The effects of nurse burnout: A nurse crossing her arms experiences nurse burnout.

The Effects of Nurse Burnout

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HealthWare Systems Blog

The Effects of Nurse Burnout

Posted on Wednesday, September 12, 2018

The effects of nurse burnout: A nurse crossing her arms experiences nurse burnout.

The effects of nurse burnout reach your nurses, patients, and bottom line.

The effects of nurse burnout are far-reaching.  Everyone, from your patients and their families to your nurses and the entire facility, can be affected by nurse burnout.


The Effects of Nurse Burnout Reach Your Nurses, Patients, and Bottom Line…


Here are some of the effects of nurse burnout:

Nurse Well-Being Nurse burnout can lead to feelings of dread about work, mental and physical exhaustion, sleep issues, and depression for your nurses.  The effects of nurse burnout also include compassion fatigue, causing your nurses to disengage from your patients.

Patient & Family Satisfaction Interactions between your nurses and patients and their family members are crucial to the patient experience and patient satisfaction scores.

A study published in the journal Medical Care found the following relationship between nurse work environment, nurse burnout, and patient satisfaction with nursing care:

“Patients cared for on units that nurses characterized as having adequate staff, good administrative support for nursing care, and good relations between doctors and nurses were more than twice likely as other patients to report high satisfaction with their care, and their nurses reported significantly lower burnout. The overall level of nurse burnout on hospital units also affected patient satisfaction.”

Patient Safety Clinicians suffering from burnout may be less motivated and/or may experience lower cognitive functioning due to emotional exhaustion, putting patient safety at risk.

An article published in the American Journal of Infection Control found a significant association between nurse burnout and UTIs and surgical site infection.  According to the researchers, “hospitals in which burnout was reduced by 30% had a total of 6,239 fewer infections, for an annual cost saving of up to $68 million.”

Reducing nurse burnout can decrease the likelihood of medical errors and improve patient safety at your facility.

Turnover & Nursing Shortage According to the American Association of Colleges of Nursing, factors contributing to the national nursing shortage include insufficient nursing school enrollment and faculty, high retirement numbers, the aging population’s need for more healthcare workers, and high turnover/number of nurses leaving the profession altogether.

Almost 1 in 5 new nurses leaves his/her first job within the first year, and about 1 in 3 leaves within the second year.  In a national study conducted by RNnetwork, “half of the nurses surveyed have considered leaving nursing.”  According to the survey, “the number one reason for wanting to leave is feeling overworked (27 percent), followed by not enjoying their job anymore (16 percent) and spending too much time on paperwork (15 percent).”

Unfortunately, there is a cyclical relationship at work here: the national nursing shortage increases nurse burnout for those who are working in the profession as their workloads consequently grow.


As you can see, the effects of nurse burnout have a critical impact on nurse well-being, patient satisfaction, patient safety, and the national nursing shortage.  Please read our next post on how to prevent and address nurse burnout to ensure your health system can avoid the dire effects of nurse burnout mentioned above.


By Stephanie Salmich

The social determinants of health are listed.

The Social Determinants of Health & Their Effect on Health Outcomes

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The Social Determinants of Health & Their Effect on Health Outcomes

Posted on Friday, August 17, 2018

The social determinants of health are increasingly on the radar of health professionals and health systems.  The National Academy of Medicine (formerly the Institute of Medicine) even recommends this information be included in patients’ medical records.

Hospitals can utilize screening tools to collect patient data concerning the social determinants of health.  While a provider may not be able to resolve all social issues faced by a patient, identifying them can help inform healthcare decisions.  (Providers should also have a list of resources that attend to social needs available to provide the patient when asked.)

When health systems consider the social determinants of health when caring for their patients, all parties benefit.  Patients have better health outcomes, communities improve, and health systems become advocates for their patients (improving patient satisfaction) while saving money.  The social determinants of health not only impact the health of patients, but also the health of a hospital’s revenue cycle.


Social factors that influence patients’ health & healthcare decisions include:


Employment – A good job can provide a patient and his/her whole family with health benefits and insurance.  Unemployment negatively affects physical and mental health.

