18 minute read
IDNs in the News
Nurse turnover doubles since the pandemic and half report feelings of burnout
As patient volumes return to prepandemic levels, nurse turnover has doubled and half report feelings of burnout, according to a new report from Vizient, Inc. and Vaya Workforce. In addition, researchers found that while contract labor utilization continues to surge, the amount of time nurses are able to spend with patients dropped earlier this year to its lowest level since before the pandemic.
Employment data spanning April 2019-June 2022 from the Vizient Operational Data Base (ODB), which contains data from 650 healthcare facilities representing over 164,000 nurses show a 20% increase in nurse overtime hours. The ODB also shows overtime doubling during that same period from approximately 4% to 8% for licensed nursing staff. Taken together with a 2022 benchmark from Safe and Reliable Healthcare of more than 26,000 nurses finding 50% have feelings of burnout, the report serves as a wakeup call for healthcare leaders.
Many hospitals and health systems continue to rely on contract labor to fill vacancies. According to Vaya Workforce, a leader in contract labor staffing, approximately 28,000 travel nurse jobs are currently open compared to 8,700 openings on average in 2019. Vaya’s data is representative of close to 80% of the total market. Vaya also forecasts demand for travel nurses to remain at least 20% above pre-pandemic levels throughout 2023. These predictions are based on historical travel demand, economic variables, acute care hospital census,
nursing core vacancies and other public and private data sets.
Cleveland Clinic receives $12M NIH grant for cancer treatment research
Cleveland Clinic’s Lerner Research Institute was awarded a five-year $12 million grant by the National Cancer Institute, part of the National Institutes of Health, to define how cytokines – proteins produced during immune response – regulate inflammation and interact with cells and molecules surrounding tumors.
Delivering cytokines in immunotherapy can signal an immune response that kills off cancer cells, but resulting inflammation also can create an environment that encourages cells to mutate and tumors to grow. Gathering detailed information on how cytokines function within specific types of cancer can help navigate the complex pathways tumors use to evade treatment and make strategies like immunotherapy more successful.
The NIH funding supports the next step in a decades-long research program at the Lerner Research Institute conducting groundbreaking research on cytokines, immune response and inflammation.
University of Utah Health starts digital health project to develop and test apps
University of Utah Health has launched a new initiative that seeks to better integrate digital health applications into daily medical care including prevention, diagnosis, and treatment of cancer, heart disease, and other life-threatening conditions.
The Digital Health Initiative (DHI) aims to develop, evaluate, and distribute tools designed to improve mental health, home monitoring, self-care, and patientcentered clinical decision support. The goal is to create health apps that are more scientifically based and reliable than those that are currently available. DHI is supported by a substantial grant from the Office of Senior Vice President for Health Sciences at U of U Health.
By Pete Mercer
2022: A Year of Reconnection and Challenges
COVID, inflation and staffing shortages were just a few of the stories that made headlines in healthcare this year.
We’re almost three years removed from the massive
shutdowns and disruptions caused by the COVID-19 pandemic. In a lot of ways, those first few months of 2020 have shaped the way we have looked at 2021 and 2022.
For businesses and industries, 2021 was a year of recovery and rebuilding. A vaccine was introduced to the general public in early 2021, which gave us an edge against the pandemic while dividing the country over the efficacy and safety of the vaccine. Mandates for the vaccine created further division, while variants popped up that challenged the vaccine’s effectiveness.
2022: A Year of Reconnection and Challenges
2022 has been a year of reconnection for people and businesses across the world. Travel has largely resumed with very few, if any, travel mandates in place throughout the world. Many of the surviving businesses have rebuilt and functionally grown in the last year, as in-person meetings and networking events have resumed operations. While vaccinations and natural immunity has rendered COVID-19 less deadly, it hasn’t entirely eradicated the virus.
There have been plenty of challenges this year as well. Disruptions are still clogging up the supply chain, straining an already incredibly fragile system. Core inflation rates hit 8.2% for the United States this year, the highest in 40 years. Healthcare is constantly challenged by staffing shortages, burnout, supply chain disruptions, and inflation. Making things more complicated for the entire world, Russia invaded Ukraine in February of this year, putting a strain on political relations and forcing businesses with operations in Russia to make some difficult decisions regarding those relationships and facilities.
