Health care providers know too well the overwhelming impact COVID-19 is having on patients, staffs, and entire facilities. The situation is profound and constantly changing. Fortunately, the relationships Q-Centrix has with providers across the U.S. allow us to follow different facilities’ experiences at different stages of the pandemic. Because of this, we have a unique ability to synthesize and share insights on managing key areas of quality amid this crisis—and support our community by taking on a responsibility that is difficult for them to perform on their own while immersed in their COVID-19 response.
Throughout the pandemic, we will provide relevant learnings to inform best practices across our community. Updates will be posted here for quality team leads and other key decision makers to access at their convenience.
June 24, 2020
Collecting Quality Data Amid and Beyond the Pandemic
COVID-19 has changed the face of health care. While no one knows exactly what the future will hold, Kimberly Rowland, BSN, RN, examines key considerations as hospitals safely “reopen” and continue evaluation of care quality and safety in our final Q-Centrix COVID-19 Expert Series interview. Rowland is Senior Director of Quality and Education for Q-Centrix. Following are noteworthy highlights from the interview.
- Preventing asymptomatic health care workers and patients from spreading the virus and reassuring patients and their families it is safe to undergo non-emergency/elective procedures are critical factors hospitals now face. The Centers for Disease Control and Prevention provides a practical framework for delivering non-COVID-19 care during the pandemic. The recommendations include:
- Being prepared to rapidly detect and respond to COVID-19 case increases.
- Providing care in the safest way possible, including optimizing telehealth services and following recommended infection control practices.
- Considering gradual expansion of services—factoring in local epidemiology and state and local official recommendations.
- Prioritizing services that, if deferred, are most likely to result in patient harm and prioritizing at-risk-populations who would benefit the most from such services (e.g., those with serious underlying health conditions).
- Learning from the COVID-19 pandemic can lead to improved care quality and processes, so it is important that clinical data continues to be collected and understood. In addition, there are signals that quality reporting is re-intensifying:
- The Joint Commission announced that it will resume regular facility surveys and reviews in June 2020 (as of the time of this post).
- There are no indications that the exceptions and extensions for regulatory measures and clinical data registry reporting that were implemented in response to the pandemic will be further extended.
- Many registry programs are adding new data elements to capture COVID-19 care information, including American Heart Association, American College of Cardiology, and Society of Thoracic Surgeons programs.
- Stand-alone COVID-19 registries are being developed and implemented.
The COVID-19 pandemic has underscored the importance of evidence-based decision-making and the speed at which information is needed. Q-Centrix continually monitors for regulatory and registry updates and ensures our team has the latest knowledge to support our community. By taking on the work of quality data abstraction and reporting, as well as infection prevention surveillance, Q-Centrix helps hospitals shift their resources to focus on pandemic-related priorities.
Watch the interview:
June 5, 2020
New NHSN Fields Available in the COVID-19 Reporting Platform
As the COVID-19 response evolves, Q-Centrix is ensuring all updates to the National Healthcare Safety Network (NHSN) and the Department of Health and Human Services (HHS) pandemic-related data collection and reporting processes are incorporated into its COVID-19 Reporting Platform.
The COVID-19 Reporting Platform offers simple, centralized data capture and powerful dashboards for managing and reporting critical hospital-level COVID-19 data. From a single location within the platform, users can populate both the NHSN and HHS forms and export them for submission. The latest NHSN form updates, consisting of the following, are available in the platform:
- New Fields
- Previous day’s admissions with confirmed COVID-19
- Previous day’s admissions with suspected COVID-19
- Previous day’s new hospital onset
- Field Modifications
- Hospital onset
- Previous day’s deaths
Ensuring health care providers can thoroughly capture data for all their quality reporting needs, including information associated with the latest program updates, is at the core of the Q-Centrix partner commitment.
From its very start, Q-Centrix focused on creating and incubating the industry’s first cloud-based, health care quality information system—known today as Q-Apps®. Now, more than 700 Q-Centrix health care providers benefit from the comprehensive data, reporting, workforce, and process management capabilities available in Q-Apps®.
