDonald, is one of the great lessons learned during the pandemic and one of the things health leaders can begin working on immediately.

“Empathy and compassion go along with candor,” he said. “It mitigates implicit bias. One of the things we’re seeing is these issues around implicit bias and racism. We know empathy and compassion can mitigate it. That means we need to use the data that identifies things around race, ethnicity, pronoun preference, issues around LGBTQ. That’s one of the things that has reared its ugly head during this pandemic.”

McDonald sees more and more providers adopting these kinds of approaches, and in fact, it’s a mindset that’s increasingly taught at the student level, meaning those just entering the healthcare workforce will have expectations of having their health and mental well-being protected and respected. It’s a mindset that in some ways defines the future of healthcare — and the future is now.

“We’re starting to get traction,” said McDonald. “We can’t afford not to do this.”

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Source: Keeping frontline healthcare workers physically and psychologically safe is paramount during the COVID-19 pandemic

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