The arrest of a University of Utah Hospital nurse is the latest in long list of violent incidents against nurses.
The viral video of a police officer roughing up and arresting a University of Utah Hospital nurse has thrust the concept of nursing workplace safety into the public spotlight.
When a Salt Lake City police officer demanded registered nurse Alex Wubbels draw blood on an unconscious burn unit patient, she refused citing hospital policy that stated blood could only be taken if the patient consented, was under arrest, or there was a warrant issued for the blood draw.
Despite calmly explaining the policy to the officer, Wubbels was grabbed, handcuffed, and forced to walk to a squad car where she was left inside for 20 minutes until she was released with no charges. The incident occured July 26. The video was released last week.
On Monday, the interim CEO of University Hospital announced that the hospital had already changed its policy so nurses would not have to interact with police in similar situations.
"It is outrageous and unacceptable that a nurse should be treated in this way for following her professional duty to advocate on behalf of the patient as well as following the policies of her employer and the law," saidAmerican Nurses Association President Pam Cipriano, PhD, RN, NEA-BC, FAAN, in a news release.
This is not the first time a nurse has been bullied or assaulted at work:
In 2009,Advocate Illinois Masonic Medical Center RN Lisa Hofstra was handcuffed in the ED by a Chicago police officer after she refused to draw blood until the driver of a car was admitted as a patient. The officer can be seen on video forcing Hofstra to sit in a police car for 45 minutes until the blood was obtained. Hofstra eventually settled a lawsuit against the officer for $78,000.
On May 13, two nurses at Delnor Hospital in Geneva, Illinois were taken hostage by an inmate who was a patient at the facility. The inmate was left unshackled by a sheriff’s officer after he used the restroom, escaped, and took two nurses hostage. One of the nurses was raped and held hostage for three hours until the SWAT team killed the inmate. A lawsuit was filed against the Kane County Sheriff's Office, corrections Officer Shawn Loomis and APEX3 security on June 1.
On June 14, RN Elise Wilson, was repeatedly stabbed in the arm and neck by a patient at Harrington Hospital in Southbridge, Massachusetts. On July 19, Senate Bill 1374—known as Elise’s Law—passed the Joint Committee of Public Safety and Homeland Security and has been referred to the Ways and Means Committee. The act requires healthcare employers develop and implement programs to prevent workplace violence.
A 2015 American Nurses Association survey of 3,765 RNs found nearly 25% of respondents had been physically assaulted while at work by a patient or a patient’s family member. Up to 50% had been bullied in some manner, either by a peer or a person in a higher level of authority.
Post-acute care has become an essential component of value-based care. By preparing new nurses through a long-term care residency program, facilities can improve nurse retention, confidence, and competency.
Accountable care organizations, value-based care, and new reimbursement models are changing the healthcare landscape, and with that the role of the post-acute care nurse is evolving as well.
"It's important that [patients] don't go back to the hospital. So these nurses have to have a different skill level than, maybe, what people perceived long-term care as previously," says Edna Cadmus, PhD, RN, NEA-BC, FAAN, clinical professor at Rutgers University School of Nursing.
There are few structured programs, however, to help newly licensed RNs develop the expertise needed to successfully transition to practice in post-acute care.
To address this issue, the New Jersey Action Coalition, is focused on implementing the Institute of Medicine's (now the National Academy of Medicine) Future of Nursing recommendations. It is one of 51 groups doing this work across the country.
Cadmus is co-lead of the coalition, which falls under the umbrella of Campaign for Action partnership between the Robert Wood Johnson Foundation and the AARP.
"We felt there were acute care nurse residency programs in many hospitals, but for post-acute settings and, specifically, long-term care, there had been no evidence of any residency programs out there," she says.
"And we knew that there was a high turnover rate of nurses in long-term care facilities."
Turnover among RNs in long-term care facilities nationally was 50% and retention was almost 67%.After the New Jersey LTC residency program, the retention rate of participants was 86%.
Long-Term Care Competencies
The program launched in 2013 with funding from the Centers for Medicare & Medicaid Services and continued until 2016 with additional funding from the New Jersey Department of Health.
Though it wasn't a walk in the park, the coalition recruited thirty-six facilities to participate in the program.
"Knowing the financial situation of how long-term care is reimbursed, it really was a challenge for us to recruit, but once we explained the return on investment, that helped," Cadmus says.
The participating organizations sent 39 preceptors and 37 new nurses through the program.
