As we approach the end of the year, it’s insightful to look back at the full scope of the year and break down the top trends in the hospital medicine industry. The world has seen a lot in these past two years and many aspects of the way the industry operates have drastically changed. Telehealth has become a new fashionable way to visit your physician, the COVID-19 pandemic is still affecting our hospitals in a negative way, and bed and staff shortages are on the rise. How is this new landscape affecting your organization?
1. Provider Burnout on the Rise – Again
As we look towards 2022, we expect to see physician burnout continue to be an important issue plaguing our hospitals and healthcare systems.
Physician burnout has been a significant issue for years, exacerbated especially by the COVID-19 pandemic. This year, something that’s become of particular concern is the mental health and well-being of providers. According to the University of Exeter-led international research, the pandemic has created a lasting effect on the mental health of providers. Their team surveyed over 5,000 doctors in Italy, Spain, and the UK. They discovered that anxiety and depression affected women and young professionals the most.
Mental health is a topic that has come up more frequently in the past year and workers are now more open to expressing their feelings around the topic. The mental health risk factors that the international research team found were: unfair and overloaded workloads, lack of organizational support, lack of PPE, and a general fear of infecting others.
These factors not only affect physicians but nurses as well. Anybody who is on the inside of the hospital caring for patients is facing these factors that can break them mentally. When providers leave an organization because of burnout, the costs to hire a new provider are awfully expensive and take time. So, what can a hospital do to solve this issue? There are many options but one option that every hospital needs to offer is some type of support system. Whether that’s group/individual counseling or peer support, we are all human and it’s normal to get burned out from time to time, there should be some type of support system at every hospital. Make sure all your providers are aware of all the resources their benefits can provide them. There may be mental support programs available that you never knew about.
Providers are in this together, a support system at your organization is not built from one person. Everybody at the organization must be on board with solutions and resources to solve the issues at hand. It is a team effort taking care of their patients, it should be a team effort to take care of each other.
2. How COVID-19 is Still Affecting Hospitals: Bed Shortages
It’s safe to say that COVID-19 is still affecting our hospitals not only in the US but around the entire world. Another one of the lasting effects of COVID-19 has been hospital bed shortages.
Our team’s office is based in Boston and many of our local Boston hospitals have been recently dealing with bed shortages because of COVID surges. Dr. Shira Doron of Tufts Medical Center told NBC Boston’s weekly “COVID Q&A” series last month:
“Our hospitals are full. All hospitals are full. Hospitals are already doing really terrible things like deferring and canceling elective surgery now in Massachusetts and so, you know, we are not in a position where we can afford an increase in COVID cases. Or flu, for that matter.”
With experts believing there is a winter surge coming, COVID hospitalizations will only be on the rise which will only exacerbate the issue. Some doctors believe the surge will last from January into February of 2022 but ultimately, it’s exceedingly difficult to predict the outcome.
To add to the Boston hospital bed shortage crisis, in November, the Boston MedFlight helicopters airlifting patients had to fly patients out of state due to no available ICU beds in Boston hospitals. Maura Hughes, Boston MedFlight CEO told CBS Boston, “That’s happened half a dozen times in the last 10 days.” The helicopters had to bring patients to neighboring states such as NH, RI, and CT. Also, on Dec. 7th, NBC Boston reported over 11,000 new COVID cases in MA, nearly double the previous week’s total. People who have been vaccinated are included in the total number and almost 300 vaccinated people were hospitalized.
Bed shortages are on the rise and providers are doing what they can to care for every patient in a fair matter. But sometimes drastic situations call for help from unlikely sources. On Dec 8th, the Governor of Maine activated 75 members of the Maine National Guard to provide help within state health care facilities. A surge is already in effect in ME, 379 people were hospitalized with COVID on Wednesday, Dec. 8th, a state record.
I could go on and on with other stories from hospitals in Boston and all over the US. This is a country-wide issue, and the fear is that it may worsen with the new COVID omicron variant and the harsh winter months approaching.
3. How COVID-19 is Still Affecting Hospitals: Staff Shortages
Not only are hospitals struggling with bed shortages, but staff shortages are becoming an increasing problem as well. With more providers and hospital medicine staff leaving their jobs because of high levels of stress, patients are suffering the consequences. A lack of continuity of care can stem from the shortage of providers. Length of stay for patients will increase as a result because hospitals that do have open beds, but nobody to care for patients means those open beds are not being filled and existing patients will remain hospitalized longer because of the lack of resources to discharge. Hospitals are losing revenue as these issues pile up.