Income – A steady paycheck allows a patient to pay for many of the other factors in this list, such as adequate housing, nutrition, and transportation, as well as healthcare costs.  (Financial assistance screening tools can help patients find out if they qualify for charitable programs to help offset the cost of care, and enable hospitals to facilitate the application process for their patients.)

Housing – Poor living conditions increase the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution.  And each year, 1.48 million Americans have no home at all.  (Here are some examples of how hospitals can help meet patient housing needs.)

Violence – The area in which patients live also can affect their exposure to violence or abuse.  Victims or witnesses to acts of violence may experience mental, physical, and/or economic consequences that affect their overall health.

Nutrition – A lack of consistent access to healthy food can negatively impact health outcomes and increase the risk of many adverse health conditions.  Over 12.7 percent of U.S. households were affected by food insecurity in 2015.  (Read our previous blog for more information on how to reduce patient malnutrition.)

Transportation – Access to reliable transportation can govern a patient’s access to medical care.  Approximately 3.6 million Americans miss or postpone medical care due to transportation issues.  (Check out these ideas for addressing patient transportation needs.)

Social Support – As reported by NPR, in a recent nationwide survey conducted by Cigna “nearly 50 percent of respondents” said “that they feel alone or left out always or sometimes.”  Two in five respondents “felt like ‘they lack companionship,’ that their ‘relationships aren’t meaningful’ and that they ‘are isolated from others.’”  Patients who feel unsupported are more vulnerable to poor health outcomes.  (Read how physician empathy can generate better health outcomes.)

Language/Culture – Culture influences our beliefs about health and healthcare.  A patient’s ability to communicate with health professionals may be impeded by language barriers.

Education – According to the CDC, people with higher levels of education are more likely to choose healthy behaviors and refrain from unhealthy ones.  People with lower levels of education are more likely to be obese and more likely to smoke.

Health Literacy – People with lower education levels are also more likely to have inadequate health literacy skills.  People who are limited in health literacy have higher rates of hospitalization and emergency room use and they use preventive care less.  (Read our blogs on reducing patient uncertainty and addressing health insurance confusion for ways to help improve your patients’ health literacy.)

Patient Engagement – A patient must have health literacy skills in order to be actively engaged in his/her healthcare.  Better engaged patients tend to see better health outcomes.  (Promoting health observances, using social media in healthcare, and educating patients about preparing for a doctor’s appointment are a few methods for improving patient engagement.)

Sex/Gender – Many health conditions affect men and women differently and certain treatments may be more or less effective depending on the sex of the patient.  Plus, men are less likely than women to see a doctor for a specific health concern, preventive healthcare, or a standard annual exam.  (Consider these tips for improving male patient engagement.)


The social determinants of health are listed.

The social determinants of health are key to improving health outcomes and the revenue cycle.


It’s not difficult to imagine how the above factors might influence one another.  The social determinants of health are interconnected and work together to impact a person’s health and healthcare decisions.

Patients whose social needs are unfulfilled are more likely to utilize healthcare resources at a higher cost (including the Emergency Department), be readmitted, miss appointments, and have poor health outcomes.

Hospitals that address the social determinants of health can create better health outcomes, reduce hospital readmission rates, and improve patient engagement while lowering no-show rates and enhancing revenue cycle management.


By Stephanie Salmich

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

How Can Hospitals Address Patient Housing Needs?

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How Can Hospitals Address Patient Housing Needs?

Posted on Wednesday, August 8, 2018

Hospitals can significantly improve the health of patients suffering from housing instability by actively addressing patient housing needs.  A patient’s living situation, conditions, and location affect many aspects of health.  Poor housing quality increases the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution.  Neighborhood conditions are related to rates of violence, crime, noise, and opportunities for physical activity.