Plus, the platform’s cloud architecture means locally hosted solution setups are a thing of the past, which improves data security and allows providers to adjust and scale their efforts to their reporting needs.
The agility of Q-Apps® combined with our expert, innovative team enabled the rapid development and deployment of the COVID-19 Reporting Platform. In fact, the platform launched mid-April 2020, just a few weeks after the federal government asked that hospitals begin reporting COVID-19-related data. These same characteristics drive the advancement and adaptation of our solution portfolio to meet the needs of our industry, including the most comprehensive registry reporting solution on the market.
All Q-Centrix partners have complimentary and instant access to the COVID-19 Reporting platform through Q-Apps®. Other providers can gain complimentary access by contacting Q-Centrix.
June 3, 2020
Managing Registry Participation Remotely
COVID-19 has changed health care delivery in numerous ways, including how quality measurement efforts are managed. As the pandemic pushes employees who are not directly involved in essential care to perform their duties outside the hospital, remote management of clinical data registries is increasing. In this seventh installment of our COVID-19 Expert Series, Lisa Everett, RN, Q-Centrix Senior Manager, Regulatory Measures Division, shares how communication, motivation, and relationship building are defining characteristics of successful remote registry management. Among the key takeaways:
Consistent communication and relationship-building help connect remote teams. Humanizing the experience motivates people and boosts morale.
- With respect to health care quality, you can have a strong presence without always being physically present if you continue to “know your numbers” and the story you want them to tell. It is important to continually share this information with clinicians and other key stakeholders to keep them updated and vested in what you and your quality team do.
- Pauses in elective procedures are a chance to find time with physicians and hospital leaders to reinvigorate their interest in the impact of your registry data on quality and outcomes.
- Meeting with newly onboarded physicians and inviting them to some of your team’s meetings will acquaint them with your registries and will facilitate strong, long-term working relationships.
- Show you care by learning something about your colleagues and team members.
- Example: Find out something unique about each person, like a personal hobby or special talent, and ask them about it. Plus, talking about what they enjoy outside of work keeps interactions enjoyable and upbeat.
- Allow fun in your management style. Meetings do not always have to be about immediately getting down to business. Allow team members to share something interesting or fun about themselves before discussing work.
- Example: Before a meeting, ask staff members to bring a description of their ideal vacation and encourage them to be creative in how they share it. You may be surprised how much they get into the activity and the impact it has on morale.
- Give team members leeway in how they participate in meetings. Video meetings are helpful but can also lead to participant fatigue when overused. Allow staff to turn off their cameras when they feel the need. Also, encourage elimination of distractions over having a polished “home office” appearance.
Take into consideration temporary and long-term staffing adjustments caused by the pandemic when re-entering “business as usual.”
- Job-sharing and adapted work schedules emerging from the pandemic are being met with mixed feelings. Clear and streamlined communication helps teams adapt to these changes and proceed in a productive manner. For example, nurses learn a communication technique known as SBAR—Situation Background Assessment Recommendation—which provides a framework for sharing information about a patient’s condition between clinical team members. However, SBAR can apply to almost any situation in which information is transferred from one person to another. Encouraging everyone who supports your registry participation to use this technique helps prevent on-duty staff from needing to ask questions of off-duty team members, who usually go uncompensated for any time taken to answer. This efficiency in communication will also ensure registry management tasks are completed regardless of who is on shift.
- Quality teams physically returning are also being asked to take on some ancillary or technical aspects of patient care, such as drawing blood and measuring blood pressure. If there is no alternative to fill these roles, use the opportunity to work alongside clinical team members to educate them about the value of clinical data registry insights in improving quality, reputation and more. You can also share with them examples of the impact of your team’s work.
- Realize you do not have to go it alone. We encourage our community to keep an open dialogue with Q-Centrix not only about the current work we do with them but any additional skills, expertise, or support we can provide—especially with respect to recovering from pandemic. This can include, to name just a few, data abstraction, inter-rater reliability review, infection prevention surveillance, and registry strategy advisement. Because we have such great partnerships with providers across the country, we have an expansive vantage point for observing best practices and uncovering new opportunities that most any facility could benefit from.
