18 minute read
Advancing Health
in This Pandemic
By Chad T. Rodgers, MD
Scientists and health professionals around the world have long anticipated a viral spread that could resemble the devastating Spanish Flu pandemic of 100 years ago. Though health care in the United States and around the globe has improved since that long-ago pandemic, the appearance in 2019 of SARS CoV-2, or COVID-19, was still a shock.
Even advances in technology – including ventilator improvements, ECMO, vaccine development, and new medications – did not prepare the world for COVID-19. The changes at hospitals and clinics to prevent the spread of infection within their walls and to reduce complications of the disease, and even improved access to health care insurance, could not adequately prepare people for the current pandemic.
Prior to its arrival in the U.S. in early 2020, there existed an awareness of weaknesses within the health care setting. Yet due to the already-busy health care world, many of these weaknesses were acknowledged and discussed, but they were put aside.
And there were weaknesses that were not yet known. The pandemic brought those weaknesses – coupled with a lack of information on how to respond – to the forefront.
LEARNING AS WE GO
When this novel virus emerged, disease surveillance and other methods of data collection quickly helped pinpoint those places where it appeared. Health care practitioners could see where it was popping up in the world and identify when it came to their regions. It was known to be deadly, especially for patients with certain disease states. What was not known was how the virus spread.
We soon learned that the virus was not spread from one person to another as readily on surfaces, but that transmission primarily occurred through respiratory spread. Identification of the vulnerabilities of certain demographics became clearer, and so did knowledge about the original virus’s contagiousness.
The effectiveness of masking in prevention of spread was identified.
Vaccine technology that had been in development for years meant that new vaccines, designed to slow the spread of the virus, began to appear in nations including the U.S. The vaccines would enable those vulnerable populations a measure of protection. Hospitalizations could be prevented; the number of patients requiring ventilation could be reduced, and ultimately, lives could be saved.
Although it didn’t feel it was possible to move quickly enough, U.S. distribution of the vaccine to a large portion of the population, including Arkansans, moved swiftly. Health care systems quickly stood up vaccine clinics within their hospitals and communities.
COLLABORATIONS ARE KEY
AFMC is a trusted source and is called upon frequently to lead initiatives. Almost immediately at the pandemic’s outbreak in Arkansas, AFMC was asked to champion COVID testing events. Testing was administered throughout central Arkansas. Our work led to a unique partnership with a major university in the state to provide testing for students. These relationships carry on today.
AFMC collaborated with Blue Cross and Blue Shield and the State Chamber in a statewide campaign, “Vaccinate the Natural State,” to make vaccines available to everyone. This combined effort highlighted the importance of the vaccine and helped reduce initial vaccine hesitancy.
During the spring, summer, and fall of 2021, various governmental agencies and private businesses called upon AFMC to handle vaccine events. Nurses spent days at businesses, schools, festivals, graduations, and football games making vaccines available to the public. Our work continues as we provide vaccine to Historically Black Colleges and Universities and other institutions of higher education in Arkansas.
MAKING LEMONADE
Health care research allowed quick development of new treatments for COVID-19. Monoclonal antibodies and new antivirals that allow high-risk patients to lower their risk of disease progression are now available. AFMC hosted several webinars on how to treat with monoclonal antibodies for health care providers around the state.
When telemedicine was emerging, providers did not prefer it as a way of managing their patients. But when COVID hit, many health care systems adapted and found ways to best utilize this technology for safe care of their patients. Payors responded, paying for telemedicine visits.
Though patients might have limited access to this service due to, perhaps, a lack of devices or internet connectivity, remote patient monitoring and telemedicine are growing as we learn more from research and best practice.
STILL LEARNING
COVID revealed a shortage of health care professionals, a situation that was exacerbated by some leaving health care; sadly, many in health care also became sick and died as a result of contracting this virus.
