Monday, October 26, 2020

QA/QI Resource: New IHI Report, "Safer Together: A National Action Plan to Advance Patient Safety"

keywords: quality assurance (QA) standards, quality improvement (QI), program leads and program managers, leadership and workplace, metrics

topics: QA/QI and workplace safety and patient safety, the latest standards on patient and workplace safety from the Institute for Healthcare Improvement (IHI) 

www.thehospitalhandbook.com


Why is this important or what is the practical application of this?

  • This is a useful resource for those of you who are updating your quality improvement (QI) processes or serve on quality assurance committees
  • This is useful for those of you who work as program leads or program managers
  • This sets a standard for patient safety and workplace safety in the healthcare setting

 

What is this, specifically? What is the reference or resource?

This is an announcement about a new Institute for Healthcare Improvement (IHI) report, Safer Together: A National Action Plan to Advance Patient Safety

This report, “provides clear direction that health care leaders, delivery organizations, and associations can use to make significant advances toward safer care and reduced harm across the continuum of care.”

“The report harnesses the knowledge and insights of the National Steering Committee for Patient Safety (NSC) members, including influential federal agencies, leading health care organizations, patient and family advisors, and respected industry experts, into a set of actionable and effective recommendations to advance patient safety.”

“The National Action Plan centers on four foundational and interdependent areas, prioritized as essential to create total systems safety. The recommendations in these four areas build on the substantial body of experience, evidence, and lessons learned that the NSC has gathered and will test and implement together to allow for future refinements as our understanding, experience, and evidence evolve over time.”

The National Action Plan has a list of 17 recommendations “to advance patient safety”. These recommendations fall into the following sub-categories:

  1. Culture, leadership, and governance
  2. Patient and family engagement
  3. Workforce safety
  4. Learning system

Read this report and its supporting materials on this IHI webpage.

 

Related HHP Resources

  • For more about our HHP recommended resources on leadership, quality assurance issues specific to hospital-based practice, and program lead/program manager resources, send me a message via the website (for specific recommendations). 
  • Or you may browse this blog with the search terms "workplace", "leadership", "quality assurance", and/or "program lead". 

 

If you found this content useful or insightful, please support this community work. You can support with cups of virtual coffee, sponsor a newsletter, or sponsor a project via the website.

www.thehospitalhandbook.com

 

Sunday, October 25, 2020

Leadership: Recommended Reading and Resources

keywords: leadership in integrative health, program leads, program managers, inspiration for the workplace

Leadership Resources at the Hospital Handbook Project

Recommended Reading and More


HHP Leaders Group & Resource

  • I have been developing a Leaders Group & Resource for program leads and managers over the past couple of years for the Hospital Handbook Project. If you are interested in this, you can contact me via the website with a note about your interest, including why you are interested.


The "Issues in Hospital-based Practice Webinar Series"

  • This didn't get off the ground again in 2020. So, right now, the plan is to roll the 2020 sessions into the 2021 series. You can sign up now to access the 2020 resources and support the ability to have sessions in 2021. 


The "Basics of Being an Employee in a Healthcare System: Focus on Performance Management"

  • A wisdom-share series with colleague Sandro Abanto, MBA, in a video interview format. Read more about it in this article.


Lunchtime Listen Recommendations


HHP Leadership & Workplace Video Series

video series on the public Facebook page


Recommended Reading: Blog articles and more


The Hospital Handbook Project Learning Opportunities Directory


If you found this content useful or insightful, please support this community work. You can support with cups of virtual coffee, sponsor a newsletter, or sponsor a project via the website.

www.thehospitalhandbook.com

Saturday, October 24, 2020

Federal Practice: Indian Health Service Program includes Licensed Acupuncturists

 keywords: federal practice acupuncturists, prospective practitioners, new hospital employee, position description, program funding, federal student loan forgiveness programs


The Indian Health Service (IHS) now includes licensed acupuncturists in their "eligible providers" category for their student loan forgiveness federal service employment program.