Watch the interview:
May 26, 2020
The Pandemic’s Impact on Cancer Care and Registries
Deferring diagnosis and treatment can have a dire effect on health and quality of life, especially for someone with cancer. In this latest installment of our COVID-19 Expert Series, Q-Centrix Senior Director of Cancer Services Lisa Ganem, CTR, addresses efforts to ensure cancer patients receive needed care despite COVID-19’s impact on health care delivery in the U.S. and what the pandemic means for reporting case data to state and central cancer registries. The following are key updates and observations Lisa expands upon in the interview:
- A regrettable consequence of the pandemic is delayed cancer diagnoses and treatments. According to a recent report, more than 80,000 common cancer diagnoses may be missed or delayed by June 2020 because of COVID-19-related health care disruptions. Fortunately, clinical teams at across the country are stepping up to the challenge. For instance, infusion centers operating at reduced capacity to distance patients per pandemic requirements are adding appointment slots to evenings and weekends to ensure patients receive needed treatment.
- Despite efforts to minimize cancer care disruptions, and inevitable pause in non-essential screenings like colonoscopies and mammograms is expected to reduce cancer registry data submissions later in the year. This will likely be felt the strongest in the third quarter of 2020, since cancer registry data is typically submitted three to six months after initial diagnosis. A silver lining is that Q-Centrix is helping facilities use this lull to focus on improving registry reporting efficiency.
- Cancer registry reporting is expected to surge in early 2021 if cancer service backlogs resulting from the pandemic are cleared during the second half of 2020. Facilities with real-time reporting capabilities will be able to manage this escalation better than those with less efficient data management processes—and may come out of the pandemic ahead of the game with respect to their registry reporting.
- Cancer program accreditation agencies and specialty societies are proactively issuing updated guidelines to help facilities navigate care delivery amid the pandemic. For example, six of these agencies collaborated to release guidelines for triage and management of elective cancer surgery cases for each pandemic phase. This demonstrated an interagency effort to provide crucial information while centralizing and streamlining communication in a manner that is is critical in a pandemic environment.
- Cancer data collected today will be tomorrow’s lessons learned. This information is critical for preparing for future pandemics, so it is important it be complete and accurate. With respect to this, Q-Centrix is working with facilities to add COVID-19-related elements to their registry data collection to better understand patient outcomes amid the pandemic and to ensure reporting compliance is achieved with minimal resource use.
Watch the interview:
May 20, 2020
Free COVID-19 Reporting Platform Available to U.S. Hospitals
In March 2020 as the COVID-19 outbreak escalated into a pandemic, the federal government asked hospitals to begin voluntarily submitting key facility-level COVID-19 data to the National Healthcare Safety Network (NHSN) and the Department of Health and Human Services (HHS). Recognizing the opportunity to support its community, Q-Centrix developed a free platform to help hospitals more easily fulfill this request.
The new COVID-19 Reporting Platform simplifies the data collection and reporting process with a centralized application to capture and analyze the relevant data. From a single location within the Q-Centrix quality information platform Q-Apps®, users can populate both the NHSN and HHS forms and export them for submission.
To ensure hassle-free submission, the platform provides detailed instructions, including a link that easily exports data in the required formats, directions on where to submit the data, and a checkbox to document when the process is complete.
Clear dashboards and reports allow platform users to check COVID metrics daily and analyze trends over longer periods. The available analytics include information on case counts, test orders, facility capacity, and supply and staffing needs. Using a simple three-color system, the platform displays a hospital’s daily metrics: green if improving, red if not, and orange if static. Advanced enterprise analytics provide health system users a view of key metrics across facilities.
The COVID-19 Reporting Platform is available to most U.S. hospitals for free. Access is granted through the Q-Apps® platform. All Q-Centrix partners have secure entry to Q-Apps as part of their partnership. Future partners can get started by contacting Q-Centrix. The partner agreement authorizes a hospital to use the platform at no cost and includes free video tutorials.
