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Source: Eric Toner, Richard Waldhorn, Crystal Franco, Brooke Courtney, Kunal Rambhia, Ann Norwood, Thomas V. Inglesby, Tara O'Toole, University of Pittsburgh Medical Center, Center for Biosecurity, Evaluation Report, March 2009

Hospitals are the backbone of the healthcare response to common medical disasters (i.e., mass casualty events that occur with relative frequency, overwhelm a single hospital, and require a communitywide health response) and, in particular, to catastrophic emergencies, such as an influenza pandemic or large-scale aerosolized anthrax attack. The need for hospitals to be prepared to respond to disasters has increasingly become a priority for hospital leaders. They have been influenced by events such as the 2001 terrorist attacks and Hurricane Katrina and the increased emphasis placed by accreditation organizations and regulatory agencies on the importance of such disasters.

Key Findings:
- Disaster preparedness of individual hospitals has improved significantly throughout the country since the start of the HPP.
- The emergence of Healthcare Coalitions is creating a foundation for U.S. healthcare preparedness.
- Healthcare planning for catastrophic emergencies is in early stages; progress will require additional assistance and direction at the national level.
- Surge capacity and capability goals, assessment of training, and analysis of performance during actual events and realistic exercises are the most useful indicators for measuring preparedness.
- To prepare the nation to respond to catastrophic emergencies, HHS should provide continued leadership to assist states in their efforts to address the many procedural, ethical, legal, and practical problems posed by a shift to disaster standards and alternate care facilities (ACFs) that is required when demand for care overwhelms available resources.
- Catastrophic emergency preparedness is a national security issue and requires the continued funding of the HPP.
See also:
Executive Summary

Source: Tami Swartz, HealthLeaders Media, April 28, 2009

Methodist Hospital has not had a hospital-acquired infection since January 8, 2008, when it opened. Chief Nursing Officer Lamont Yoder, RN, attributes the hospital's infection control success not just to its staff members' compliance, but to the physical environment in which they work every day.

Source: Robert J. Rosati, Joan M. Marren, Denise M. Davin, Cynthia J. Morgan, Journal for Healthcare Quality, Volume 31 Issue 2, March/April 2009
(subscription required)

From the abstract:
Greater accountability for patient outcomes, reduced reimbursement, and a protracted nursing shortage have made employee and patient satisfaction results central performance metrics and strategic imperatives in healthcare. Key questions are whether the two interact and if so, how can that relationship be leveraged to obtain maximum gains in both employee and patient satisfaction. This article examines the experience of a large, nonprofit home care agency in exploring these issues. The agency found that organizational commitment to patient care and customer service are fundamental to patient satisfaction. The more employees perceived that the organization is focused on quality and customers, the more patient satisfaction increased. Among nurses, work-life balance, fair compensation, and regard for employees all influenced patient satisfaction.

Source: Selena Kaplan, Soren Bisgaard, Donna Truesdell, Sharren Zetterholm, Journal for Healthcare Quality, Volume 31 Issue 3, Published Online: 27 Apr 2009
(subscription required)

From the abstract:
Nonclinical healthcare processes are sometimes created on an ad hoc basis and hence over time may grow unnecessarily complex and difficult to assess, teach, improve, or transfer. Intentionally designing processes are more likely to yield an efficient and effective process. Originally developed in industry, Design for Six Sigma (DFSS) is a method for planning new processes applicable to healthcare. Benefits from using DFSS include well-defined process steps and documentation that makes processes easier to teach, monitor, control, and transfer to other units. We describe the DFSS process and provide an example of its application to an employee influenza vaccination program at a New England hospital.

Source: Marcia Faller, AMN Healthcare, April 29, 2009

For the past week, the media has been filled with stories about the swine flu epidemic. During this time, it's important that your staff know the facts about the swine flu so they can better care for their patients and prevent the possible spread of infection.
See also:
- Centers for Disease Control and Prevention
- Pandemic Flu
- World Health Organization

Source: Glenna Murdock, AMN Healthcare, April 29, 2009

Healthcare facilities across the U.S. have felt the pinch of the nursing shortage, which is only projected to grow worse in the coming years and the sector that looks to be most seriously affected is that of home healthcare nursing.

Source: American Hospital Association, April 27, 2009

Six out of ten hospitals nationally are seeing a greater proportion of patients without insurance coming through their emergency departments and nearly half have reduced staff according to a March 2009 survey of hospitals.

• The economy is taking its toll on the patients and communities
hospitals serve. For the majority of hospitals:
- The proportion of emergency department patients without insurance is increasing.
- A higher proportion of patients are unable to pay for care and many hospitals are seeing more patients covered by Medicaid and other public programs for low income populations.
- Fewer patients are seeking inpatient and elective services raising concerns that individuals are putting off needed care.
- Community need for subsidized services such as clinics, screenings and outreach is increasing even as charitable contributions are down for many hospitals.
• Nine in 10 hospitals have made cutbacks to address economic concerns.
- Nearly half have reduced staff.
- Eight in 10 have cut administrative expenses.
- One in five have reduced services communities depend on including behavioral health, post acute care, clinic, patient education and other services that require subsidies.

Source: Medical News Today, March 31, 2009

A new research study, published in the March/April issue of the journal Nursing Economics, has determined what factors can help keep new nurses from leaving their jobs and - in doing so - save health systems money. When nurses leave for another position or retire early, it dramatically affects a hospital's bottom line - as much as 5 percent of a hospital's budget may go to paying for nursing turnover costs.

Source: Barbara Bowers, Kim Nolet, Tonya Roberts, and Sarah Esmond, Commonwealth Fund, April 2009

From the summary:
Implementing Change in Long-Term Care: A Practical Guide to Transformation is a manual for nursing home staff that offers evidence-based recommendations on preparing a nursing home to take the first steps toward clinical and cultural changes, as well as methods to implement and sustain those changes.

Source: American Federation of Labor and Congress of Industrial Organizations (AFL-CIO), April 16, 2009

An influenza pandemic is projected to have a global impact requiring a sustained, largescale
response from the healthcare community to provide care to sick patients. Healthcare workers will be at very high risk of becoming infected when caring for patients with pandemic flu unless adequate health and safety measures are in place, in advance of the pandemic, that will protect them. There is no existing comprehensive federal OSHA standard with mandatory and enforceable provisions that require planning and preparation designed to protect healthcare workers from exposures to pandemic influenza. Nevertheless, it is essential that workplaces plan and prepare for safety and health issues before the flu arrives.

In an effort to assess the extent of employer efforts in planning adequate safety and health measures for healthcare workers, a group of unions developed a "pandemic flu preparedness survey" to assess the level of preparedness on a facility basis. The survey was distributed to union leaders across the country who represent healthcare workers in unionized facilities. One hundred four (104) facility surveys were collected by six unions in fourteen states.