Quote:

"25 U.S.C. 1616a, authorizes the IHS to determine specific health professions for which IHS LRP contracts will be awarded....The list of priority health professions that follows is based upon the needs of the IHS as well as upon the needs of the American Indians and Alaska Natives

(a) Medicine--Allopathic and Osteopathic doctorate degrees 

(b) Nursing--Associate Degree in Nursing (ADN) (Clinical nurses only).

(c) Nursing--Bachelor of Science (BSN) (Clinical nurses only).

(d) Nursing (NP, DNP)--Nurse Practitioner/Advanced Practice Nurse in Family Practice, Psychiatry, Geriatric, Women's Health, Pediatric Nursing.

(e) Nursing--Certified Nurse Midwife (CNM).

(f) Certified Registered Nurse Anesthetist (CRNA).

(g) Physician Assistant (Certified).

(h) Dentistry--DDS or DMD degrees.

(i) Dental Hygiene.

(j) Social Work--Independent Licensed Master's degree.

(k) Counseling--Master's degree.

(l) Clinical Psychology--Ph.D. or PsyD.

(m) Counseling Psychology--Ph.D.

(n) Optometry--OD.

(o) Pharmacy--PharmD.

(p) Podiatry--DPM.

(q) Physical/Occupation/Speech Language Therapy or Audiology--MS, Doctoral.

(r) Registered Dietician--BS.

(s) Clinical Laboratory Science--BS

(t) Diagnostic Radiology Technology, Ultrasonography, and Respiratory Therapy: Associate and B.S.

(u) Environmental Health (Sanitarian): BS and Master's level.

(v) Engineering (Environmental): BS and MS (Engineers must provide environmental engineering services to be eligible.).

(w) Chiropractor: Licensed.

(x) Acupuncturist: Licensed.

Learn more about this program and how to apply here:

Their October 15th, 2020, funding announcement:

https://www.federalregister.gov/documents/2020/10/13/2020-22649/loan-repayment-program-for-repayment-of-health-professions-educational-loans

source: October 15th, 2020 announcement


If you currently work in the IHS as a licensed acupuncturist and haven't connected to The Hospital Handbook Project community yet, start here by submitting your request or questions to us via the contact page on our website. Thank you.

If you are a student or prospective practitioner and are interested in starting practice in a large health care system, whether federal or civilian, a good starting place is our Getting Your Foot in the Door: First Steps e-book and workbook resource.


www.thehospitalhandbook.com

Monday, July 20, 2020

The Telehealth Roundtable for Hospital-based Programs Event Recording with Time Stamp Notations

keywords: telehealth, hospital-based acupuncture programs, remote work options for clinicians, policy and procedures, hospital-based acupuncture & telehealth programs, telehealth & Chinese Herbal Medicine (CHM), VA acupuncture telehealth program, inpatient telehealth acupuncture, new program creation, wisdom-sharing, billing & reimbursement, coding for hospital-based acupuncture work, hospital-based acupuncture program manager, hospital-based acupuncturist, hospital-based integrative health programs, telehealth programs and policy for hospital-based integrative health providers, pandemic prep & response for integrative health care providers

Event recording linkhttps://youtu.be/tf-wAYHk-Ns



Timestamps and Notes--a pdf of this document is available in the event's online resource module here: https://hospital-practice-basics.teachable.com/p/telehealth-roundtable-june-2020

Recording made public July 11th, 2020, and is available here: https://youtu.be/tf-wAYHk-Ns

For all the event resources, go to the event’s online resource module: https://hospital-practice-basics.teachable.com/p/telehealth-roundtable-june-2020

Time Stamps and Notes from the 6.20.2020 Telehealth Roundtable Event

Revised with the edited event recording
You can help offset the outgoing costs of this resource (video editing, transcript creation, etc.) in these ways:
·        Buy access to the event's online resource module: https://hospital-practice-basics.teachable.com/p/telehealth-roundtable-june-2020
·        Encourage your organization to sponsor this resource (if this work aligns with their work)
·        Support via the virtual coffee option
·        Buy access to another resource via our website
o   Support a community discussion
o   Paths to Practice: Interview with Dr. Annie Budhathoki (Huntsman Cancer Institute, outpatient and inpatient integrative acupuncture and oncology in hospital-based practice)

Thank you.

