A study launched in 82 HCA Healthcare hospitals found that an AI tool could help staff identify and react to an infection and help contain an outbreak
Healthcare organizations are training an AI tool to rapidly identify outbreaks within a health system, giving clinicians more time to contain the infection and treat patients.
A four-year study in 82 hospitals across the US, recently posted in The New England Journal of Medicine, found that the automated tool reduced potential outbreaks by 64% compared to traditional methods of identifying an outbreak. The tool identified potential outbreaks, on average, three times per year per hospital.
“Outbreaks in hospitals are often missed or detected late, after preventable infections have occurred,” Meghan A. Baker, MD, ScD, a Harvard Medical School assistant professor of population medicine at the Harvard Pilgrim Health Care Institute and lead investigator of the study, said in a press release. “This study provides a practical and standardized approach to identify early transmission and halt events that could become an outbreak in hospitals.”
Funded by the U.S. Centers for Disease Control and Prevention (CDC), the CLUSTER study was conducted in 2019-22 at hospitals within the HCA Healthcare system by a team of investigators from HCA, the Harvard Pilgrim Health Care Institute, and the University of California, Irvine (UCI) Health.
The research aims to help a healthcare industry still reeling from the effects of the COVID-19 pandemic (which, coincidentally, interrupted this study) and looking for better methods of tracking outbreaks before they cripple hospitals and harm more people. Researchers are turning to AI tools to sort through data and more quickly and accurately identify trends.
“Despite significant progress in reducing healthcare-associated infection outbreaks, including of antimicrobial-resistant pathogens, they remain an industry challenge and can present as clusters that signal potential for transmission to patients,” Joseph Perz, DrPH, MA, senior advisor for public health programs in the CDC’s Division of Healthcare Quality Promotion and a committee member for the CDC’s Council for Outbreak Response: Healthcare-Associated Infections, said in the release. “The CLUSTER trial provides evidence that early detection powered by automation tools and quick action can prevent outbreaks from growing.”
In this trial, researchers created an “algorithm-driven statistical detection tool” that combed through laboratory data for signs of more than 100 bacterial and fungal infections, then posted real-time alerts to infection control programs. The process included both an automated review of patients’ clinical cultures and a statistical assessment of whether patients with these specific infections were increasing in number.
The results of the study were affected by the COVID-19 pandemic. According to researchers, automated alerts weren’t as effective during the pandemic because hospital staff were so busy that they weren’t able to respond to the alerts in time. Researchers decided instead to focus on the results gained prior to the pandemic.
The research team said the underlying software will be available to all health systems, but it must be integrated into their EHR and other clinical workflow platforms.
The ONC and The Sequoia Project have added new enhancements for FHIR adoption in version 2.0 of the Common Agreement, which sets thew stage for nationwide interoperability through the TEFCA framework
Federal officials are showing further support for FHIR with the release of version 2.0 of the Common Agreement, which established the foundation for the Trusted Exchange Framework and Common Agreement (TEFCA) data exchange framework.
HL7’s Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface (API) exchange has long been seen as a key element to nationwide interoperability, but many are worried that healthcare organizations are ready to embrace the standards just yet. Version 2.0, released by the U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) and The Sequoia Projects, ONC’s Recognized Coordinating Entity (RCE) for TEFCA, includes enhancements and updates for FHIR support.
“Today’s release includes framework enhancements, including greater use of FHIR, better support for use cases beyond treatment, and simplified onboarding for participants like clinicians, digital health apps, public health agencies, and other end users of health data,” Mariann Yeager, The Sequoia Project CEO and RCE lead, said in a press release.
“We have long intended for TEFCA to have the capacity to enable FHIR API exchange,” ONC chief Mickey Tripathi, PhD, added in the release. “This is in direct response to the health IT industry’s move toward standardized APIs with modern privacy and security safeguards, and allows TEFCA to keep pace with the advanced, secure data services approaches used by the tech industry.
Nurse leaders must come together to tackle these three main pain points in workforce development.
2024 has been a wild ride in the world of healthcare so far. With increasing turnover rates and the rapid rise of new technologies pushing their way to the forefront, the question of how to address core issues becomes increasingly dizzying.
In nursing, it's no different.
Many nurse leaders are strategizing as best they can to deal with the growing nursing shortage and how to incorporate new innovative solutions for redesigning care models to fit the modern care needs of patients.
From April 24 to 26, the members of the HealthLeaders CNO Exchange will be meeting in Miramar Beach, Florida, to talk about how to address the workforce development issues facing CNOs today.
Strategic workforce planning
To combat the nursing shortage, CNOs need to develop a plan of action that involves several different components. Leaders must come up with new recruitment strategies that include promoting diversity, equity, and inclusion as well as building pipelines through academic partnerships.
Retention strategies must include how to build resiliency, and transition-to-practice programs that help situate new graduate nurses in their roles. Additionally, leaders must offer educational and personal growth opportunities, along with robust and competitive career paths.
