Becker's Clinical Quality & Infection Control

27 PATIENT & CAREGIVER EXPERIENCE Pandemic surgery delays exact an emotional toll, too, physicians say By Mackenzie Bean A s hospitals again pause nonemer- gency surgeries in response to surg- ing COVID-19 patient volumes, healthcare leaders and physicians are closely watching what effect this will have on pa- tients' health and healthcare experience. One of the most obvious concerns is that delaying care may worsen health conditions for patients with cancer or other serious issues. Another concern is that surgery delays will hinder the patient experience or disengage patients. "I've seen patients get ready to have their open-heart surgery that day. I've seen patients have [a] brain tumor with visual changes, or someone with lung cancer, and their procedures are canceled that day, and they have to come back another day," Kent Dauterman, MD, a cardiologist and co-director of the regional cardiac center in Medford, Ore., told the e Seattle Times. "You always hope they come back." ere is also a mental toll — for both patients and physicians — that comes with long wait times for surgery and the uncertainty of when someone will receive much-needed care, e New York Times reported Sept. 22. "It might medically make no difference, but emotionally it could have a huge impact," Matthias Merkel, MD, PhD, senior associate CMO for capacity management and patient flow at Portland-based Oregon Health & Science University, told the Times. Research shows canceling nonemergency procedures has been an effective way to free up intensive care unit beds for COVID-19 patients. "But we as a society have not really em- phatically asked the question 'At what price in the long term?'" said Brajesh Lal, MD, a professor of surgery at the University of Maryland School of Medicine who studied the elective surgery pause during the pan- demic's first wave. To thoroughly answer this question, more long-term research is needed, Dr. Lal told e Seattle Times. n 2 EHR measures that can predict physician departures By Katie Adams T wo key EHR use metrics can help flag which physicians are most likely to leave their posi- tion, according to a study published Oct. 12 in JAMA Network Open. The researchers analyzed 314 physicians' EHR use data at a large outpatient practice network from March 2018 to February 2020, looking for measures that could be indicative of physician turnover. The first measure they identified is the portion of a physician's EHR orders that were placed by other team members. Physicians were more likely to stay in their position when other members of the care team were contributing to their EHR work. The second measure is the amount of time physicians spend managing their EHR inbox. Spending less time was associated with higher rates of turnover. "That was a counterintuitive finding. Less time spent on inboxes could mean a physician is more efficient or that they have fewer patients, but we controlled for both of those possibilities and still came to the same conclusion," Ted Melnick, MD, the study's lead author, said in a news release. The researchers said that prospectively tracking these measures could identify physicians at high risk of departure and allow for earlier, targeted interventions. n COVID-19 linked to drop in patients' likelihood to recommend services By Cailey Gleeson T he overall number of patients who would definitely rec- ommend a hospital to others fell by 4.5 percent during the pandemic, reflecting a national decrease in patients' perceptions of care across all care settings, according to a Nov. 4 Press Ganey report. Researchers conducted a national HCAHPS analysis to gauge shifts in the likelihood of patients to recommend their health- care experience to family and friends since the onset of the pandemic. Five key findings: 1. The overall number of patients who rated their hospital experience a 10 out of 10, with zero being the worst hospital possible and 10 being the best hospital possible, also de- creased by 4 percent. 2. Seventy-five percent of COVID-19 patients would definitely recommend a hospital to their family and friends, compared to 72 percent of non-COVID-19 patients. 3. Medical practices saw the greatest decreases in likelihood to recommend scores regarding patients' ability to access timely care. 4. Emergency departments saw the greatest decrease in scores about getting care within 30 minutes of showing up. 5. New England states saw the greatest decrease in patients' likelihood to recommend, while Southeastern states saw the least change in patients' perceptions. n

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