Not only did many hospitals run out of hospital beds, in some locations they also ran out of nurses and doctors to care for patients. In response, many nurses and other health-related professionals traveled to those hospitals needing help the most. While this filled a need, it also created a loss of staff at those hospitals they left. Staffing remains a challenge.
There is still room for improvement in health care coverage. Such improvement could result in a healthier population and a healthy workforce. Access to providers, especially in rural areas, is often limited. We need more health care professionals.
During the pandemic, AFMC reached out, and continues to reach out, to providers to see where we could assist in responding to needs. We collaborated with other organizations to help meet needs as they arose. We assisted providers as they sought to improve use of telemedicine within their practices to better reach patients and receive reimbursement.
We continue to reach out to the community to respond to the increased stresses the pandemic brings. We seek to increase knowledge of Adverse Childhood Experiences and how to build and sustain resilience. We continue to work with hospitals, clinics, and other health care facilities to ensure good quality of care despite the stresses the pandemic brings.
Although the pandemic may yet continue for a while, it is time to consider what life will be like on the other side. We can plan how to better respond to a pandemic and other health care needs. Health care must continue to move forward.
Chad T. Rodgers, MD, FAAP, serves as Chief Medical Officer at AFMC. He is a partner and pediatrician at Little Rock Pediatric Clinic.
Take a stand: No more violence to Take a stand: No more violence to Forms of violence to health care workers Harassing Harassing Name calling Harassing Intimidating Harassing Threatening 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being reported annually Workers in health care settings are four times more likely to be reported annually service settings (OSHA) reported annually Health care workers have a 20 percent higher chance of being the service settings (OSHA) reported annually victim of workplace violence than other workers (National Crime service settings (OSHA) Violence-related injuries are four times more likely to cause health service settings (OSHA) care workers to take time off from work than other kinds of injuries Violence against health care workers is grossly underreported their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Being given “bad news” about a diagnosis – Domestic disputes among patients or visitors – Presence of rearms or other weapons Factors associated with perpetrators of violence 48 SPRING 2022 | ARKANSAS HOSPITALS
health care workers Forms of violence to health care workers – Harassing – Stalking – Beating Name calling Intimidating Threatening – – – Choking Stabbing Killing 75 percent of nearly 25,000 workplace assaults 25 percent of nurses reported being physically assaulted by a reported annually patient or a patient’s family member, and about half reported being occurred in health care and social
Workers in health care settings are four times more likely to be service settings (OSHA)
Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime
Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries Violence against health care workers is grossly underreported Only 26 percent of emergency department physicians report violent incidents their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Being given “bad news” about a diagnosis – Domestic disputes among patients or visitors – Presence of rearms or other weapons
!Report it! Notify leadership, security and, if needed, law enforcement. Factors associated with perpetrators of violence Issue 59, “Physical and verbal violence against health care workers,” for more information. © 2018 The Joint Commission | May be copied and distributed | Published by the Department of Corporate Communications
Take a stand: No more violence to health care workers Forms of violence to health care workers – Harassing – Stalking – Beating Name calling Intimidating Threatening – – – Choking Stabbing Killing 75 percent of nearly 25,000 workplace assaults 25 percent of nurses reported being physically assaulted by a reported annually patient or a patient’s family member, and about half reported being occurred in health care and social
Workers in health care settings are four times more likely to be service settings (OSHA)
Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime
Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries Violence against health care workers is grossly underreported Only 26 percent of emergency department physicians report violent incidents their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Being given “bad news” about a diagnosis – Domestic disputes among patients or visitors – Presence of rearms or other weapons
Take a stand: No more violence to health care workers Forms of violence to health care workers – Harassing – Stalking – Beating Name calling – Choking Intimidating – Stabbing Threatening – Killing 75 percent of nearly 25,000 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being workplace assaults reported annually occurred in health care and social
Workers in health care settings are four times more likely to be service settings (OSHA)
Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime
Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries Violence against health care workers is grossly underreported Only 26 percent of emergency department physicians report violent incidents their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Being given “bad news” about a diagnosis – Domestic disputes among patients or visitors – Presence of rearms or other weapons
Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Harassing – Shoving – Yelling – Stalking – Beating – Choking Statistics on violence against health care workers – Stabbing – 25 percent of nurses reported being physically assaulted by a – Killing patient or a patient’s family member, and about half reported being bullied (ANA) 75 percent of nearly 25,000 – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the workplace assaults victim of workplace violence than other workers (National Crime Victimization Survey) reported annually occurred in health care and social service settings (OSHA) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Only 26 percent Health care workers of emergency department – think that violence is “part of the job” physicians report violent – are sometimes uncertain what constitutes violence incidents – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons Factors associated with perpetrators of violence
– Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence
health care workers Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Shoving – Yelling
Statistics on violence against health care workers – 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being bullied (ANA) – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime Victimization Survey) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Health care workers – think that violence is “part of the job” – are sometimes uncertain what constitutes violence – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons Report it! Notify leadership, security and, if needed, law enforcement. Factors associated with perpetrators of violence See Sentinel Event Alert Issue 59, “Physical and verbal violence against health care workers,” for more information. © 2018 The Joint Commission | May be copied and distributed | Published by the Department of Corporate Communications – Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence Only 26 percent of emergency department physicians report violent incidents What to do when violence occurs
Take a stand: No more violence to health care workers Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Shoving – Yelling Statistics on violence against health care workers – 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being bullied (ANA) – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime Victimization Survey) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Health care workers – think that violence is “part of the job” – are sometimes uncertain what constitutes violence – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons Report it! Notify leadership, security and, if needed, law enforcement. Factors associated with perpetrators of violence
– Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence
Take a stand: No more violence to health care workers Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Shoving – Yelling Statistics on violence against health care workers – 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being bullied (ANA) – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime Victimization Survey) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Health care workers – think that violence is “part of the job” – are sometimes uncertain what constitutes violence – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons Report it! Notify leadership, security and, if needed, law enforcement. Factors associated with perpetrators of violence
– Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence
Take a stand: No more violence to health care workers Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Shoving – Yelling Statistics on violence against health care workers – 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being bullied (ANA) – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime Victimization Survey) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Health care workers – think that violence is “part of the job” – are sometimes uncertain what constitutes violence – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons Report it! Notify leadership, security and, if needed, law enforcement.
– Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence
Take a stand: No more violence to health care workers Forms of violence to health care workers – Biting – Scratching – Kicking – Spitting – Punching – Name calling – Pushing – Intimidating – Pinching – Threatening – Shoving – Yelling Statistics on violence against health care workers – 25 percent of nurses reported being physically assaulted by a patient or a patient’s family member, and about half reported being bullied (ANA) – Workers in health care settings are four times more likely to be victimized than workers in private industry (SIA and IAHSSF) – Health care workers have a 20 percent higher chance of being the victim of workplace violence than other workers (National Crime Victimization Survey) – Violence-related injuries are four times more likely to cause health care workers to take time off from work than other kinds of injuries (BLS) Violence against health care workers is grossly underreported Only 26 percent of emergency department physicians report violent incidents Health care workers – think that violence is “part of the job” – are sometimes uncertain what constitutes violence – often believe their assailants are not responsible for their actions due to conditions affecting their mental state Factors associated with perpetrators of violence – Altered mental status or mental illness – Patients in police custody – Long wait times or crowding – Being given “bad news” about a diagnosis – Gang activity – Domestic disputes among patients or visitors – Presence of rearms or other weapons What to do when ! Report it! Notify leadership, security
– Harassing – Stalking – Beating – Choking – Stabbing – Killing 75 percent of nearly 25,000 workplace assaults reported annually occurred in health care and social service settings (OSHA) Only 30 percent of nurses report incidents of violence