Time Stamps and Short Notes for the Recording


Introduction (Megan)

0:00 start

Minute 2:10 review of agenda

Minute 3 – 5 Where to find extra content for this event

Minute 4:50 – 8:20
Review of what the Hospital Practice Handbook Project is

Minute 08:30
Why Telehealth?

Minute 09:30 – 1140
Why this Event?
“Do not follow where the path may lead. Go instead where there is no path and leave a trail.” -Ralph Waldo Emerson

Minute 11:20
Defining Telehealth

Minute 12:20 – 14:30
Introduction of Panelists

Paul Magee’s presentation

Start at Minute 14:30

Minute 17:20 – 17:50
Paul mentions the metrics his program is tracking

Minute 22:30 – 23:20
I mention Paul’s other video recorded in May 2020 on the “The Allina Inpatient Telehealth pivot”.


End 24:35

John Burns’ presentation

Starts at 24:45
14 LAcs in the integrative medicine department

Minute 30
Telehealth for oncology patients receiving treatment at the infusion center(s)

Minute 31 -32
John discusses how the acupuncture team collaborated on the development of a training/competency program to deliver “TCM Acupuncturist Directed Therapeutic Strategies”.

Minute 32 -33
Setting up reimbursement for telehealth services by LAcs.
Coding, billing, reimbursement agreement with third party payors (3PP)
Getting LAcs the access to tech for virtual visits and the system’s EHR compatibility


End minute 34:00

 

Juli Olson’s presentation

Starts at minute 34:15
Currently, there are 71 LAcs in the VHA. Most hired within the last 2 years.

Minute 43:45 – 44:15
Slide example of acupressure visual handouts

Minute 44:20
Slide with lots of links to share with practitioners


End minute 44:50

Galina Roofener’s presentation

Starts at minute 45:00

Minute 51:43
Basic review of SOAP documentation in telehealth TCM visit

Minute 52:15 – 53:45
Obtaining and recording objective measures for a telehealth visit
Tongue photo
Pulse rate and echocardiogram (EKG)

Minute 54:00 – 56:30
CHM and telehealth at a medical center


End at minute 57:35

Mori West’s presentation

Starts at minute 57:40

minute 60
Telehealth virtual codes 99421 – 423 are time-based codes
Phone codes 99441-443 are time-based codes
Time is cumulative in a 7-day period

64:30 – 66 min
E/M codes for telehealth 99201, 99212, etc.

66-67 minutes
Modifiers

End at 70 minutes

Nancy Gahles’s presentation

Starts at 70 minutes

minute 73
Public health initiatives and telehealth
Telehealth, a tool for public health

Minute 75
Over the counter (OTC)

77 minutes
Grants are available for implementing telehealth

78 minutes
Language in federal law—IHPC is working on this

79 – 81 minutes
ICE/NCCA accreditation of national certification. Why/reasons for this standard from a federal perspective
Example: NCCAOM is an LAc’s national certification exam. NCCAOM has the NCCA/ICE accreditation

81 minutes
CMS info and May 1st date

84 minutes
FQHCs mentioned
The IHPC caucus…

End at 84 minutes, 30 seconds

Panel Discussion

Starts at 84 minutes, 40 seconds

Questions for Nancy Gahles
Socratic discussion amongst panelists
Interim rules, working with the national association (ASA)
The Act of Congress
Bundled payment for opioid treatment plans
ASA Town Halls—6/24/2020 session on Medicare Megan mentioned.

minute 90—Question on % workload in telehealth
Paul, John, Juli, Galina

Minute 94 (aka 1 hour, 34 minutes)
—Question on
1.       Sustainability of the telehealth program…
a.       What is the patient buy-in of your telehealth program?
b.       How do you know it is sustainable?
c.       What metrics are you tracking?
Paul, John, Juli, Galina

Minute 103 (aka 1 hour, 43 minutes)
Telemetry, Telehealth, & LAcs
Galina is uploading EKG (echocardiogram)
               Visual of heart rate, pulse quality
               one lead EKG…Apple watch, Cardio Life electrodes
Juli, John, Paul
               LAcs can see the data uploaded in the EHR by in-person tech or at-home blood pressure cuff and readings.