At the Exchange, the members will come up with new ideas to tackle these challenges as well as ideas for new innovative care models that have the potential for positive outcomes.
Digital solutions
Modern health systems should be up to speed on the best uses of AI and robotics, as well as successful methods of device integration. Leaders should be using data and analytics to support the nursing workforce and the nurse managers by minimizing the burden of documentation.
In addition to workforce strategy, the Exchange members will brainstorm digital solutions to fill gaps and enhance nurse workflows. They will also discuss how to plan and execute virtual nursing models, and the constraints, outcomes, and ROI of using virtual technology.
Leadership
The key to all of these strategies is strong leadership. CNOs should be fostering teamwork between colleagues and nurse departments, and they should be able to clearly communicate with staff and build relationships with them.
The Exchange members will discuss change management and how to get to a "Yes we can" culture. They will strategize ways to create healthier work environments by reducing staff assaults and implementing more effective patient behavior policies. Lastly, they will discuss C-suite trends and financial stewardship and come up with strategies that align the CNO with the CFO and improve performance metrics.
Follow along to learn more about these topics and solutions for workforce development.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
UMMS' new CNE aims to lead the health system on a journey to become a high reliability organization.
Peggy Norton-Rosko brings more than three decades of nursing experience and leadership. Most recently, Norton-Rosko served as the Regional Chief Nursing Officer for Trinity Health's Illinois and Indiana regions, where she oversaw nursing practices across a network that included an academic medical center, two community hospitals and a large ambulatory care network. She also served as an affiliate faculty member with the Loyola University Chicago Marcella Niehoff School of Nursing.
Following a nationwide search, Norton-Rosko has been named Chief Nurse Executive for the University of Maryland Medical System (UMMS), an academic-focused system which employs more than 9,300 nurses, effective May 20th.
For our latest installment of the Exec, we sat down with Norton-Rosko to discuss how she began her journey into nursing, her thoughts on the future of virtual nursing, and meeting the needs of a multigenerational workforce.
Lisa Stephenson, chief nursing informatics officer at Houston Methodist, chats with nursing editor G Hatfield about technology in nursing and how CNOs and CNIOs can use smart technology and AI to improve nurse retention and patient outcomes.
The average tenure of employees on the VPs team is 10 years.
Succession planning was revealed to be a common issue among revenue cycle executives during the recent HealthLeaders’ Revenue Cycle Exchange. The leaders agreed on its importance, yet many stated their organizations didn’t have the time to allocate towards it.
However, at Moffitt Cancer Center in Tampa, Florida, Lynn Ansley, Healthleaders Exchange member and vice president of revenue cycle management, has made succession planning an integral part of the employee experience for her team and has seen great outcomes because of it.
Where to Start
Simply creating an organizational chart is a step in the right direction.
“When you look up an [organization’s leadership] chart, no matter where you’re sitting in that org chart, you want to know there’s a path for you to go,” Ansley told HealthLeaders. “Whether it’s up or even laterally across the organization.”
Succession planning then begins with an informational interview, where the employee is able to learn more about the role or department they’re interested in, qualifications, and discuss what they need to do to meet those qualifications.
During this stage, in particular, Ansley looks for potential leaders and will give them stretch assignments, which is a task where they have the chance to display their skills and capabilities as a leader.
They’ll be included in the organizational wide programs Moffitt’s development team puts together where they learn more about the organization and how different roles intersect with each other. Employees will also meet with their leader each quarter for professional development meetings to check their progress.
“When you look down in any area of my front, middle, and back-end shared services, there’s a pipeline of who’s up next for that leadership role,” Ansley said.
Different ladders within the organization require a particular HFMA certification, which, upon receiving the certification, makes them qualified to advance in the organization and increases their marketability should they ever decide to pursue other opportunities at a different organization.
Pictured: Lynn Ansley attends the 2024 Revenue Cycle Exchange.
Looking Forward
In addition to training opportunities, employees are encouraged to think about how and where they want to grow in the organization, especially now that the practice is growing.
“What I encourage our team members to do a lot is not just focus on the next six months, but look out a little bit further,” Ansley said.
“If the role that you think you want isn’t available today, we’re going to be multiplying the number of opportunities in the short term and into the next 10 years.”
The average tenure of members on Ansley’s team and leaders she reports to is 10 years. Because of this, she stated, the organization has a wealth of internal knowledge on their operations and processes, which contributes to a greater culture of continuous learning and improvement.
“We have a lot of, I call it ‘musical chairs’ in rev cycle, because it means that our team members are growing throughout all of the areas,” Ansley said.
“I’m not sure that there’s any more valuable of a team member that has sat in multiple seats on the bus and got to see the view from all of those different angles to see how the cycle really impacts one another.”
TheHealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
The nurse leaders at AONL looked to the future to solve the current workforce issues.
The 2024 AONL Conference wrapped up last week in New Orleans after three days of brainstorming, collaboration, and leadership discussion. There were many common themes throughout the sessions and the keynotes, but as expected, workforce development was front and center. Turnover rates are high among frontline nurses and in leadership positions, and even though predictions are positive, the current nursing shortage is going strong.
