Becker's Hospital Review

55 FINANCE CMO / CARE DELIVERY 3 factors that may increase risk of death in COVID-19 patients By Mackenzie Bean O ld age, signs of sepsis and blood clotting issues may put hospitalized COVID-19 pa- tients at greater risk of death, accord- ing to a study published in The Lancet. For the study, researchers analyzed clinical records, treatment data and lab results for 191 adult COVID-19 patients admitted to two hospitals in Wuhan, China, after Dec. 29, 2019. Pa- tients either died or were discharged by Jan. 31. Seven study findings: 1. Patients' median age was 56, and 62 percent were men. 2. Forty-eight percent of patients had underlying chronic diseases, the most common being high blood pressure and diabetes. 4. The median time for illness onset to discharge was 22 days, while the average time to death was 18.5 days. 5. The risk of death was higher among patients who were older, had a higher sepsis-related organ failure assessment score or had elevated blood coagulation levels. 6. Patients who died were also more likely to experience complications such as respiratory failure, sepsis and secondary infections. 7. Researchers noted findings may be limited due to the small sample size. n Cluster of heart surgery deaths spurs internal review at Ballad Health hospital By Mackenzie Bean B allad Health resumed cardiac sur- geries at Kingsport, Tenn.-based Holston Valley Medical Center Feb. 24 after a temporary suspension to investigate a cluster of patient deaths, CBS affiliate WJHL reported. Johnson City, Tenn.-based Ballad Health acknowledged the cluster of post-car- diovascular surgical deaths in a Feb. 23 statement on its Facebook page. "What concerned the team was that it is atypical for us to see a cluster so close together. This does NOT mean anything was wrong with the care," Lindy White, CEO of Kingsport Market Operations for Ballad Health, wrote in the post. The health system deployed its quality support and infection prevention teams to participate in an internal review of the deaths at Holston Valley Medical Center. Leaders also notified the Ten- nessee Department of Health and CDC, which sent state and federal health offi- cials to help with the process. After sev- eral days of investigation, Ballad Health leaders and health officials determined the patient deaths were not due to any infection or systemic issues at Holston Valley Medical Center. "The ultimate conclusion is that the out- comes were not outside the scope of what would be expected based on the severity of the patients' illnesses," Ms. White wrote. Ballad Health is now seeking to hold ac- countable one or more employees who posted false information about the situ- ation online, which was then circulated on social media. "This is not tolerable, and steps will be taken to identify who violated our pol- icies, and maybe even the law," Ms. White wrote. "We will seek to hold any- one accountable who spreads misinfor- mation about patient care, and we will do so unapologetically." n Healthcare quarantines spur staffing concerns: 'We'd run out of healthcare workers' By Kelly Gooch W orries about staffing shortag- es are emerging as more U.S. hospitals and health systems order workers to self-quarantine amid the spread of the new coronavirus, according to Kaiser Health News. Sutter Santa Rosa (Calif.) Regional Hos- pital, Doctors Hospital of Sarasota (Fla.), University of California Davis Medi- cal Center in Sacramento and Kirkland, Wash.-based EvergreenHealth all ordered quarantines for healthcare workers. Kaiser Health News reported that North- Bay VacaValley Hospital in Vacaville, Ca- lif., also quarantined about 100 of its work- ers for 14 days. Nurses in Washington state told their union they were concerned about proto- cols for assessing exposure to COVID-19, the disease caused by the new coronavi- rus, and hospital procedures for deter- mining whether a nurse or other care- giver should self-monitor or be placed in quarantine. It's a concern echoed throughout the healthcare community, according to Kai- ser Health News. Jennifer Nuzzo, DrPH, a senior scholar at the Johns Hopkins Center for Health Secu- rity in Baltimore, told the nonprofit news service that it's "not sustainable to think that every time a healthcare worker is ex- posed, they have to be quarantined for 14 days. We'd run out of healthcare workers." She added that people showing infection signs associated with the virus should stay home, but providers who may have been exposed but who are asymptomatic should not necessarily be quarantined. Dr. Nuzzo and others recommended that healthcare providers balance the chang- ing science related to the virus with operational needs. n

• Cover