Preceptors took five days away from their facilities for training to learn new skills to help them mentor new nurse residents. The new nurse residents were away from the facilities once a week to learn key competencies in geriatric care such as:
Both residents and preceptors obtained dementia care certification and all residents did a quality improvement project for their organization. "They were giving back but also contributing as a new nurse leader into the organization as a new nurse," Cadmus says.
The Residency Blueprint
The improvement in turnover was an obvious bonus. "If you have such a high turnover and you can [start to] keep people you're obviously saving money," Cadmus says.
But the residency had other benefits as well.
"We surveyed the nurses and found that their confidence as well as their competence increased," she says.
"Usually somewhere around six months is when a new grad is looking to leave their first level of employment. We felt we got them over that hurdle to really kind of get them stable for that first year."
Still there are challenges in developing residencies in post-acute care. Unlike acute care organizations which can hire a group of new nurses to go through a residency as a cohort, post-acute care organizations usually hire just one or two nurses at a time.
And the setting does not always have a robust career ladder for nurses to climb.
"When you're in a hospital situation there's a lot of opportunities to move up, to go into a clinical ladder, to try different departments to work in. It's not the same environment in long-term care," Cadmus says.
"So when you think about the new graduate, especially this new generation, they're looking to be able to not only make a difference, but also to have opportunities to change into different roles or to be promoted into different things. If you don't have those opportunities they're out the door."
Cadmus and her co-authors share their experience with developing and implementing the residency program in the book Developing a Residency in Post-Acute Care. They hope it can serve as a blueprint for others wishing to launch their own residency programs.
"We've gotten a lot of calls from people asking about how you do it. We're giving you everything you need to know about how to make this work," she says. "That was why we felt it was important to document how to do this. There's no reason why anybody should have to reinvent the wheel."
From financial outcomes to mortality rates, nurse leaders can positively influence a healthcare system’s metrics.
Nurse leaders are responsible for a vast array of metrics related to processes, clinical outcomes, and everything in between.
"Our CNOs are held accountable for readmissions, mortality rates, [and] hospital-acquired conditions, and for the financial bottom line in their particular hospital," says Maggie Hansen, RN, BSN, MHSc, senior vice president and chief nurse executive at the South Florida–based Memorial Healthcare System.
"Nurses have to worry about almost every touch point on the continuum of care.”
That’s a big job. And with the immense amount of information generated in today’s healthcare environment, knowing exactly how data should be measured to create meaningful metrics is a challenge.
But nurse leaders are up for it.
“We’re counted on to produce great and enviable metrics,” Hansen says. “We’re the ones that can make it happen, because healthcare is about the patient care that nurses provide."
Patient Experience on the Radar
To help CNOs get their arms around the myriad metrics they need to collect, Sean Lynch, RN,MSN, SCRN, assistant administrator for patient services and nurse executive Baptist Medical Center Beaches in Jacksonville Beach, Florida—part of Northeast Florida’s five-hospital Baptist Health system—suggests looking at data through four "pillars:”
Finance
Quality
Patient experience
Team engagement
Throughout the Baptist system, all meetings in every department begin with a review of quality metrics. And while quality is important, Lynch says the pillar of team engagement should not be underestimated.
"Your team is what makes the other three pillars happen," he says.
To measure employee engagement, Baptist Medical Center Beaches administers a Willis Towers Watson team engagement survey every two years.
"Each department identifies their strengths and their weakness, and they build action plans based on their opportunities," he says.
Hospitals and health systems may also want to consider collecting metrics in real-time, Lynch says.
Baptist Medical Center Beaches is piloting a program called Rounding and Driving Awesome Results (RADAR), which one of the organization’s administrators created to help leaders respond to patient issues as they occur.
During a RADAR survey, nurse managers ask patients five questions, including "Are we meeting all your expectations?" and "Are the staff responsive to you?" The patients’ answers are entered into a tablet, and each day at 7 AM a report is printed.
Depending on the patients’ responses, the program issues a red light (dissatisfied) or a green light (satisfied or very satisfied).
The organization’s leadership can also review patient comments entered into the survey. The color-coded system makes it easy to identify opportunities for service recovery before a patient leaves the hospital.
"If there are opportunities, we want to intervene as a leadership team," Lynch says.
Reduction in Harm
At Mission Health, a nonprofit, independent community health system in Asheville, North Carolina, the organization is improving care by collecting metrics across the board related to harm.
"We benchmark that," says Jill Hoggard Green, PhD, RN, Mission Health System’s chief operating officer and president of Mission Hospital, the system’s 763-bed flagship hospital.