Improving patient housing situations can result in better health outcomes and quality of life for patients and their families.  Plus, there are financial incentives for addressing patient housing needs.  According to the American Hospital Association’s Social Determinants of Health Series:

“The economic benefits for hospitals can be significant, since homeless or unstably housed individuals are more likely to be uninsured, be hospitalized more frequently, have longer lengths of stay in the hospital, be readmitted within 30 days and use more high-cost services. Reducing homelessness and other forms of housing instability—through case management, supportive housing (supportive services combined with housing), housing subsidies or neighborhood revitalization—improves health outcomes, connects individuals with primary care and reduces these high levels of utilization. When hospitals and health systems focus their resources on housing supports and case management, the cost savings can offset the expenditures by between $9,000 and $30,000 per person per year.” (p. 8)

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

Hospitals can significantly improve the health of patients suffering from housing instability by addressing patient housing needs.


Here are a few ways hospitals can address patient housing needs:


Contribute to neighborhood improvement projects.  Collaborate with your local government and other organizations that hold a shared interest in the state of your community.  Get involved or make monetary donations to make a difference.

Provide home assessments and patient education for vulnerable populations.  For example, the Seattle-King County Healthy Homes Project targeted low-income households with asthmatic children.  The initiative sent a nurse and community health workers to patients’ homes to educate the families about asthma and self-management and to identify and address environmental triggers (with resources like bedding covers, vacuums, and cleaning supplies).  The goal was to improve health outcomes for patients with asthma and to reduce the use of healthcare services such as urgent care.

Set up a home repair referral program.  Don’t stop at simply assessing patients’ homes for health and safety risks; refer them to a local business that can take care of necessary home renovations for them.  Establish partnerships with businesses who will offer their services at a reduced rate to your referrals or find charitable organizations like veterans’ clubs and churches that may have volunteers who could do the work for free.  The One Touch e-referral program has seen success in linking government and nonprofit groups like Habitat for Humanity to create healthier homes.

Bring care to homeless patients via a mobile health center.  Visit shelters, churches, and community centers and offer primary and preventive health services to at-risk patients.  (Take a virtual tour of the Calvert Health System Mobile Health Center.)

Create a transitional arrangement for homeless patients whose conditions require they be discharged from the hospital, but who are not yet well enough to go back to a shelter or live on the street.  St. Joseph Health created a Medical Respite Program consisting of 15 beds set at three different locations to meet this need.  As its website explains, these beds are for homeless patients “who are being discharged from the hospital, and who need the opportunity to rest in a safe, healing environment while accessing medical care and other supportive services post-hospitalization.”

Invest in your own affordable patient housing.  According to its website, Bon Secours Baltimore “has developed and now owns and operates more than 720 apartment units for low- and moderate-income seniors, families and people with disabilities.”  The heath system has committed to “revitalize West Baltimore.”

Compile a list of affordable patient housing options near your facility.  UW Medicine created a list of both short-term and long-term housing options to help patients, as well as their family members and caregivers, find lodging.  Some of their local hotels even offer a discount to patients’ families and a shuttle service to and from the hospital.


Many of the above ideas for addressing patient housing needs are suggested by and discussed in further detail in the AHA’s guide, “Housing and the Role of Hospitals.”  This guide also outlines steps hospitals should take when determining which method(s) would best address the patient housing needs in their own communities (p. 10-11).

Ensuring patients go home to safe, clean environments is critical in helping to reduce hospital readmission rates, which is crucial to reimbursement.

Patient housing instability is one of multiple interconnected social factors that affect health outcomes and healthcare costs.  Along with patient housing needs, health systems should attend to other social determinants of health by, for example, addressing patient transportation needs and working to reduce patient malnutrition.


By Stephanie Salmich

Preparing for a Doctor’s Appointment: A person holds a card that reads “Be Prepared.”

Preparing for a Doctor’s Appointment: 6 Tips for Your Patients

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Preparing for a Doctor’s Appointment:

6 Tips for Your Patients

Posted on Wednesday, June 27, 2018

Educating your patients and their caregivers about preparing for a doctor’s appointment can benefit all parties involved.  Patient preparation for doctor’s appointments improves patient engagement, produces better health outcomes, saves doctors time, keeps appointments on schedule, and improves the revenue cycle.