May 6, 2020
Infection Prevention in the Battle Against COVID-19
Hospital infection prevention (IP) practices are as critical now as ever—and will prove crucial in safely resuming non-essential care and reevaluating future pandemic plans. This is a major takeaway from our fourth COVID-19 Expert Series installment with Q-Centrix Clinical Consultant for Advisory Solutions Sara Bienvenu, RN, MSN, CIC. Following are key insights from Sara’s unpacking of this timely topic.
Reducing COVID-19 Related Mortality Rates
Since patient surges can overwhelm facilities, hospitals want to do everything they can to keep COVID-19 patient numbers low. From community education to addressing vulnerable populations, notable steps Q-Centrix has observed its partners taking include:
- Airing public service announcements on how everyone can help curb transmission in the community, including hand hygiene and social distancing.
- Addressing health disparities through social assessments of patients to identify vulnerable populations and transmission hot spots. Plus, including social worker support in care plans for individuals and families at increased risk for virus exposure at home or work.
- Ensuring clinical teams are up to date on the latest best care practices. For example, the emergency approval of remdesivir gives clinicians a new option for treating COVID-19 patients. Guidance on ventilator usage also continues to evolve.
Avoiding Cross-Contamination, Minimizing Secondary Upticks
As the pandemic response shifts to recovery, hospitals will need to determine how to safely restart non-emergency and non-essential care, as well as minimize secondary upticks of COVID-19 cases. Among the considerations for achieving this are:
- Screening staff and patients for COVID-19 symptoms prior to facility entry.
- Having designated “COVID” and “Non-COVID” entry zones.
- Requiring staff to wear surgical masks at all times and face shields with N-95 respirator masks during aerosol-generating and other high-transmission-risk procedures.
- Requiring cloth face coverings for all patients and accompanying family members.
- Prohibiting visitors except for certain aspects of care that require a family member or other caretaker to be present. Plus, partnering with local and state authorities to continually evaluate visitation policies.
- Implementing administrative and engineering controls to facilitate social distancing, such as limiting patient numbers and properly spacing chairs in waiting rooms.
- Testing all patients for COVID-19 who are visiting the facility for planned procedures, as tests become more available. Plus, regular testing of staff who care for non-COVID-19 patients.
- Establishing protocols for deep cleaning and disinfecting patient care spaces and medical equipment.
- Monitoring COVID-19 incidence in the community and ceasing non-essential care when surges occur.
Reevaluating Future Pandemic Plans
In many ways, the COVID-19 pandemic redefined care delivery and brought about some hard lessons in the form of critical supply shortages. Many experts agree that evaluating supply chains and emergency preparedness plans at the state and facility levels should be a priority in preparing for future pandemics, including deciding on funding for emergency stockpiles.
Optimizing Partnerships for Meeting IP Resource Demands
Lastly, many facilities are evaluating their IP resources. While the government is not requiring the reporting of health care-associated infections (HAI) until later this year, hospitals continue to reach out to Q-Centrix for relief. This includes shifting HAI surveillance and public reporting work over to Q-Centrix so the hospital’s infection preventionists can focus on more-immediate COVID-19-related demands. Plus, such a partnership can be optimized to meet each facility’s unique circumstances.
Watch the interview:
April 30, 2020
Expert Series Interview Addresses Key Cardiovascular Registry Updates
An unintended consequence of the COVID-19 pandemic is reduced volumes of patients entering hospitals for non-elective procedures like heart attack and stroke—a concerning trend since delaying care is associated with increased complications. In this next installment of our COVID-19 Expert Series, Q-Centrix Cardiovascular Division Senior Manager Sarah Demmin, RN, discusses how hospitals are addressing this issue. She also shares key observations and updates surrounding clinical quality data collection for cardiovascular services. Among the salient points:
- Anyone experiencing signs of a serious or life-threatening condition—whether believed to be tied to COVID-19 or not—should seek immediate medical care. It is important that hospitals continue to stress this to their communities, including communicating steps they are taking to protect non-COVID patients from exposure to the virus. Ensuring these patients receive prompt care will reduce complications during their treatment, which helps to get them released sooner.