Minute 107
Coding and Billing Questions from other Panelists for Mori
John, Juli, Galina

Minute 114 (aka 1 hour, 54 minutes)
Issues and Solutions, more
1.       What was your biggest issue?
a.       Did you overcome it?
b.       If yes, how?
c.       Any other outstanding issues?
2.       Last note/lesson you want to end on.

Paul, John, Juli, Galina, Mori.

Ended at 128 minutes, 49 seconds (aka 2 hours, 8 minutes, 49 seconds)



Related blog articles


Related Playlists on our YouTube Channel



You can support this not-for-profit work virtually at our website with a virtual cup of coffee/tea ☕. Thank you.
www.thehospitalhandbook.com

Thursday, June 11, 2020

Pre-Event resource: Why Telehealth? What Could a Patient-Centered, Integrative Health Telehealth Program Look Like? (Video + summary notes)

keywords and phrases: telehealth, patient-centered care, hospital-based integrative health programs, hospital-based acupuncture programs, teaching self-care, delivering patient care virtually to support patient-led health goals, virtual one-on-one patient care, virtual group patient care classes, supporting patient lifestyle change for better health through the medium of telehealth, benefits of telehealth for providers and for patients in general and during a respiratory virus-based pandemic, upcoming online telehealth roundtable event on hospital-based acupuncture programs

The Hospital Practice Handbook Project's Telehealth Roundtable Pre-Event, Part 1: Why Telehealth? and What Could a Patient-Centered, Integrative Health Telehealth Program Look Like?


Reserve your Event Ticket

Telehealth & Acupuncturists in Hospital-based Practice
Preparing for the HHP-hosted Telehealth Roundtable Event
Part 1: What & Why
video recorded and published June 8th, 2020
presenter: Megan Kingsley Gale, MSAOM, founder of the Hospital Practice Handbook Project

Topics covered in this video
  • Why is telehealth important as part of phased re-opening?
  • What is the potential for telehealth in the integrative health paradigm of patient-centered care?
  • Short examples to explain this idea
  • How to buy a ticket and access the event scheduled for June 20th, 2020
  • The pdf of this presentation will be available in the "recordings access" portion of the Roundtable ticket (Ticket Plus or Recordings Only ticket options).
Learn more about the Hospital Practice Handbook Project's Vision and Mission here.

Video
video link: https://youtu.be/ixN0mx8n9L4


Summary notes with time stamps

minutes 0 - 2

minute 2:13 - 6
  • Why Telehealth?
    • generally
    • during the pandemic
    • benefits for provider personnel
    • benefits for patient
Event

minute 6
  • Why a telehealth online event?
    • Meet the community request to publicly present examples of telehealth programs in hospital-based acupuncture practice
minute 8
  • Defining "Telehealth"
  • with a citation from a peer-reviewed paper published in May 2020 by a Duke University team
    • Jedrek Wosik, Marat Fudim, Blake Cameron, Ziad F Gellad, Alex Cho, Donna Phinney, Simon Curtis, Matthew Roman, Eric G Poon, Jeffrey Ferranti, Jason N Katz, James Tcheng, Telehealth transformation: COVID-19 and the rise of virtual care, Journal of the American Medical Informatics Associationhttps://doi.org/10.1093/jamia/ocaa067 
minute 9

  • Telehealth vs. Direct Patient Care
    • False comparison
  • Clinical vs. No Clinical care is the true comparison
  • Leveraging technology
  • example: the active duty military family communication

minute 11 - 18
The Telehealth Model for Integrative Health
Go to video
  • Telehealth potential for integrative health practitioners
  • One-on-one telehealth options
    • individualized sessions
    • with self-care: acupressure, tuna, movement (tai chi, qi gong), etc
    • prescribe TCM dietary therapy.  examples are given
    • prescribe CHM
  • Group telehealth
    • webinars/group classes
    • examples
Go to presentation video
minute 14:50 - 17:50