Preparing for a Doctor’s Appointment: A person holds a card that reads “Be Prepared.”

These tips for preparing for a doctor’s appointment will benefit both patients and providers.


Provide your patients with these tips for preparing for a doctor’s appointment:


1.      Complete all forms before you arrive. – Call ahead and find out if there are any forms you need to fill out before your appointment.  Instead of completing documentation in the waiting room, fill it out at home.  This ensures you have plenty of time to finish without delaying your appointment.  Plus, at home you will have access to any documents and information the forms ask for, which can be hard to remember on the spot.  Also, don’t forget to bring your photo ID and insurance card (especially if you have a new Medicare card).

2.      Bring a list of everything you are taking. – This includes any prescriptions, over-the-counter medications, supplements, herbal remedies, and vitamins.  You may want to bring in the actual bottles or containers as well so that your doctor can quickly find the information he/she needs.

3.      Anticipate questions the doctor is likely to ask. – If you prepare answers ahead of time, you can conduct a more efficient appointment and avoid wasting precious minutes trying to recall when your symptoms started, for example.  You can find a list of common questions here.

4.      Write down your questions in order of priority. – It can be easy to forget questions if you haven’t created a list.  Start by asking the most important questions first, to make sure you get to them.  Bring a pen and paper to write down the doctor’s answers.

5.      Practice what you want to say. – Taking the time before your doctor’s appointment to state your concerns out loud can help you remember them and stick to the point.  It can also make you more comfortable discussing personal and potentially embarrassing matters with the doctor so that you can resist any temptation to stretch or withhold the truth, which will impede your care.

6.      Bring someone with you to the appointment. – This is especially useful if you are preparing for a doctor’s appointment that involves a serious, emotionally difficult issue.  A friend or relative can remind you of the concerns you want to address, bring up appropriate follow-up questions, and remember the doctor’s answers and instructions, freeing you from these burdens during what can be an emotional time.


Patient preparation for doctor’s appointments is mutually beneficial for both providers and patients.  These tips for preparing for a doctor’s appointment can help your patients maximize their limited time with the doctor and ensure they cover everything they wanted to discuss.  Preparing for a doctor’s appointment also keeps patients on schedule, allowing providers to serve more patients and improve the revenue cycle.


By Stephanie Salmich

Male patient engagement: A doctor and male patient shake hands.

Male Patient Engagement: Improving Men’s Health Outcomes

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Male Patient Engagement: Improving Men’s Health Outcomes

Posted on Tuesday, June 5, 2018

Improving male patient engagement is a struggle for many providers who find that men are much less likely than women to seek care, whether it be for a specific health concern, preventive healthcare, or standard annual exam.

Consider the following alarming statistics concerning men’s health outcomes:

Men’s Health Network provides these explanations for “The Silent Health Crisis” men are experiencing:

  • “A higher percentage of men have no healthcare coverage.
  • Men make ½ as many physician visits for prevention.
  • Men are employed in the most dangerous occupations, such as mining, fire fighting, construction, and fishing.
  • Society discourages healthy behaviors in men and boys.
  • Research on male-specific diseases is under funded.
  • Men may have less healthy lifestyles including risk-taking at younger ages.”

Improving Male Patient Engagement

Male patient engagement: A doctor and male patient shake hands.

Improving male patient engagement is critical to improving men’s health outcomes. Start your commitment today.


June is Men’s Health Month.  Men’s Health Month presents an opportunity for healthcare facilities to address the epidemic of poor male patient engagement.  Men’s Health Network offers many ideas for promoting Men’s Health Month and improving male patient engagement and men’s health outcomes, including: 

In addition, hospitals should educate male patients about their payment options.  Costs may deter male patients from seeing a doctor, and they may not realize that they could be eligible for free or low-cost screenings through their insurance carrier, Medicare, or financial assistance programs.

Healthcare facilities should also make the issues of improving male patient engagement and men’s health outcomes top priorities all year long.  A great example for providers is the work of Dr. Paul Turek (an international leader in men’s health who boasts a 90+% patient engagement rate).  Dr. Turek’s blog lists his suggestions and rules for improving male patient engagement.