"Over the last three years, we have had a substantial reduction in harm across the board. For us, that’s everyone’s goal. We do it at the system level and then we look at it on individual units, usually with specific measures, where we can see we have opportunities."
At Mission Hospital, the facility is creating team-based care units where a physician provider, care manager, and nurse leader co-lead a unit that focuses on a specific patient population.
"We work on having standard work with outcomes, and we have huddle boards where we assess our metrics and how well we’re moving forward," says Karen Olsen, MBA, BSN, RN, NE-BC, vice president and chief nurse executive at Mission Hospital.
Length of stay, readmissions, leader rounding, and patient experience are all evaluated and used to improve unit processes.
For example, if the goal is to discharge patients earlier in the day, metrics are assessed to help identify barriers to reaching that goal. If the unit-based leadership team notices there is a delay in a specific department, they work together to find solutions to the hurdle.
Unit-based safety issues are also reviewed.
"We do root cause analysis and partner with our safety and quality leaders to [develop] action plans," she says. "We have a strategic committee, and we are very transparent with our metrics. Those units that are excelling and doing well—we want to transfer that knowledge and that experience so we can have gains across all of our units as well."
"We need to support women and be present and available to them to help them have the birth they want but also keep things safe. Then we also need to be patient enough to say, 'If everything's looking fine, there's no reason to be moving ahead to any decisions here. We can sit and watch a little longer, and we can try a couple of different things."
This go-with-the flow philosophy seems to be paying off for St. Mary's Hospital.
The U.S. Department of Health and Human Services' national benchmark is 23.9% for low-risk births.
Nursing Presence and Support
There are many things that go into creating an environment that keeps C-section rates in check. The standard course of care at St. Mary's Hospital includes no elective inductions before 39 weeks of gestation, avoiding unnecessary elective inductions, and not putting time limits on deliveries.
"If the baby is looking fine and tolerating what's going on and you've got the mom that you're supporting who's in it for the long haul, we have a team that is comfortable with just waiting on what, hopefully, is its natural progression," Lesser says.
The facility has also worked hard to ensure staffing comes as close as possible to the Association of Women's Health, Obstetric and Neonatal Nurses' guidelines for care, which means one-to-one nursing care for actively laboring patients.
"That presence of the nurse to be able to support the mom in whatever kind of birth she's choosing is important," Lesser says. "[It] gives [the mom] the time and the support to get where she wants to be."
Communication and Patient Safety
Communication is also essential to St. Mary Hospital's C-section rate success. The organization has done a great deal of work around safety and communication using AHRQ's TeamSTEPPS model.
"Everyone who works here is trained in that, but we really reinforce the importance of huddles, briefs, and debriefs to keep us all on the same page," Lesser says.
The goal of these communications is to keep care patient-centered yet safe.
"We do bedside handoffs with nurses so that the patient is included," she says. "Every shift we're updating and asking, 'Does this sound right? Are we on the right course for what you're wanting?'" she explains.
Additionally, the charge nurses lead a team review (nurses, obstetricians, neonatologists, and anesthesiologists) of the care management plan of every patient in labor and delivery. They discuss whether they are on track with the plan and what needs to be addressed or adjusted.
"We come together and look at the data we have—be it the patient experience, vital signs, or monitor strips," Lesser says. "[We discuss] the best way we can go to move forward to help the mother achieve what she wants and what we know is safest, which is a vaginal birth if all else is looking OK."
Other organizations on the list include Comcast NBCUniversal, Wegmans Food Markets, Inc., and PricewaterhouseCoopers LLP.
“At NewYork-Presbyterian, we know that our strongest assets in providing excellent patient care are our talented and committed employees,” said Steven J. Corwin, MD, president and CEO of NewYork-Presbyterian in a news release. “We are proud to be on this distinguished list of exceptional workplaces.”
Employee Feedback
The list to into account the Great Place to Work survey results from some 137,000 employees’ assessments of their organizations. The survey assessed over 50 different metrics, including management transparency, professional development, meaningful work, promotion equity, and the generosity of benefit programs.
"At WESTMED, we invest in our people by offering ongoing training and development opportunities, mentoring programs, and employee engagement initiatives that are championed by senior leadership—with a sole purpose of collaboratively guiding culture. By equipping employees with tools and resources to consistently deliver exceptional service, we are able to create an outstanding workplace culture, and ultimately deliver a more positive patient experience,” says Anthony Viceroy, CEO of WESTMED Medical Group in a news release.