Staffing issues are coming up all over the US. For example, there were more than 3,800 inpatient COVID hospitalizations reported in Ohio on Dec 1st – the most seen in the state since Jan. 12. But Ohio hospitals do not have an issue with bed shortage, they are struggling with a staffing issue. Now some hospitals must transport patients to various parts of the state to receive care from available providers. Dr. Andy Thomas, CCO (Chief Clinical Officer) of The Ohio State University Wexner Medical Center told NBC 24 News:
“Staffing is a major limitation at most of the hospitals in my zone and I would say most of the hospitals across the state.”
It’s clear staffing issues are a challenging obstacle to hurdle. With no real answer for what hospitals and health systems need to do, providing support systems for providers is vital. If stress and workload levels are high, providers need available resources to aid them as new virus variants are here, and the cold months are upon us. If there are no providers to care for patients, the worst will come.
4. Shift towards value-based care (MIPS)
A trend observed in the past year has been the shift towards value-based care or Merit-based Incentive Payment System (MIPS). Value-based care is a healthcare model in which providers and hospitals are paid based on patient health outcomes – a transition from traditional fee-for-service-based care. Providers are being paid for their quality of care rather than the quantity of care they provide. So why the shift?
- Patients spend less money for better health
- Reduce overall costs spent on healthcare
- Patient satisfaction increased
- Providers paid based on quality, not quantity
- Bundling payments for patients
- Prices aligning with patient outcomes
The main ideas of value-based care are to provide better care and outcomes for patients while reducing costs. For example, if a patient has a chronic condition such as diabetes, value-based care can help avoid complications of the disease. The patient would work with a care team that already knows the patient and their background as opposed to going to various locations in search of personnel to aid the patient. The care team aiding the patient could include their PCP and supporting health professionals they have an existing relationship with. This will create a smoother process for the patient dealing with the chronic disease.
So how does it reduce costs? Physicians will not be paid based on the number of procedures done, the number of patients seen, or by how much they charge. The patient will not be charged for every individual service but rather charged in bundled payment. This allows the patient to move through the system at a quicker rate and the result being reduced costs. The goal of value-based care is long-term, the ideal result is fewer admissions and hospitalizations. To improve the overall health of patients, costs are being kept down to produce better outcomes.
Telehealth is a way for patients to visit their providers virtually. Patients can log in to their health care provider’s portal and chat with their provider on their mobile device via text or voice. COVID-19 has been the reason for the use of telehealth over the past two years. Telehealth is being used all over the country and some are pushing for it more than others.
On Dec. 7th, Healthcare IT News reported that The American Hospital Association, Johns Hopkins, and others launched a pro-telehealth campaign. 16 organizations were involved in the launch of this campaign geared toward expanding access to telehealth. The full list of organizations behind the campaign:
The point of this campaign is to nudge Congress to act and expand patient access to telehealth in every community. Dr. Brian Hasselfield, Medical Director of Digital Health and Telemedicine at Johns Hopkins Medicine had this to say on the matter:
“We owe it to our patients to make health care access easier, and patients with Medicare should not be excluded from this opportunity.”
It’s clear telehealth access is not available to everyone. In a report from the US Department of Health and Human Services, it was found that Medicare telehealth use was 63 times larger during the pandemic. A significant increase in a short period of time. However, Black Medicare beneficiaries and people in rural areas were not as likely to use telehealth services compared to white communities.
There has also been fear in the trust of telehealth services. Many people do not like the idea of all their health records being available on a virtual platform. Cybersecurity firm, Kaspersky, released a report around the fears of data privacy and security with the use of telehealth and virtual care.
Telehealth is a solution that is being backed by many reputable health organizations, but the platform still has its issues that need to be resolved. In a world where everything seems to be going digital, it’s no surprise that healthcare is now in virtual space. Predicting the future of telehealth is up for debate but it’s hard to see a world where it doesn’t exist on some level.
Every year we look back at the trends that fell into place and the ways that different communities are receiving care. In the past couple of years, it seems like the negatives have been outweighing the positives. The world is in crisis mode and actions are being taken at the forefront of the challenges at hand. But as we look towards 2022, there’s a lot of positive trends we’re encouraged by. Processes like value-based care and telehealth have been implemented to create a smoother experience for the patient while reducing costs. Provider burnout, bed and staff shortages have plagued the hospital medicine industry and as a result, drastic measures have been frequently implemented to resolve issues. These are tough times for us all, but as new technology emerges and organizations work to create processes to aid our physicians and nurses on the front lines facing these challenges, better care for patients is what we can expect. We’re all human and we’re all trying our best to do what’s right to protect our peers and loved ones.
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