Men’s health outcomes affect not only the men and boys in all our lives, but also their families and the women who love them.  Through improving male patient engagement providers can benefit families and their community by improving men’s health outcomes, all while boosting revenue (in the form of more appointments kept by, and more preventive screening tests administered to, male patients).

You can also find ideas for promoting other health observances throughout the year here, and a detailed calendar of this year’s health observances and recognition days here.


By Stephanie Salmich

A nurse speaks with an elderly patient: Directing assistance toward at-risk patients can reduce hospital readmission rates.

8 Ways to Reduce Hospital Readmission Rates

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8 Ways to Reduce Hospital Readmission Rates

Posted on Wednesday, May 2, 2018

There are many ways facilities can reduce hospital readmission rates while producing better health outcomes for patients and avoiding CMS reimbursement reductions.  As the study “Reducing Hospital Readmission: Current Strategies and Future Directions,” published in the Annual Review of Medicine, aptly recommends, these strategies to reduce hospital readmission rates are best used in conjunction:

“The effect of interventions on readmission rates is related to the number of components implemented, whereas single-component interventions are unlikely to reduce readmissions significantly.”

Here are 8 ways to reduce hospital readmission rates at your facility:


A nurse speaks with an elderly patient: Directing assistance toward at-risk patients can reduce hospital readmission rates.

Directing assistance toward at-risk patients can reduce hospital readmission rates.

1. – Focus on delivering quality care.  Ensure that avoidable readmissions are not due to preventable errors on the part of your facility.

2. – Determine the cause of readmission.  As RevCycleIntelligence states, “Understanding why a patient returns to the hospital after discharge is key to preventing readmissions and solving challenges of follow-up care.”  Is the reason for readmission condition-related or are other factors at play (see #3)?  Was the hospital readmission unnecessary and/or preventable?

3. – Screen for at-risk patients.  Certain conditions, such as heart failure and pneumonia, have higher hospital readmission ratesSocial factors that can affect hospital readmission include housing instability, tobacco use, alcohol/drug abuse, malnutrition and access to nutritious food, access to reliable transportation, health literacy, social support, language barriers, and psychiatric disease.  Assistance may be best directed toward patients most vulnerable to readmission.

4. – Address no-show appointment issues to encourage at-risk patients to keep the follow-up appointments that may lower their chances of hospital readmission.

5. – Improve the discharge process.  Patients and their caregivers face much uncertainty upon leaving the safety net of the hospital environment.  Take the time to thoroughly explain instructions for at-home care before they are discharged; follow-up with phone calls or home visits to again confirm their understanding and give them an opportunity to ask questions.

6. – Take advantage of telehealth opportunities.  Telehealth devices enable clinicians to monitor discharged patients’ health at home and can help reduce patients’ uncertainty about whether or not they need to revisit the hospital.

7. – Improve the transition process between facilities.  Just as when a patient is moved from the hospital to home, moving from one facility to another can result in poor health outcomes and/or readmission if the transition does not go well.  Follow one of the transitions of care models, many of which employ a care team to coordinate effective transitions and have been proven to reduce hospital readmission rates.

8. – Establish true interoperability.  Better communication (in the form of successfully and consistently electronically sending, receiving, finding, and integrating/using data) is needed between facilities for proper care transition (and even across departments within the same facility).  Without it we risk patient safety and increase the likelihood for medical errors that affect readmission rates, such as adverse drug events due to inaccurate medication reconciliation.

Reduce Hospital Readmission Rates with a Multi-Strategy Approach


Again, the most successful efforts to reduce hospital readmission rates and create better health outcomes will utilize numerous strategies.  As the study “Reducing Hospital Readmission” in the Annual Review of Medicine concluded:

“Effective interventions share certain features: having multiple components that span both inpatient and outpatient settings and delivery by dedicated transitional care personnel. New evidence suggests that the number of components in a care transitions intervention is significantly related to its effectiveness . . . which strengthens the argument for more robust interventions.”