- As hospitals eye resuming elective procedures, they will need to determine workflows and other precautions to keep these patients separate from COVID-19 populations and the staff treating them.
- The cardiovascular organizations are proactively updating guidelines for data capture to account for COVID-19 patients, including adjustments so disruptions due to the virus process aren’t counted against facilities. Q-Centrix is helping its partners understand these changes to ensure the relevant data is accurately captured.
- Accurate and thorough documentation by physicians is especially critical amid the pandemic for a myriad of reasons. One of them is to understand determinations made about each case to ensure the facility receives maximum credit from clinical quality programs. This is an area in which Quality Teams can play an important role.
- Telemedicine, which many providers have turned to for safely caring for certain patient populations during the pandemic, offers numerous benefits for cardiovascular patients, such as remote screening and follow-up on stable patients, as well as at-home rehab. Providers are examining how to continue many of these practices after the pandemic subsides.
Watch the interview:
April 22, 2020
Expert Series: Managing a Team Through Crisis
This interview with Q-Centrix Lead Consultant on Advisory Solutions, Doug McGill, offers fresh insights and tips on team communication and reporting during a crisis, as well as new opportunities for process improvement, goal setting, and virtual workspaces. Several highlights:
- You can’t under-communicate in a crisis. It’s critical to maintain open lines of communication to voice observations and problems so others across your team and organization can help share experiences and ideas to help solve them.
- Crisis inherently causes change, so use this momentum and mindset to make needed strategic adjustments that may have been difficult to do before. This can include taking a fresh look at ways to streamline processes as well as evaluate quality-related goals.
- Be aware of your reporting cadence. Crisis calls for fast and frequent data to make necessary changes on the fly that could ultimately impact patient and staff safety. Your pace of reporting may need to increase to quickly respond.
- Think about how the pandemic is reshaping the virtual workspace, including the value of remote teams to provide support and problem-solving from outside the hospital’s “four walls.”
Watch the interview:
April 15, 2020
Webinar: Quality During the COVID-19 Pandemic
During this roundtable, six experts provide updates on key areas related to health care quality management amid the pandemic. Guidance ranges from managing teams to clinical data registry updates. Among the many takeaways:
- Supporting your care teams during crisis includes assessing behavioral needs to mitigate the stress of traumatic events. Be aware of compounding smaller stresses that can have long-term effects like burnout and increased errors. Regularly check in with team members and hold debriefings for them to share their experiences. Hand off deeper concerns and needs to professional counselors and crisis teams.
- Use the pause in national reporting requirements to assess current processes, including the value you are getting from your data platform. Consider how deployment of information structure updates and new partnerships may enable stronger analytics and reporting.
- Consider utilizing staff normally involved with elective procedures that are now on hold to help with facility pandemic preparedness.
- Seek out the available education and direction from clinical data registry programs on how to report events in COVID-19-positive patients. Q-Centrix is proactively educating our team on this so we can continue providing high-level registry support to our community.
- Engage clinical team and organization leaders in understanding registry data observations amid the pandemic. Set up regular calls to communicate and ensure they have the information they need to present to their stakeholders.
- Work closely with your clinicians on their documentation. The pandemic intensifies how vital capturing information about the COVID-19 patient population is, including being able to go back and review as guidelines and requirements are updated.
Watch the roundtable:
COVID-19 Response: Infection Prevention Key Steps
Without a vaccine, infection prevention (IP) practices are critical to slowing COVID-19’s spread within health care facilities. The COVID-19 Response: Infection Prevention Key Steps reviews relevant IP best practices in a pandemic, including:
- Staying informed of the latest guidance from public health authorities on meeting effective infection control standards.
- Coordinating efforts with those overseeing the facility’s emergency preparedness/response plan.
- Working with local and state public health authorities to coordinate testing of suspect COVID-19 cases.