Authors: Censis Education
The COVID-19 pandemic isn’t over yet, but already it’s left a mark on healthcare. Non-coronavirus patients have been encouraged to stay home and the importance of environmental cleanliness is front and center. And masks are as ubiquitous as trees in a forest.
As the world keeps spinning and states throughout the U.S. move into various stages of reopening (or return to stricter closures), healthcare administrators and providers are exploring ways to better care for patients. The pandemic has exposed weaknesses in healthcare. Could it also provide the impetus for change? Only time will tell.
For now, here are several aspects of healthcare that are receiving new (or renewed) attention because of the pandemic:
The need to socially distance and keep healthy people away from potentially infected people and places led to widespread cancellation or postponement of treatments or routine checkups. Rather than halting all medical consultations, many providers have implemented virtual checkups, using video chat technology to provide remote interfacing between patients and medical professionals. This enables patients who don’t require hands-on care but may have a health concern that warrants professional attention to meet with their doctor without exposing themselves to potential infection.
Telehealth services aren’t new, but COVID-19 has provided an opportunity to normalize this approach to seeking medical care. In an effort to encourage patients to use this offering during the pandemic, the Centers for Medicare & Medicaid Services (CMS) lifted a number of Medicare restrictions that previously applied to telehealth services (these restrictions may be restored post-pandemic).
CMS has made other efforts to support at-home care, including proposing changes to Medicare’s payment system that apply to dialysis treatment. Many Medicare dialysis patients travel to a hospital three times a week for dialysis treatment. According to the Centers’ release, “Dialysis patients are among the most vulnerable population covered by Medicare” and those with end-stage renal disease have “the highest hospitalization rates due to COVID-19 among Medicare beneficiaries.” CMS’s proposal calls for Medicare coverage of home dialysis treatment for these patients, which would keep them out of hospitals that put them at higher risk of contracting additional illnesses.
At-home care is beneficial for all people in the middle of a pandemic but has particular potential to improve the care of vulnerable populations. Normalizing and even prioritizing at-home care now could lead to post-pandemic changes in the medical system—which could mean better care for vulnerable populations.
When hospitals are admitting patients at significantly higher than average rates, paperwork has a tendency to pile up. Regulations are needed to ensure health care quality, but too much paperwork can overload healthcare facilities and delay the delivery of patient care e. To address the potential of unnecessary regulatory burden for healthcare providers, CMS recently announced the formation of the Office of Burden Reduction and Health Informatics.
The office grew from CMS’s Patients over Paperwork (PoP) Initiative and follows CMS’s March announcement that the agency was providing “clinicians, providers, and facilities participating in Medicare quality reporting programs … exceptions to reporting requirements and extensions for reporting measures and data.”
The agency’s burden reduction efforts started about three years ago and are expected to save healthcare providers $6.6 billion through 2021. Beyond just reducing cost and human hours spent on regulatory reporting, the new office is also supposed to consider how new regulations impact healthcare delivery and operations, with the overall goal of improving patient care.
Mental Health of Healthcare Professionals
Pre-pandemic, practitioner burnout was already a concern for healthcare institutions, according to the National Academy of Medicine. Medical professionals, especially in emergency or intensive care units, experience a host of stressors and trauma that can negatively impact their mental health if ignored or unchecked. Add long shifts due to a labor shortage and pile COVID-19 on top, and you have the makings of what could be a parallel crisis.
To help healthcare institutions better support their staff and combat stigmas that may prevent medical professionals from seeking mental health support, The Joint Commission published a special issue of its Quick Safety newsletter, called “Promoting psychosocial well-being of health care staff during crisis.” The newsletter offers practical ways for managers and team leaders to support their staff, as well as self-care tips to help healthcare workers cope.
Building Design and Cleanliness
In an interview with Infection Control Today, Stephanie Taylor, M.D., a researcher and consultant focused on how physical healthcare environments influence patient health, spoke of the importance of hospital airflow in terms of preventing or worsening the spread of infection.
The way air travels within a hospital building influences the transmission of airborne diseases in that space—a fact that is nothing new, according to Taylor. “However, in general, airflow has been managed by the engineers, by the architects, by the facility managers, and not so much by the clinicians,” she said. “There is a lot you can do in indoor air management to decrease the transmission of infections. … If we ignore the impact of the environment and indoor air, specifically, on our health, we’re missing the utilization of one of the most effective toolboxes for controlling infections.”
The physical environment of a hospital has the potential to make or break patient outcomes. This means facility managers and janitorial staff play a crucial role in providing effective patient care. Everything that goes into creating a clean hospital environment ultimately supports patient care and recovery.
Surge beds. Stockpiles of personal protective equipment. Staff redundancy. All of these are components of emergency preparedness that hospital administrators have been considering and rethinking. If a fresh wave of infections—whether of COVID-19 or another illness—comes through, will hospitals be ready?
As summer wanes, the next flu season is just around the corner. Concerns are rising about the potential for a double pandemic if COVID-19 continues and another bug emerges, as well as the likelihood of more sickness in general due to lower immunization rates because of pandemic-induced stay-at-home orders. Medical providers are starting to see a need to promote standard vaccines, for school-aged children especially, as a way to stave off potential ripple effects of the pandemic.
There’s always more to refine and reconsider in a field as complex as healthcare. COVID-19 has brought a host of concerns to the forefront for healthcare providers, regulators, professionals, and patients. As we move forward—not knowing when the pandemic will end or what will be on the other side—the hope, as always, is to support patient health with the best tools and practices available.
ANSI/AAMI ST79:2017. Association for the Advancement of Medical Instrumentation (AAMI)
Performance Management & Quality Improvement. CDC. https://www.cdc.gov/publichealthgateway/performance/index.html
Performance Management: Turning Point. Public Health Foundation. http://www.phf.org/programs/turningpoint/Pages/Turning_Point_Performance_Management_Refresh.aspx
Process. A Publication of the International Association of Healthcare Central Service Material Management. May/June 2020. www.iahcsmm,org
Quality Audit – A Tool for Continuous Improvement and Compliance. https://www.mastercontrol.com/gxp-lifeline/quality_audit_tool_compliance_0810/
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