What We're Watching: March 27, 2020

MORE HOSPITAL SURVEY RESULTS

We have published results from a member survey of hospitals’ and health systems’ levels of personal protective equipment (PPE) to gauge the impact of COVID-19.

What we’re saying: According to our survey, roughly 97% of respondents have implemented at least one conservation protocol for PPE. Despite the conservation protocols, hospitals are still burning through more N95 respirators, surgical masks, isolation gowns and face shields than can be replaced. Specifically, the survey found that:

• Hospitals ranked the supply of N95 respirators as their top concern.
  • While the largest number of respondents (≈39%) reported having more than 1,000 N95s on hand, a plurality of respondents (23%) are burning through more than 100 masks a day
  • There is still significant room to further improve conservation measures specific to N95 masks, including extending the wear of N95s (a measure followed by 60% of respondents), reusing N95s (40%), using expired N95s (33%) and using industrial N95s (20%)
• Hand sanitizer was the second most concerning shortage for survey respondents, with 64% reporting an active shortage
  • An additional 25% have less than two weeks’ supply
• Surgical mask shortages were the third most concerning shortage for survey respondents
  • Most respondents (56%) reported having more than 1,000 surgical masks on hand, but a quarter (26%) burn through that amount every day
• Half of survey respondents (50%) reported having more than 1,000 isolation gowns on hand, however, about 25% also burn through that same quantity each day
• Viral swabs are another area of concern, as most respondents (60%) have fewer than 250 swabs on hand, while about 21% burn through more than 100 swabs a day
• According to the survey results, 20% of respondents report needing additional ventilators immediately
  • Approximately 27% can take on an additional one to five patients before they require additional ventilators
  • About 24% can accommodate six to 10 more patients, and about 30% can take 11 or more patients before they need additional ventilators

Premier is recommending:

• All members to follow CDC-recommended conservation protocols for PPE and to be judicious with supply orders for the foreseeable future
• Caution before purchasing from gray market vendors, as products can be of questionable quality and/or counterfeits

MINDING THOSE ON THE FRONTLINES

Caring for the caregivers is becoming more critical than ever. Physicians and staff are dealing with several facets right now that risk taking burnout to the next level.

What we’re saying: Premier’s expert lays out ways to prevent burnout from taking hold:

• To the extent possible, enable staff to complete tasks remotely and virtually. Utilize virtual care options such as e-visits and telehealth when possible
• Leverage clinical teams for identifying and ideating ways to create efficiencies and optimize workflow
• Take advantage of space outside the four walls of the hospital (e.g., mobile clinics, drive-thru testing, remote monitoring, etc.)
• Ensure downtime by limiting the volume of emails, phone calls, alerts and safeguarding time off/away

Happy to share further insights on this important topic.

NO TIME TO WASTE

The massive emergency stimulus package passed by the Senate last night, the Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748), contains $100 billion for hospitals and other healthcare entities to cover unreimbursed expenses or lost revenues attributable to the coronavirus.

What we’re saying: Premier worked with key lawmakers to include as a mechanism for distributing these funds an option to receive prospective payments in the CARES Act.

Yesterday, Premier joined eight other hospital and physician organizations in sending a letter urging CMS to immediately begin making periodic interim payments to ensure that caregivers on the front lines are receiving comparable levels of funding and are able to continue providing care. Raising concerns that many providers will not be able to fully reconcile their periodic payments after the conclusion of the public health emergency, the groups also urged CMS to use the funds provided in the CARES Act to allow no or reduced reconciliation.

What We’re Watching is a bi-weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members. Check out our last update!