Issue link: https://beckershealthcare.uberflip.com/i/1337263
17 PATIENT SAFETY Clinician burnout. Clinician burnout has long been a problem in healthcare, prompting concerns about how it affects patient safety and care quality — and the unprecedented pressure brought on by the pandemic has pushed burnout to record high levels for many clinicians. In a nationwide survey from August, 58 percent of physicians expressed feelings of burnout, an increase from 40 percent in 2018. A separate survey in October found 72 percent of emer- gency physicians are experiencing more burnout at work. Nota- bly, few physicians who said they experienced burnout sought help, both surveys found. Respondents cited several reasons they were reluctant to seek mental health support, including stigma at work. Experts recommend several strategies to curb physician burnout, including a reduction in administrative tasks and fostering an orga- nizational environment that supports well-being. A 2020 study also found that a workplace mindfulness program significantly reduced healthcare professionals' burnout. Health equity. While health systems paid close attention to social determinants of health and patient outcomes before 2020, the COVID-19 pandemic has shined a spotlight on many inequities that have contributed to healthcare disparities for years. Many healthcare organizations have launched efforts to address COVID-19's dispro- portionate effect on people of color, as numerous studies show racial and ethnic minority populations are at higher risk of contracting and dying from the virus. In July, the CDC issued a strategy document pledging steps toward reducing COVID-19 disparities and achieving health equity. Some analytic companies are partnering with healthcare systems to identify and examine how social and economic factors affect patient health. Federal health agencies and individual healthcare systems are also committing to address social inequities as a population-specific public health measure so they can better understand and care for the patients in their community. ese efforts will maintain importance in 2021 and beyond. Healthcare-associated infections. CMS suspended HAI reporting requirements through June, allowing infection preventionists to shi their focus to COVID-19 emergency response activities. As a result, these leaders have spent less time on HAI surveillance and preven- tion efforts in 2020, and many have said they've seen an uptick in HAIs at their facilities since the pandemic's start, according to a Dec. 3 survey from the Association for Professionals in Infection Control and Epidemiology. While it is still too early to fully assess how this shi will influence HAI incidence at hospitals nationwide, researchers noted large jumps in some infections at Mount Sinai Morningside in New York City and Christian Hospital in St. Louis this summer. Mount Sinai Morningside saw a 420 percent increase in central line-associat- ed bloodstream infection rates during the pandemic compared to the prior 15 months, while Christian Hospital reported a 324 percent jump. COVID-19 patients are at higher risk of CLABSI, so researchers said they expect this rate to rise the most of all HAIs amid the pandemic. Surgical mistakes. Surgical mistakes such as retained foreign objects or wrong-site surgery are rare, but can pose severe consequences when they occur. Most healthcare organizations postponed or can- celed elective surgeries amid COVID-19 surges this spring and fall. Hospitals will likely have a large backlog of elective surgeries they must complete safely and efficiently in 2021 once the current virus surge wanes. A strong focus on surgical safety protocols will be key as hospitals ramp up surgical volumes. In April, the American Hospital Association, American College of Surgeons, American Society of Anesthesiologists and Association of periOperative Registered Nurses published a road map for how to safely resume elective procedures and provide surgical care during the pandemic. e road map was most recently updated in Novem- ber to include special considerations for hospitals struggling with capacity restraints. Standardizing safety efforts. e COVID-19 pandemic did little to deter healthcare mergers and acquisitions in 2020 and may actually serve as a catalyst for these strategic partnerships moving forward, according to an October report from Kaufman Hall. Nineteen healthcare mergers and acquisitions were announced in the third quarter of 2020, up from 14 transactions in the second quarter of 2020, the report found. Hospital mergers, acquisitions and divestitures cause various changes in an organization's culture, leadership, equipment and operating environment that can pose a threat to patient care. As health systems continue to expand their footprints, they must prioritize efforts to standardize safety processes and culture across every healthcare setting under their umbrella, including ambulatory and long-term care facilities. n Safety board halts high-dose blood thinner trial for severe COVID-19 patients By Erica Carbajal A safety board temporarily halted a clinical trial that uses high-dose blood thinners in severe COVID-19 patients because of potential harm, The New York Times reported Dec. 22. The monitoring board did not specify potential harms in its Dec. 22 statement, though high doses of anti- coagulants are associated with increased bleeding, including in the gastrointestinal tract and inside the skull. Full-dose blood thinners have not reduced the need for organ support among critically ill patients, indicating the treatment offers no benefit. The trial's leaders are now urgently trying to reach hospitals that may still be administering high-dose blood thinners to critical patients in belief that the benefits outweigh the risks, according to the NYT. Currently, the trial will continue only for hospitalized patients who are moderately ill, meaning they are not in intensive care, not on ventilators or at risk of organ failure. The trial's leaders said they would continue monitoring data to determine whether severe patients can be enrolled again. n