By Stephanie Salmich

A doctor and patients smile behind the blog’s title: ADDRESS PATIENT TRANSPORTATION NEEDS TO CREATE BETTER HEALTH OUTCOMES.

Address Patient Transportation Needs to Create Better Health Outcomes

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Address Patient Transportation Needs to Create Better Health Outcomes

Posted on Wednesday, April 18, 2018

Patient transportation needs can critically affect access to care and health outcomes; approximately 3.6 million Americans miss or postpone medical care due to transportation issues.

Improved access to transportation benefits patients, health facilities, and communities.  Health systems that address patient transportation needs are advocates for their patients, produce better health outcomes, lower readmission rates, reduce no-show appointments, and improve the general health of the community.

Efforts should begin with screening patients to determine their need/eligibility for transportation or other financial assistance.


Here are some specific ways your facility can then help those patients and create better health outcomes:


A doctor and patients smile behind the blog’s title: ADDRESS PATIENT TRANSPORTATION NEEDS TO CREATE BETTER HEALTH OUTCOMES.

Educate Patients About Transportation Options


Compile a resource list of patient transportation options available in your area.  For example, many senior centers and churches provide free or low-cost transportation and Pace offers a “Call-n-Ride” service in the Chicago suburbs for as little as $2.00.  What affordable local transportation options could you suggest to your patients?

Promote patient transportation options through flyers, posters, or digital signage at your facility.  If you use a lobby display screen or patient notification board, include notices for patient transportation options that appear throughout your rotation of announcements.

Assign staff members to address patients’ needs, one-on-one.  These employees can help patients determine which transportation assistance programs they may be eligible for (e.g. Medicaid non-emergency medical transportation (NEMT), the American Cancer Society’s Road to Recovery program), help them apply or sign up for assistance, and help them understand their existing benefits or coverage (e.g. how ambulance transportation may or may not be covered under Medicare).

Promote patient transportation options through your hospital’s social media accounts.

Create New Patient Transportation Options


Institute a driver volunteer program to provide rides to eligible patients, as Grace Cottage Family Health & Hospital and Green Mountain RSVP have done.

Start a hospital van service, like the one Taylor Regional Hospital created to deliver prescriptions and bring patients to and from the hospital.

Partner with an on-demand transportation service, like Maryland Health System has with Uber and Denver Health has with Lyft, to offer free or discounted transportation to qualifying patients.

Provide shuttle, bus, or taxi travel vouchers.  Create an incentive program for eligible patients who keep their appointments.

Participate in local government and community planning projects.  The American Hospital Association suggests hospital representatives “participate in local or regional transportation planning initiatives and educate decision-makers about how health can be affected by transportation” to encourage the development of new patient transportation options (such as more walkable routes, bike lanes, bike-sharing programs, bus or shuttle services, etc.).

Alleviate Patient Transportation Needs by Bringing Care to the Patients


Invest in a mobile health center, as Calvert Health System has; the Calvert Health System Mobile Health Center brings primary and preventive health services to patients by visiting churches and community centers.

Create a prescription delivery or mail service, or provide pharmacy services on site to cut travel for patients, as the American Hospital Association advises here (p. 12).

Provide more telehealth opportunities and encourage use of the patient portal for minor questions.


Make a commitment to address patient transportation needs using the suggestions above, and your patients, community, and facility will all enjoy the benefits of better health outcomes.

You can read in further detail how the health systems mentioned above (Grace Cottage, Taylor Regional, Denver Health, and Calvert Health) address patient transportation needs in the case studies provided by the American Hospital Association.


By Stephanie Salmich

Improve patient safety for patients like the family and newborn pictured here.

Medical Errors Statistics Reveal the Need to Improve Patient Safety

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Medical Errors Statistics Reveal the Need to Improve Patient Safety

Posted on Monday, March 12, 2018

In 2018, it can be easy to take patient safety for granted; however, studies show that we have a long way to go to truly improve patient safety:

According to a nationwide survey conducted by NORC at the University of Chicago, 21% of patients report experience with medical errors.  The survey also found that these medical errors “often have lasting impact on the patient’s physical health, emotional health, financial well-being, or family relationships.”