In September, the FDA authorized omicron booster vaccines for Moderna and Pfizer for a single booster dose. This was the beginning of a national rollout of omicronupdated COVID-19 vaccines. Both vaccines were more effective against omicron strains, and Pfizer’s was even authorized for people as young as 12 years old.
To fully understand the scope of the challenges and successes of 2022, let’s take a look at some of the biggest events throughout the year.
Where we stand with COVID-19
For the entirety of 2022, omicron was the dominant strain of COVID-19. After reaching the United States in December 2021, omicron strains have peaked and troughed throughout the year, generating mostly milder symptoms compared to the previous variants. Based on weekly COVID reports by Mark Van Sumeren, omicron cases began to recede in February, before two sister variants, BA.4 and BA.5, emerged in April. BA.5 is still the dominant strain of omicron.
In September, the FDA authorized omicron booster vaccines for Moderna and Pfizer for a single booster dose. This was the beginning of a national rollout of omicron-updated COVID-19 vaccines. Both vaccines were more effective against omicron strains, and Pfizer’s was even authorized for people as young as 12 years old. FDA Commissioner Robert Califf, MD, said in a statement, “As we head into fall and begin to spend more time indoors, we strongly encourage anyone who is eligible to consider receiving a booster dose with a bivalent COVID-19 vaccine to provide better protection against currently circulating variants.”
In June, Vizient released its annual Impact of Change® Forecast from its subsidiary Sg2, projecting hospital resources will experience even greater strain due to a rise in patient acuity over the next decade that will outpace inpatient volume and impact patient length of stay. Fueled in part by COVID and its lingering effects, health care organizations can potentially expect increased number of patients with more complex conditions creating capacity constraints that may require new strategies for patient care delivery. The forecast predicts that adult inpatient volumes will recover from pre-pandemic numbers, but only having gradual growth by 2% over the next decade.
Most recently, experts are concerned that a swarm of COVID-19 variants could push a winter surge this year that is continuing to mutate against immunity. Additionally, as the flu season continues to escalate, hospitals are preparing for what could be a very difficult season. In an NBC News report, Dr. Carlos Del Rio, an executive associate dean at the Emory University School of Medicine and Grady Health System in Atlanta, said, “If you go around the nation and ask hospitals how busy they are, every single one of them will tell you: They’re busy.”
In the same report, Matthew Binnicker, director of clinical virology at the Mayo Clini said, “We’ll see an increase in COVID cases – probably not to the extent that we saw in the winter of 2020 and winter of 2021 – but we will see a rise. Most of those will be infections that lead to mild to moderate illness.”
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2022: A Year of Reconnection and Challenges
How inflation affects healthcare
Inflation is the highest it’s been in 40 years. In April, Dukal examined the inflation pressures on the healthcare supply chain. The report found that there were three key reasons for the current inflation hike:
ʯ Lockdowns and labor shortages. After businesses and cities shut down across the world at the beginning of the pandemic, it’s been a long road to recovery for many organizations. Lockdowns and surges persisted, leaving many manufacturers to scramble to maintain consistent product levels.
ʯ Global logistical backlogs. Last year, we saw a record number of container ships that were waiting to dock in ports on the Pacific and Atlantic coasts. The report said, “With unprecedented ocean volumes from Asia and domestic land transportation stretched thin, backlogs drove many supply chains to a halt.”
ʯ Raw material and product shortages. Across the world, there has been a shortage of raw materials, leading to a shortage of finished goods.
The rise in inflation has created many challenges for healthcare, not least of which involves the purchase of supplies and medical equipment. As the largest equipment-focused national medical distributor in the U.S., CME is seeing annual price increases that are four or five times higher than usual. Cindy Juhas, chief strategy officer of CME told FOX Business in May, “The manufacturer for one of CME’s most popular wheelchairs added a 20% surcharge to cover the cost of raw materials and freight for the product in the last four months.”
