Becker's Hospital Review

38 CMO / CARE DELIVERY CDC gives vaping illness new name: EVALI By Gabrielle Masson T he CDC has penned a new name for vaping-related ill- ness: EVALI, which stands for e-cigarette, or vaping, prod- uct use associated lung injury, according to healthcare recom- mendations released Oct. 11. The interim guidelines focus on initial assessment, criteria for hospital admission and treat- ment, patient follow-up, con- siderations for high-risk groups and public recommendations regarding EVALI. Rapid diag- nosis and an understanding of treatment options could reduce EVALI morbidity and mortality, the CDC said. Initial assessment recommen- dations include a respiratory vi- rus panel, especially during flu season, and evaluation of com- munity-acquired pneumonia. Additionally, treatment guide- lines suggest using cortico- steroids. Of 140 patients who received the medication na- tionwide, 82 percent showed improvement, according to the CDC. However, the agency cau- tions providers to withhold cor- ticosteroids if an infection, like pneumonia, is expected. Those illnesses could potentially wors- en with corticosteroid treatment. As new data emerges, the CDC will develop more guidelines for EVALI healthcare encounters. While the exact chemicals re- sponsible for the illness are still unknown, CDC recommends people stop or decrease use of products containing THC and/or nicotine. As of Oct. 11, 1,299 EVALI cases have been reported in the U.S., with 26 related deaths reported in 21 states. n Hospitals, physicians push back on new surgery regulations in Massachusetts By Mackenzie Bean T he Massachusetts medical board faced pushback from hospitals and physicians regarding stricter surgical regulations in the state, The Boston Globe reported. The regulations require physicians to disclose who will participate in surgeries be- fore getting written consent from patients. During surgery, they're expected to doc- ument every time the lead surgeon enters and leaves the operating room. The new rules also threaten stricter punishments for physicians who come to work impaired or delegate responsibilities to unlicensed team members. The Massachusetts Health & Hospital Association and the Massachusetts Medical Society on Sept. 20 called on the state medical board to delay the requirements by a year. The lobbying groups argued that the board rushed to implement the regula- tions, which they said are confusing and burdensome for physicians. The board declined the groups' postponement request but offered to meet to discuss the regulations. "These regulatory enhancements have been in development for three years," Can- dace Lapidus Sloane, MD, a pediatric dermatologist who chairs the medical board, told The Boston Globe. "I struggle to understand the motivation for second-guess- ing these regulatory enhancements at this late stage." n Are patient-reported outcome measures worth the effort? 47% of clinical leaders are unsure By Gabrielle Masson F orty-seven percent of clinical leaders, along with 40 percent of executives and 31 percent of clinicians, are unsure if it's worth it for organizations to use patient-reported outcome mea- sures, according to an NEJM Catalyst Insights Council report published Oct. 3. PROMs convert patient responses about symptoms and function loss into numerical scores for com- parative analysis. Implementing PROMs can be complicated, according to the report, requiring integra- tion of new data with existing EHR applications and potentially increasing staff workload. When NEJM Catalyst Insights Council members were asked in a June 2019 survey whether the effort to collect, process and implement PROMs was worth the result, 49 percent of all respondents said it was worth it, while 38 percent said they didn't know and 13 percent said it was not. A higher percentage of clinical leaders than clinicians said they didn't know if the effort was worth it, while more clinicians than executives or clinical leaders said the result wasn't worth the effort. e University of Rochester (N.Y.) Medical Center has used PROMs for about four years and it has been well worth the effort, according to Judy Baumhauer, MD, professor and associate chair of orthopedic surgery at the university and director of coordinating and collecting patient-reported outcomes. In the report, Dr. Baumhauer added that there were implementation challenges, citing "growing pains" that come with new initiatives. irty-eight percent of organizations use PROMs, the report found, with 17 percent of respon- dents planning to use PROMs in the next three years. e main reason to use PROMs was improv- ing patient experience (60 percent), followed by better quality metrics (52 percent). n

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