  • Set patient-centered goals
  • Create a treatment plan with steps to help the patient meet their defined health goals
  • Use metrics--this is a basic aspect of professional practice
  • Examples


minute 18

  • Questions for the Telehealth Panel?
minute 18:21


Related blog posts



Related newsletter 



More videos
www.thehospitalhandbook.com

Monday, June 8, 2020

Phased Opening/Closure and Remote Work Options, including Telehealth, the Summer 2020 HHP Community Survey

keywords: community survey, pandemic prep & response, telehealth, acupuncture programs, hospital-based acupuncture, FQHCs, county clinics, community health centers, phased re-opening and closing, tiered re-opening and closing, remote work options, community resource

Community Survey Summer 2020


Access the survey here


Background
As you know, I have been hosting community discussion zoom sessions since mid-March to help the hospital-based acupuncture community discuss and share ideas on the pandemic prep & response. And, all the share-able content generated from those sessions so far is (and continues to be) uploaded to the online resource module here.

Three weeks ago a colleague recommended creating a survey to capture all the information on all the changes in a format that can:

  1. Be edited by the data entrant [because things change!]
  2. Create some summaries
  3. Be a quick source of share-able community information

Situation
I finished edits on it last week and it is up and running! It is available for acupuncturists and program managers who work with acupuncturists to input their information.

Assessment & Recommendation
This could be a useful resource for the community during this time of great change if enough of us complete it.
Please complete the survey to the best of your knowledge for your program and share this link with other hospital-based practice colleagues.

Who can take the survey?
Anyone who works in an organization or facility that is accredited by or eligible for accreditation by The Joint Commission.

What is "hospital-based"?
For purposes of this survey, I define "hospital-based" as any organization or workplace that is accredited by or eligible for accreditation by The Joint Commission. This definition includes FQHCs, county clinics, community health centers, and other federal health care spaces.

The survey is available here

Wednesday, June 3, 2020

Telehealth Roundtable for Hospital-based Acupuncture Programs--the Event

keywords: telehealth, pandemic prep & response, virtual health care, hospital-based acupuncture programs, coding and reimbursement for telehealth services for integrative health practitioners, acupuncture employee, acupuncture program manager, program examples, online event


You need a ticket to attend--looking for a ticket?

Join our experienced panel of hospital-based acupuncture program leads and managers to discuss setting up a telehealth program in medium to large healthcare systems and pivoting the work during the pandemic as part of phased re-opening/closing plans 


Get your ticket to the “Telehealth Roundtable on Hospital-Based Acupuncture Programs”, an online conference scheduled for Saturday, June 20th, 2020, starting at 0900 Central.

Theme for this Event
Telehealth Programs in Hospital-based Acupuncture Practice: Pivoting in the Pandemic
Lessons Learned, Benefits (patients, providers, system), Issues, Examples of Innovation, and Discussion

Why this online event?
The Hospital Practice Handbook Project has been hosting community discussion space online and in live zoom sessions at least weekly since mid-March for the hospital-based community to provide space for discussion, problem-solving, and sharing examples of innovation as we all respond to the pandemic in our various programs and through different stages of closing and re-opening.
The content approved to share with the community from those discussions are located in this online resource module.
Out of these sessions came a consistent need to do even more, particularly to host our own conference on telehealth.

Why a telehealth event specific to hospital-based acupuncture programs?
Telehealth capability is critical for all clinicians in the phased clinic opening/closing as communities respond to the pandemic. Some organizations had a telehealth program in place before the pandemic, but many stood theirs up during the pandemic as a way to support and protect both provider personnel and patients during a respiratory-based pandemic. Some are still in the process of standing theirs up and looking to the community for examples that match their system.
However, not all systems have been supportive or understanding of how acupuncturists can work via telehealth (vs. in-person), citing “lack of access to current examples”.
So, here we are, presenting current examples of telehealth programs in hospital-based acupuncture practice. And, having a professional Socratic discussion on the related topics.

