A pair of Institute for Healthcare Improvement leaders highlighted trends for health equity in 2022 yesterday at the IHI National Forum.

The IHI National Forum is being held virtually this week. More than 6,000 people have registered to attend the annual event, which features more than 150 sessions and 375 presenters.

Yesterday during a press briefing, IHI President and CEO Kedar Mate, MD, and IHI President Emeritus and Senior Fellow Donald Berwick MD, MPP, discussed health equity trends for 2022.

Next year, there likely will be a movement toward outcome-based measurement for health equity, Mate said.

As part of its effort to promote joy in work at healthcare organizations, the Institute for Healthcare Improvement has adopted a framework of five guiding principles to foster workplace equity.

“When we are talking about workplace equity, one of the drivers of joy and wellbeing in work is psychological safety,” says Marina Renton, MPhil, a research associate at the Institute for Healthcare Improvement. “We see workplace equity as an important component of ensuring psychological safety for staff members. Workplace equity is a vital component of their ability to find joy in the workplace and to feel safe at work. It is foundational to starting to work toward improving staff experience.”

As we close in on the second anniversary of when everything went (more) sideways (than usual), all things COVID seem to be heating up for the holidays with the omicron variant and cases spiking here, there & everywhere (probably not what Sir Paul had in mind almost 60 years ago).

Clinical debriefing efforts can drive several benefits at health systems and hospitals, according to the NYC Health + Hospitals presenters of a session at this week’s IHI Forum.

The Agency for Healthcare Research and Quality provides a definition of clinical debriefing: “A dialogue between two or more people whose goals are to discuss the actions and thought processes involved in a particular patient care situation to encourage reflection on those actions and thought processes and incorporate improvement into future performance.”

“Three key things stick out to me: dialogue, reflection, and improvement,” said Mona Krouse, MD, patient safety officer at NYC Health + Hospitals.

Newsletter: Inside Accreditation & Quality

In the upcoming year, surveys will include new standards, revised requirements, modified processes and procedures, and a continued focus on infection control and fire safety. However, none of that promises to be more difficult than facing the COVID-19 pandemic.

Unfortunately, there will still be a COVID-19 pandemic as the new year opens.

Both The Joint Commission (TJC) and DNV Healthcare will be surveying to new and revised standards, but few if any of the changes are unexpected. Many of them concentrate on eliminating repetitive requirements or aligning standards with new or changing CMS expectations.

Newsletter: Patient Safety Monitor Journal

Sepsis is a problem that won’t go away. Globally, one in five deaths are caused by sepsis. In U.S. hospitals, sepsis is the leading cause of death and hospital readmissions. The condition is fast acting, is often misdiagnosed, and can be caused by a virus, bacteria, fungus or parasite.

But one of the biggest barriers to sepsis prevention and response is simple: knowledge. While most healthcare workers are aware of sepsis, many patients in the community aren’t. And with 87% of sepsis cases originating in the community, rather than in a facility, gaps in knowledge can be fatal.

“If [people] don’t realize that sepsis is a medical emergency, they’re just sitting at home thinking “this is OK, it’s going to get better,” says Sara Follin McMannus, RN, BSN, MBA, clinical advisor for the Sepsis Alliance, the leading sepsis organization in the U.S. that works to save live and reduce suffering from sepsis. “If they know the signs and symptoms of sepsis, that gets them to get help sooner.”

Newsletter: Healthcare Life Safety Compliance

Vary the start time of your quarterly fire drills by at least an hour on each shift because surveyors will be checking.

And beware of establishing a pattern of scheduling drills because both The Joint Commission (TJC) and the Healthcare Facilities Accreditation Program (HFAP), now operating under the Accreditation Commission for Health Care (ACHC), have cited hospitals for problems.

CMS inspectors also regularly check fire drill logs

Newsletter: Healthcare Safety Leader

A key element of an emergency preparedness plan is assessing how the staff and facility handled the disaster at hand and what lessons were learned for the next event.

In July 2019, after three earthquakes in two days, including a 7.1 magnitude temblor that was the largest earthquake in California in two decades, Ridgecrest Regional Hospital in Ridgecrest, California, had several takeaways, said Stephanie Meeks, MBA, HACP, the hospital’s emergency management and regulatory compliance manager.

She offered these lessons during a presentation at the DNV Healthcare annual symposium in November:

Newsletter: Medical Environment Update

The numbers are staggering—more than 10,000 prescription medications on the market, with many patients on more than one medication at a time (PSNet, 2019). According to a recent study by the Get the Medications Right Institute (GTMRx), nearly a quarter of the patients surveyed said their medical team did not regularly review their medications, despite a third of the respondents saying they were currently taking four or more medications (GTMRx, 2021b).

The opportunity for error grows from there: One in five said they were prescribed medications by three or more physicians in the past year (GTMRx, 2021b). Healthcare leaders have identified lack of communication between prescribers and pharmacists as a major challenge in medication management (GTMRx, 2021a). But how do we improve this situation?

“We have an explosion of life-saving medications,” says Katherine H. Capps, co-founder and executive director of GTMRx. “Also 80% of how we treat and prevent illness is with medications. But multiple medications prescribed by multiple physicians to treat multiple conditions is a huge area of risk.” That’s a finding echoed in the medical literature, including a recent study in Annals of Pharmacotherapy (Watanabe et al., 2018).