With approximately 251,454 deaths in the U.S. per year due to medical errors, Johns Hopkins University researchers estimate that this is the third leading cause of death in the country.  (Research published in the Journal of Patient Safety estimates the number of premature deaths due to medical errors could be even higher – over 400,000 per year.)

Patient safety is of the utmost importance to any healthcare system, so how can these numbers be so high?

As the PatientSafe Network explains, there are many obstacles that thwart or diminish efforts to improve patient safety.  These include issues regarding cognitive dissonance, blame/pointing fingers, complexity, cost, and many more.  See their full list of (18!) obstacles here.

Improve Patient Safety

Improve patient safety for patients like the family and newborn pictured here.

Make the commitment to reduce medical errors and improve patient safety during National Patient Safety Awareness Week.

This week is National Patient Safety Awareness Week, an initiative of The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) “designed to mark a dedicated time and a platform to increase awareness about patient safety among health professionals and the public,” according to their website.  There will be two main issues highlighted this year – safety culture and patient engagement.

National Patient Safety Awareness Week offers an opportunity for both healthcare professionals and healthcare consumers to come together to improve patient safety.  IHI and NPSF offer plenty of ideas for getting involved and a day-by-day guide to activities for the week, and invite you to join the conversation on social media (use the hashtag #PSAW in your posts).

You can also find ideas for promoting other health observances throughout the year here, and a detailed calendar of this year’s health observances and recognition days here.

In order to improve patient safety and reduce medical errors and patient safety risks, it will take the work of all stakeholders (administrators, clinicians, staff, patients, family members, etc.) to raise awareness of this critical issue.  It will also take their commitment to making the changes necessary for lowering risks to patient safety.


By Stephanie Salmich

A doctor holds a tablet showing healthy food images representing the blog topic – reduce patient malnutrition.

Taking Steps to Reduce Patient Malnutrition is Critical to Health Outcomes

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Taking Steps to Reduce Patient Malnutrition is Critical to Health Outcomes

Posted on Wednesday, March 7, 2018

When we look at the statistics, the importance of taking steps to reduce patient malnutrition becomes clear.  A study of 818 inpatients published in Clinical Nutrition found that up to one third were malnourished, resulting in “poor hospitalization outcomes” such as increased mortality rates and higher costs of care.

Indeed, according to an article published in the Journal of the Academy of Nutrition and Dietetics:

“Malnutrition is associated with many adverse outcomes, including an increased risk of pressure ulcers and impaired wound healing, immune suppression and increased infection rate, muscle wasting and functional loss increasing the risk of falls, longer length of hospital stay, higher readmission rates, higher treatment costs, and increased mortality.”

The authors of the article point out that malnutrition is often overlooked, despite its dire consequences and the startling number of patients who suffer from it.  Per research cited in the article, it is estimated that in developed countries at least one third of patients are malnourished to some degree at the point of admission; during their hospital stay, the nutrition of about two thirds of these patients will worsen if untreated; and about one third of patients who are not malnourished when admitted may become malnourished during their stay.

Fortunately, hospitals can prevent many of the negative effects of malnutrition.  The authors of the article in the Journal of the Academy of Nutrition and Dietetics suggest healthcare facilities apply the following six principles to nutrition care in order to reduce patient malnutrition:

Reduce Patient Malnutrition


1 – “Create an institutional culture where all stakeholders value nutrition” – Administrators and all healthcare professionals (doctors, nurses, physician assistants, pharmacists, dieticians, etc.) must collaborate.

2 – “Redefine clinicians’ roles to include nutrition care” – Provide clinicians with nutrition training and continuing education.

3 – “Recognize and diagnose all malnourished patients and those at risk” – Every hospitalized patient should be screened according to a standardized procedure.

4 – “Rapidly implement comprehensive nutrition interventions and continued monitoring” – Immediate nutrition interventions must be a high priority; consumption must be monitored and adjusted as necessary.

5 – “Communicate nutrition care plans” – Ensure patients’ nutrition care plans are updated in the EHR and all healthcare professionals are informed.