The nurse leaders in attendance offered many creative and innovative solutions for the different prongs of the workforce crisis. Here are the top five subjects they focused on.
Ben Wobker, founder and CEO of Lake Washington Physical Therapy, joins HealthLeaders strategy editor Jay Asser for a discussion on what the industry can learn from the recent Change Healthcare attack, as well as his experience with implementing electronic payment strategies.
On this week’s episode of HL Shorts, we hear from Jennifer Croland, vice president and chief nursing officer at OSF HealthCare Saint Francis Medical Center, about how CNOs can identify which nurses are experiencing burnout. Tune in to hear her insights.
The nurse leaders at AONL looked to the future to solve the current workforce issues.
The 2024 AONL Conference wrapped up last week in New Orleans after three days of brainstorming, collaboration, leadership discussion, and heavy rain.
There were many common themes throughout the sessions and the keynotes, but as expected, workforce development was front and center. Turnover rates are high among frontline nurses and in leadership positions, and even though predictions are positive, the current nursing shortage is going strong.
The nurse leaders in attendance offered many creative and innovative solutions for the different prongs of the workforce crisis. Here are the top five subjects they focused on.
5. Workplace violence prevention
Workplace violence incidents are rising, and even though many physical safety measures have and are still being taken by health systems, there seems to be little to no improvement.
This is due to the wrong approach, according to Mary Beth Kingston, chief nursing officer at Advocate Health. In a conference session, Kingston suggested that taking a more patient-centered approach to workplace violence is the missing piece of the puzzle.
Kingston recommended getting to the bottom of why incidents occur, by meeting patients where they are at, and trying to understand what might be going on in their life to cause certain behaviors. De-escalation training should be meaningful and involve some kind of "customer service" training to help nurses speak to patients, families, and visitors in stressful situations.
4. Addressing burnout
Burnout was a part of almost every conversation at AONL this year. Burnout is one of the biggest reasons for turnover rates for both frontline nurses and nurse leaders. Nurses are expected to do too many extraneous tasks that take away from the time they have to spend with patients, and many of the CNOs and nurse leaders at AONL emphasized the need to remove those tasks from daily workflows.
In another conference session, Linda Alderson, chief nurse executive at Tacoma General and Allenmore Hospitals, and Jennifer Graham, chief nurse executive at MultiCare Health System, spoke about how they are leveraging technology to lessen the workload for nurses.
Graham spoke about how they use a robot called Moxi, who currently works as a delivery robot in the hospital. Moxi is responsible for running supplies and smaller lab specimens to and from locations to assist the nurses on the floor. So far, Graham said the results have been successful in diverting the task of supply delivery away from nurses.
3. Career development
Creating career development opportunities for nurses who want to become leaders in their space was also a hot button topic. In the same session, Kingston gave advice about personal career accelerators that nurses should take into consideration.
Kingston recommended that nurses who want to become leaders engage in professional organizations, and partaking in the opportunities offered by those groups. They should also become comfortable with the idea of taking calculated career risks, and recognize that they have skills that are transferable.
2. Mentorship
Along the same lines, there was a general consensus at the conference that the gap between new graduate nurses and tenured nurses is concerning, to say the least. The idea of mentorship programs is not a new one, but it is becoming more necessary in the current state of the industry.
Erin Kirk, director of patient care services at Norton Children's, discussed in a session how the health system has a mentorship program where nurses can become part of a learning cohort through a nomination process.
In the hybrid learning program, they learn skills such as interprofessional communication and how to problem solve using critical thinking. According to Kirk, 59% of participants have gone on to expand their roles or involvement with the health system since completing the program, which Kirk deems a success.
1. Virtual nursing
To no one's surprise, virtual nursing was the number one trend at AONL in 2024. Not only was the topic the subject of many of the sessions, but it was the main theme in the exhibit hall as well. It is crystal clear that the future of the nursing industry is virtual, and that nurse leaders need to be ready for the implications on workflows and patient care.
Along with Moxi, Graham and Alderson shared their findings from the new nursing care model they are currently testing. The care model involves a unit made up of an RN, an LPN, a virtual nurse, a robot, and a CNA. The model separates the duties of the virtual nurse and the RN and LPN, and outlines the places where they cross over each other.
According to Graham and Alderson, the virtual nurse is in charge of admissions, discharges, dual nurse signoffs, and mentoring and clinical support. The bedside RN and LPN are responsible for physical assessment, patient safety, medication administration, procedures, and other hands-on care. Things like patient rounding, patient education, care plan updates, pain reassessment, interdisciplinary rounding, and connecting with patients and families are all integrated duties that both parties are responsible for.
Graham and Alderson have seen success with this model, and while it still has a long way to go, this is a good example of how CNOs and other nurse leaders can incorporate virtual nursing into their hospitals.
Pictured: Lynn Ansley attends the 2024 Revenue Cycle Exchange.