The FOX Business report also found that crutches went up 20%, and exam tables, up 20-30%, were backlogged four to five months. Juhas projected that the increase in costs and shortage of supplies will last the year and push into 2023.
The Russian-Ukrainian conflict
Early 2022 saw a massive socio-political upheaval in the Russian invasion of Ukraine, a staggering move that sent ripples across the world in various mediums. Most notably, this invasion spurred many organizations with operations in Russia to reconsider those business relationships altogether. Organizations like Owens & Minor and S2S Global, a Premier subsidiary, donated essential medical supplies to the people in Ukraine. HIDA issued a press release in late April acknowledging that members of HIDA had contributed over $15.75 million in and cash and in-kind donations to humanitarian efforts in Ukraine.
Matthew J. Rowan, HIDA President and CEO, said, “We are proud that our industry can partner with humanitarian relief organizations to deliver critical medical supplies to the Ukranian people.”
In July, Banner Health announced that emergency trauma physicians were delivering live virtual training sessions on trauma for medical professionals and healthcare workers on the frontlines of the conflict. The sessions included training on basic trauma care, as well as scenarios involving crush injuries, blast wounds, burn treatment, and mental health trauma. Each session took place in the Simulation Emergency Trauma Center, using mannequins with realistic wounds to teach how to clinically assess and treat these patients.
The ramifications of the Russian-Ukranian conflict also extend to the healthcare supply chain, causing disruptions for equipment like canes, crutches, exam tables, and wheelchairs. Cindy Juhas, chief strategy officer of CME told FOX Business that the “war on Ukraine is only exacerbating those supply chain issues – which persisted over the past two years – because Russia is a major producer of nickel, chrome, and steel.”
Continued supply chain disruptions
Starting in March, Supply Chain Dive tracked the shift to 24/7 supply chain operations for public and private sectors across
2022: A Year of Reconnection and Challenges
the country. Ports across the country were attempting to engage with dozens of stakeholders to try to improve the operations, resulting in regulatory tweaks and a series of commitments from the private sector. In October of 2021, President Joe Biden announced the Port of Los Angeles’ goal to move to 24/7 operations, saying “A 24/7 system is what most of the leading countries in the world are already operating on. Except us, until now.”
In April, White House officials said that even though COVID-19 exacerbated issues with the supply chain, the issues were not created by the pandemic. The New York Times reported that economists analyzed supply chain disruptions as part of the Economic Report of the President. The report says, “Because of outsourcing, offshoring and insufficient investment in resilience, many supply chains have become complex and fragile. This evolution has also been driven by shortsighted assumptions about cost reduction that have ignored important costs that are hard to turn into financial measures, or that spilled over to affect others.”
Healthcare staffing shortages
In 2021, we witnessed a unique phenomenon in the workplace known as “The Great Resignation,” as hordes of employees resigned from companies for a litany of reasons. This was not an industry-specific occurrence, but it swept across healthcare as staff experienced heightened anxiety and burnout from the pandemic.
In one example, healthcare laboratory industry officials said their sector was hit especially hard. Tara Luellen, VP of Laboratory Director Services at Lighthouse Lab Services told Dark Daily, “The lab industry has been hurt at the greatest extreme from this Great Resignation just in terms of the dire need for lab roles and the small pool of correctly qualified individuals in many instances.” Because it’s a highly specialized industry, it’s creating more challenges for healthcare labs as fewer new lab techs and pathologists are entering the field while many of the current crop of lab professionals are leaving.
The Great Resignation also affected nurses, physicians, and long-term care staff. In May, a diverse group of frontline nurses, nursing leaders, patient safety representatives, CEOs, CFOs, and HR professionals launched the Nurse Staffing Think Tank. This group meets to tackle a wide range of issues related to the nurse staffing crisis, like the impact of COVID-19 on nursing and the importance of trust and transparency in a healthy work environment.
In September’s issue of Repertoire, Dr. Robert Pearl examined the root causes of burnout, which physicians are being affected the worst, and what can be done to fix it. According to a Medscape survey of 13,000 doctors, the nation’s most burned out physicians are in emergency medicine and critical care, experiencing “long-term, unresolvable job-related stress that leads to exhaustion, cynicism, and feelings of detachment.” These types of psychological issues are predictable outcomes for physicians who have been fighting a continuous and stressful battle against COVID-19.
