As the 2019 hurricane season continues to challenge many in the United States, and as Hurricane Dorian recovery efforts continue, now is the time to prepare for flu season. As we think back to the 2017-2018 flu season, many will recall the virulent H3N2 strain—along with a flu vaccine that was only 36% effective. That combination led to operationally and clinically significant increases in patient volumes and acuity. Many patients with the flu experienced serious respiratory failure, requiring ventilator and intensive care support. These patients not only required higher levels of care, but they also remained hospitalized longer, consumed more disposable supplies, and demanded more clinician time.
The combination of higher acuity patients, longer hospitalizations, and higher rates of flu transmissions led to a crisis situation in hospitals and health systems globally. Images of disaster tents being deployed in hospital parking lots, over-crowded emergency departments, and long waits for patients to be off-loaded from ambulances remain fresh in our minds. The impact of flu season is expected every year, and we have made progress in our vaccination programs. The reality is our healthcare systems must prepare for flu season―and we need to prepare now; even as tropical storms continue to be a threat.
And while a robust influenza vaccination program is essential, so is transmission prevention. For example, efforts to ensure clinicians, staff, patients and visitors practice hand-hygiene are improving. Tools such as hand sanitizer dispensers equipped with RTLS enabling technology provides automated, 24/7 help to track use and provide accountability for users. Strategic placement within high traffic corridors, entrances, and congregation points gives easy access and encourages frequent use. Likewise, respiratory and droplet precautions are necessary to further prevent the spread of the flu. Availability of masks, signs on proper use, and requiring use for even minor symptoms has well-known positive impacts and is another way to prepare for flu season.
Another point to consider as you prepare for flu season, is the primary and secondary points of entry to your facilities. Ambulatory settings and clinics may choose to implement proactive screenings by telephone. In cases where flu symptoms may be identified, alternative appointments or methods, such as telemedicine may be appropriate. When patients present to urgent care or emergency department settings, systematic screening is a good line of defense to place patients with symptoms on respiratory and droplet precautions. And for patients being transferred between facilities―either for higher levels of care or for on-going post-acute care―be sure to require screening to rule out influenza infection.
Each of these efforts is intended to help you prepare for flu season and minimize flu transmission and impact. And while these are all important and effective to a degree, preparing for increased patient volumes and acuity is also critical. Evidence from the past informs our future practice. We know our health systems are already operating at high-census, and additional pressures in both volume and acuity will lead us towards new solutions. Now is the time to consider how your facilities will accommodate overflow patients. Identify your facility’s designated alternative care spaces and be familiar with how they are managed.
Through the use of patient level attributes and Disaster Readiness Portals, shared situational awareness is immediate and continuous. As the flu season begins, peaks, and then subsides resources can be allocated in real-time, while proactive operational planning can address predicted patient volume. Enterprise, facility, and unit level insight and foresight informs care delivery and operational needs―with intelligent, evidence-based decision-making capabilities that lead to actions that positively impact patient care.
Every healthcare system must consider their ability to:
Regardless of the time of year or season, health systems are operating at higher and higher levels of occupancy and acuity. In times of increased population-based needs, such as during a disaster or flu season, the ability of our health systems to expand care is reduced. So, when routine healthcare operations are instrumented, measured and monitored, planning can be done proactively, before the crisis arrives. Operational and clinical delivery systems use historical data, seasonal data, and current data to predict future needs. And these predictions guide planning and inform readiness activities.
Do you feel your health system is prepared for flu season? If not, drop us a note and we will be happy to help.
Dr. Scott Newton has more than 30 years of experience in healthcare—working as an EMT, a nurse, an educator and a patient flow command center leader—he is also a trusted adviser and thought leader.
Scott has deep knowledge of the healthcare system and understands that success is tied to high reliability, just-in-time responses, and responsible solutions—that it’s about getting it right the first time for patients and clinicians.
A graduate of the Doctor of Nursing Practice program at Johns Hopkins School of Nursing, Scott built a Command Center as an output of his doctoral project and believes that as healthcare continues to evolve, patient flow will play an even more prominent role across the care continuum.
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