You can't attend without a ticket.
Choose the type of event ticket that fits you here


How to engage in or support this event
Buy a ticket and share these links. 😊
Per community request, there are 3 ticket options:
  1. Basic Ticket—access to the live event
    1. https://www.thehospitalhandbook.com/support-the-project/basic-ticket
  2. Ticket Plus—basic ticket plus access to the online resource with all the recordings and other content created for this event
    1. https://www.thehospitalhandbook.com/support-the-project/telehealth-roundtable-ticket-plus
  3. Recordings only—just access to the online resource with the recordings. No access to live event.
    1. https://www.thehospitalhandbook.com/support-the-project/telehealth-roundtable-recordings-only

I hope you are able to attend or if you are otherwise engaged that day, consider supporting via the “recordings only” ticket and submitting your questions to the panelists in your ticket form.

All ticket revenue goes directly toward the outgoing costs of this event (platform hosting, data, recordings, video editing, etc.). My time and work are 100% volunteer.

For more information on confirmed panelists and updates
Go to our Facebook Event page and choose “interested” or “going” to see social media updates on this event.

Event Agenda
Introduction
Panelists each give short summaries of their programs
Socratic discussion of the topic by panelists
Some Qs from attendees posed to the panel for more discussion

Panelists include (confirmed to date)
  • Paul Magee, lead acupuncturist, Penny George Institute of Health and Healing, Allina Health, Minnesota
  • Christine Kaiser, acupuncture program manager and quality assurance, University Hospitals Connor Integrative Health Network, Cleveland, Ohio
  • John Burns, acupuncture program manager, Advocate Aurora of Wisconsin and Illinois
  • Juli Olson, National Lead, Acupuncture, Integrative Health Coordinating Center, Veterans Health Administration
  • Galina Roofener, acupuncturist, Cleveland Clinic, Cleveland, Ohio
  • Mori West, C.P.C. of AcuClaims, coding & billing expert
  • Nancy Gahles, Integrative Health Policy Consortium, IHPC

Please buy a ticket and share this event with anyone who may benefit from it or enjoy attending and supporting. Thank you.



More resources on telehealth


University of WA Survey of Acupuncturists during the COVID-19 Pandemic
  • For those of you practicing as acupuncturists, check out this IRB-approved survey from a colleague who is doing this research through the University of Washington. Looks like she is collecting data on how the pandemic is affecting practice, from direct clinical care to pivots in online resources including the use of telehealth: https://redcap.iths.org/surveys/?s=7FTTYN73X9& 
    • suspension date: the survey closes June 8th, 2020
  • More info: 
    • The survey is intended for ALL licensed acupuncturists. You don't need to have a telehealth service in place to respond to the survey. One of the aims of this survey is to set the stage for larger survey studies of profession-wide effects similar to the benchmark studies in other healthcare professions. 
    • The estimated time to complete the survey is 5 minutes.
    • Principal Investigator: Tamsin Lee, DAOM
New Research Paper on Relevance of Telehealth Programs During Pandemic and Beyond, from a Duke University Team
  • At a time when I hear disagreement in the definition of "telehealth", I offer this very useful definition they published, which dispels all previous confusing terminology I have heard in the medical field the last year or so:
"The term 'telehealth' refers to the entire spectrum of activities used to deliver care at a distance--without direct physical contact with the patient. Telehealth encompasses both provider-to-patient and provider-to-provider communications and can take place synchronously (telephone and video), asynchronously (patient portal messages, e-consults), and through virtual agents (chatbots) and wearable devices."
  • The article was published May 17th, 2020, by a team from Duke University, "Telehealth transformation: COVID-19 and the rise of virtual care" in the Journal of the American Medical Informatics Association
    • citation
      • Jedrek Wosik, Marat Fudim, Blake Cameron, Ziad F Gellad, Alex Cho, Donna Phinney, Simon Curtis, Matthew Roman, Eric G Poon, Jeffrey Ferranti, Jason N Katz, James Tcheng, Telehealth transformation: COVID-19 and the rise of virtual care, Journal of the American Medical Informatics Association, https://doi.org/10.1093/jamia/ocaa067 


More Community Resources on Pandemic Prep & Response
You can support this community-wisdom-sharing work by buying me a coffee
or other support option via our website.
Thank you.