Moving on to 2023
The road ahead is, for lack of a better word, uncertain. Supply chain disruptions are likely not going away any time soon. COVID, while not as much of a threat as it was this time last year, is still putting people in the hospital. We are still in an active pandemic scenario.
There’s no way to know what 2023 will hold. There will be new challenges, yes. But there will also be new breakthroughs for healthcare organizations. New ways to succeed in this industry. New ways to tell the story of healthcare.
If there’s anything to derive from the last year – or even the last three years – it’s that we can rebound, recover and reconnect with each other, even in the most difficult of circumstances. That even in the darkness, the dawn is still coming.
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1. Abbott. ID NOW COVID-19 2.0 Product Insert. 2. CFR - Code of Federal Regulations Title 21. U.S. Food & Drug Administration. Updated March 29, 2022. Accessed July 26, 2022. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=866.3328 3. ID NOW Strep A 2 Product Insert 4. Chartrand, C. et al. Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis. J Clin Microbiol. December 2015 vol. 53 no. 12 3738-3749 5. ID NOW RSV Product Insert
The ID NOW COVID-19 2.0 product has not been FDA cleared or approved. It has been authorized by the FDA under an Emergency Use Authorization (EUA) for use by authorized laboratories and patient care settings. The test has been authorized only for the detection of nucleic acid from SARS-CoV-2, not for any other viruses or pathogens, and is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostic tests for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner. © 2022. All rights reserved. Any photos displayed are for illustrative purposes only. Any person depicted in such photos is a model. COL-15359-01 09/22
MobileCare Medical Carts
DETECTO’s brand new, innovative and highly customizable MobileCare medical carts offer the most advanced security level features in the medical carts market with nearly unlimited configuration and color possibilities available.
There are three lock types to choose from: ʯ Electronic Lock – RFID with three different frequencies available and full-color touchscreen pin code ʯ Quick Release ʯ Keyed Lock
Windows software is included for one centralized point for all employee cart access and security settings, including Wi-Fi or Bluetooth for instant updates. The proprietary onboard and PC software has been developed by DETECTO.
The innovative quick release unlocking can save lives when a patient codes, and the breakaway plastic tags and red/green flag can be reset easily by biomed technicians.
Robust cart customization
MobileCare carts offer robust cart customization. They come with the choice of three unlocking methods: one lock and individual drawer sensors, individual drawer locks and individual drawer sensors, or simply one lock. Detailed employee audit tracking mitigates narcotics theft and user setup can be done at the cart or within the included Windows software.
Up to 5,000 users are available per cart, and dual authentication is available by RFID and pin code touchscreen entry. The PC software can update individual users, carts, locations/buildings and departments, and hold up to 50,000 records. It can print, download and export detail history reports, and history tracking is available to check accountability of individual drawer inventory.
The full-color touchscreen LCD features graphical menus for intuitive prompts and easy usability, and multiple alarms are featured on the electronic carts, through both audible and e-mail/text notifications.
Cart design
Ten standard colors come with unlimited Pantone and RAL color options. The ABS thermoplastic countertop with molded edges is one continuous piece for optimal hygienic cleanup. Handrails can be specified on all three sides with two, one or no handrails. Spacious soft-close drawers glide shut for more convenience and two self-closing side extension trays are included standard for additional counter space.
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The carts come standard with full wrap around, high-impact bumper trim, extending beyond the handrails for complete protection. Versatile corner extrusion mounting provides easy optional accessory attachment and customized locations.
A full range of accessories are available, including IV poles, sharps container holders, defibrillator shelves, cardiac boards, oxygen tank holders, 12-bin organizers, catheter holders, waste bins and more. The carts are made in the U.S. with American and foreign components and are TAA compliant.
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Carts with touchless RFID, touchscreen keypad, keyed, and quick release lock types available
Nearly unlimited configuration possibilities available from DETECTO
Full-color touchscreen LCD with graphical menus on electronic carts Powerful PC software included to manage your carts via secure Wi-Fi
