Continuing our rundown of the top stories with readers, we look at features focused on patients and where hospitals are succeeding and where they can improve.
Healthcare leaders say they are striving to improve the patient experience, and with good reason.
Federal officials and patient advocates have pointed to the need to improve safety measures for patients, which have declined during the COVID-19 pandemic. Hospital and health system executives are undertaking novel measures to try to serve patients better.
Here are the five most popular stories in Chief Healthcare Executive about the “patient experience,” a core element of our mission. The stories look at where hospitals are having success and where healthcare organizations can do better.
In the early months of the COVID-19 pandemic, some hospitals stood out in the face of unprecedented challenges.
Healthgrades compiled a list of 24 hospitals that excelled in their treatment of coronavirus patients in the opening months of the pandemic.
Each year, Healthgrades produces a ranking of America’s best hospitals. Brad Bowman, chief medical officer of Healthgrades, said the group’s examination of hospitals in the COVID-19 pandemic “is completely different than anything we’ve ever done before.”
In an interview with Chief Healthcare Executive, Bowman said, “We wanted to recognize these hospitals, almost as a thank you.”
Healthgrades examined hospitals that had cared for a heavy volume of COVID-19 patients. Healthgrades evaluated hospitals that treated more than 750 COVID-19 patients from January through September 2020. The average mortality rate of those hospitals was 24.6%, and the 24 hospitals recognized by Healthgrades had mortality rates below that mark.
Healthgrades examined patient data from the Centers for Medicare & Medicaid Services for the vast majority of U.S. hospitals (the survey did not include military hospitals or Veterans Administration facilities).
The 24 hospitals recognized by Healthgrades demonstrated the ability to act and react quickly, Bowman said.
“One thing that stood out for me was the ability for them to adapt rapidly, to create new care models in response to what was a really unprecedented set of circumstances,” Bowman said. “The ones that were flexible and more adaptable did better.”
Hospitals across America have treated more children with respiratory viruses, with some saying they have rarely, if ever, seen so many cases.
Health systems reported significant spikes of children with respiratory syncytial virus, more commonly known as RSV, weeks earlier than normal. For much of the fall, about 75% of the beds in pediatric hospitals nationwide were filled.
While the virus tends to be mild for many people, it can be more serious in children, it can lead to serious complications for children 5 and under, older adults, and others with health issues.
Doctors say they’re worried about the uptick in RSV cases, rising flu cases and COVID cases forming a “triple-demic.” In recent weeks, some hospitals have seen those fears realized.
Hasbro Children’s Hospital in Rhode Island reached 125% of capacity.
“RSV is clearly the number one cause,” Michael Koster, director of pediatric infectious diseases at Hasbro Children’s Hospital, told Chief Healthcare Executive in October. Two-thirds of the patients admitted with respiratory distress had tested positive for RSV, he said.
Health systems, including Hasbro Children’s typically see peak volume with RSV in December or January.
“This is definitely unprecedented and historic in a lot of ways,” Koster said. “More importantly, we’re constantly in a continuous crisis and dealing with the ebbs and flows where none of the ebbs have provided any relief for the staff. It's tidal wave on top of tsunami.”
In children’s hospitals, some doctors and leaders likened the heavy volume to the early days of the COVID-19 pandemic, when patients packed hospitals.
On a raw, gray October morning, Penn State Health Lancaster Medical Center began accepting patients for the first time.
Penn State Health opened the new $375 million hospital in Lancaster County, Pennsylvania, about an hour outside of Philadelphia. For Penn State Health, it’s the system's second new hospital in a year. Penn State Health opened a hospital just outside of Harrisburg, the state capital, in October 2021.
Inside the new, sleek 132-bed hospital a few miles outside the city of Lancaster, Joseph Frank, Penn State Health East Region hospital president, lauded “the enormously capable staff we assembled here.”
Health system executives around the country have talked about the difficulties they have had finding and keeping workers. Frank admitted to having some anxiety a year ago about hiring enough staff for a new hospital. Penn State Health recruited some experienced leaders, and they helped entice other doctors and nurses to follow, Frank told Chief Healthcare Executive.
“I think we were very fortunate in that we were able to attract a lot of nursing leaders who had reputations and experience, and lots of other nurses followed them and wanted to be part of this new culture,” he said.
In fact, the hospital has a waiting list for registered nurses. “Other people are waiting to join us,” he said.
“They want to be part of something fresh, something new,” Frank said.
Amid heavy criticism over a number of setbacks, the Department of Veterans Affairs pushed back the deployment of its new electronic health record system yet again.
Citing technical and system issues, the VA is postponing the rollout of the new Oracle Cerner system at additional facilities until June 2023.
The VA said in an Oct. 13 news release that an investigation of the five facilities that are using the new system have identified a host of problems, including “latency and slowness, problems with patient scheduling, referrals, medication management, and other types of medical orders.”
Lawmakers and federal watchdogs have faulted the VA for years over problems with the project, which has a price tag of $16 billion. The VA awarded a 10-year contract for the modernization project to Cerner in 2018. Oracle acquired Cerner in a $28 billion deal in June 2022.
The VA said it will work closely with Oracle Cerner to correct the problems, particularly those that could affect patient safety.
Deputy Secretary of Veterans Affairs Donald Remy, who oversees VA’s EHR program, said in a statement that the new system won’t go out to other facilities until all the problems are resolved.
“Right now, the Oracle Cerner electronic health record system is not delivering for Veterans or VA health care providers – and we are holding Oracle Cerner and ourselves accountable to get this right,” Remy said in a statement.
“We are delaying all future deployments of the new EHR while we fully assess performance and address every concern,” he said. “Veterans and clinicians deserve a seamless, modernized health record system, and we will not rest until they get it.”
Jaewon Ryu said the goal of moving healthcare one click to the left isn’t quite on target.
“It’s really about moving care one click toward the center,” said Ryu, the president and CEO of Geisinger, the Pennsylvania-based healthcare system.
“We’ve been on a journey to build our delivery system focused on the center,” Ryu said.
Speaking at the HLTH Conference in November, Ryu outlined impressive statistics demonstrating the effectiveness of Geisinger’s home-based health program and an initiative to help patients get better food.
To engage in such efforts, Ryu said, “You need a payment model that supports it.” And that’s where he made the case for health systems to move toward value-based care, and away from the traditional fee-for-service model.
With value-based care, health systems are rewarded for improving patients’ health, and are essentially taking on the risk that they will be successful in keeping patients healthy, or at least from avoiding more costly care.
Geisinger manages 10 hospital campuses and a health plan with more than 500,000 members. He implored healthcare leaders to move toward value-based care, even if it’s just one step.
“For any of us, it’s a journey and you start where you start,” he countered. “As you take bites at this, it takes you further down to the continuum to reach this kind of model.”