6 – “Develop a comprehensive discharge nutrition care and education plan” – Communicate the nutrition care plan to the patient and caregivers, provide them with nutrition education, and follow up to check adherence to the plan.


A doctor holds a tablet showing healthy food images representing the blog topic – reduce patient malnutrition.

Reduce patient malnutrition to improve health outcomes.

A piece featured on the Hospitals & Health Networks website proposes that “before implementing interventions, a hospital must first visualize food as medicine to realize the impact that food can make in the community.”  This article provides many ideas for hospitals looking to serve their communities and reduce patient malnutrition (such as establishing on-site gardens, healthy cooking classes, food pantries, and food pharmacies).

March is National Nutrition Month®, an education and information campaign created by the Academy of Nutrition and Dietetics.  This is the perfect time to start implementing the above principles at your facility and take steps to reduce patient malnutrition.  You can also promote healthy eating habits for your employees and patients using the tools the Academy of Nutrition and Dietetics provides here.

Don’t forget to recognize the RDNs who serve and advance the health of your community by celebrating Registered Dietitian Nutritionist Day (the second Wednesday in March) as well!


You can also find ideas for promoting other health observances throughout the year here, a detailed calendar of this year’s health observances and recognition days here, and information on the other social determinants of health here.


By Stephanie Salmich

Managing the flu season: Sick patients sit in the waiting room.

Managing the Flu Season and High Patient Volume

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HealthWare Systems Blog

Managing the Flu Season and High Patient Volume

Posted on Wednesday, February 28, 2018

Managing the flu season has been especially difficult for hospitals this year as health systems around the country are overflowing with record numbers of flu patients, resulting in ambulance diversions and delays, bed shortages, and ERs that are operating beyond capacity.

For example, Saint Agnes Medical Center’s ER in California has been operating at 104% capacity and UCLA Medical Center’s ER, which usually treats around 140 patients/day, recently treated over 200 patients in one day.  In January Illinois had 100 more flu outbreaks than it did last year at the same time.

Here are some suggestions for managing the flu season:


Prevention

The best thing you can do in your work toward managing the flu season is to take preventive measures to reduce the number of patients the flu will bring in in the first place.  Be diligent in your efforts to educate patients about, and encourage them to receive, the flu vaccine.  Many may not realize that it’s not too late to get the flu shot for this flu season.  Provide them with the CDC’s tips for prevention and dispel any of the common flu myths they may believe.

The ModernMedicine Network outlines the importance of considering how you might compete with drug stores and retail clinics to secure your patients’ business for flu shots.  They suggest providing for walk-in vaccinations, setting up after-hours or weekend vaccination clinics, and partnering with nearby businesses to arrange flu shot clinics for their employees (which has the potential to generate new patients), among other ideas.


Preparation

Prepare for managing high patient volume, which you’re likely to see during the flu season.  Adjust your staffing needs and keep in mind that your employees may get sick, too.  A patient tracking system will help you to better allocate staff and resources and will vastly improve efficiency and patient throughput.

Other workflow automation tools will also aid you in managing high patient volume by increasing efficiency and perhaps compensating for an uptick in sick/absent employees.


Containment

Research published in the American Journal of Infection Control found that 4 in 10 healthcare professionals work while experiencing flu-like symptoms, risking the safety of the most vulnerable patients such as the elderly and those with chronic diseases.  Sick employees with a fever and respiratory symptoms should be instructed not to return to work “until at least 24 hours after they no longer have a fever (without the use of fever-reducing medicines such as acetaminophen),” according to the CDC.

Additionally, create a designated space in the waiting room for patients with flu symptoms where they can sit without spreading the flu to other patients.  And make sure plenty of hand sanitizer, tissues, and masks are available to help contain the virus.

Managing the flu season: Sick patients sit in the waiting room.

High patient volume makes containment in the waiting area especially important to managing the flu season.

Managing the flu season is a challenge, but prevention, preparation, and containment will help you to operate efficiently while managing high patient volume and keeping your patients safe.


By Stephanie Salmich