Key findings from the Great Place to Work survey taken by NewYork-Presbyterian Hospital employees include that 91% say they are proud to tell others where they work, and 87% believe their work has special meaning. A great work atmosphere was reported by 92% of employees, and 88% report they have a great boss.
“We believe employee engagement is a key pillar to our overall commitment to excellence in patient care, research, education and community service,” Laura L. Forese, MD, executive vice president and chief operating officer of NewYork-Presbyterian “We constantly strive to evaluate and improve efforts to promote professional development, diversity and inclusion, work-life balance and a sense of community among our workforce.”
Healthcare leaders need start viewing the nursing workforce through the lens of supply and demand in the marketplace.
There's a tendency to view nursing shortages as cyclical events that come and go. But, nurse leaders may do well to move away from a strict recruitment and retention mindset by applying a more comprehensive approach toward RN supply and demand.
"We really have to change our thinking from the nursing shortage [being a] cyclic idea to really understanding nursing supply and demand in terms of economic and non-economic factors," said Richard Ridge, PhD, MBA, RN, CENP during his presentation at AONE 2017 in Baltimore.
Ridge acknowledged that the nursing workforce is a major concern for nurse leaders.
"Many of us spend inordinate amounts of time on this issue—developing our workforce, understanding our workforce, preparing our workforce, presenting business plans for FTEs as we move forward trying to meet the needs of our patients," he said.
Drawing on both his own experiences and those of his colleagues, Ridge developed the Relationship-based Nursing Workforce Pipeline Model as a way of assessing and planning nursing workforce needs.
"It's a model that, hopefully, you can look at and try to better conceptualize your own plans," he said. "Nothing here is presented as a recipe; it's really presented more to open up possibilities."
Three Pillars
The three theoretical underpinnings of Ridge's model are:
"That's really the major theoretical underpinnings of a good, effective workforce model," he said.
Stakeholder Theory
This emphasizes the need to identify all stakeholders, including primary, secondary, and tertiary parties, and understanding what makes them successful. These stakeholders can include nursing schools or even competing organizations.
"It doesn't necessarily mean you have to help them be successful, but it does mean that you have to understand how they define success," he explained.
Systems Theory
By applying systems theory, nurse leaders consider nursing workforce issues at the macro, meso (intermediate), and micro levels.
"Macro could be considered what's happening in the country, what's happening at the state level," Ridge said.
Nurse leaders need to understand the macro level data—like HRSA workforce projections and state workforce center supply and demand reports—and then consider how it affects the nursing workforce at the local level.
"What does that have to do with your hospital, your organization, your county, your city? It's the context," Ridge said. "Our plans are at the local level, but within the context of the overall."
Individual facilities are considered the meso level and the interacting departments are the micro level, Ridge explained.
"One of the big pitfalls when we don't think of systems is we end up with department level programs. Everybody's working on their own thing… and what it's called in systems theory is suboptimization," he said.
"All these little micro units, departments, might be doing a terrific job, but in the whole scheme of things, then at the meso level, your organization's level, you're really not seeing synergies, you're not seeing the outcomes that you need."
Nursing is a Brand
The third underpinning is development of a nursing brand. Many hospital and healthcare system brands market the organization's services to the community, Ridge said. But leaders also need to be mindful about marketing their organizations to prospective employees.
"When we look at brands, at many hospitals, it's really two approaches. We're marketing our services to the community and then we market our brand as an employer," he said. "Look at your own organizations and see how you're tying the two brands together."
A few years ago, when Ridge was assessing how Magnet designation and nursing was portrayed on hospital websites in New Jersey, he found that 30% of Magnet hospitals mentioned they had Magnet recognition but only 20% identified their CNOs.
Data Matters
Of course, even when taking a comprehensive approach to nursing workforce planning, nurse leaders need to assess and adjust their workforce plans based on data.
"You must have metrics that strategically support change at all levels," he said.
Researchers evaluated 246 patients who underwent elective colorectal operations at Advocate Illinois Masonic Medical Centerin Chicago. They compared results of patients whose surgeries were performed using the ERACS protocol to those who underwent surgery before the protocol was implemented.
The study determined that use of the protocol, which standardizes care before, during, and after colorectal operations, reduced hospital stays by more than half, reduced complications by more than one-third, and cut costs up to $11,000 per procedure,
“Our goal was to determine whether we could send patients home sooner after surgery without having to worry about increased complications or increased readmission rates,” says Deepa Bhat, MD, a second-year surgery resident and lead study author, in a news release. “We found that not only does our pathway not negatively impact their hospital length of stay, readmission rate, and complication rates, but that ERACS actually improves these outcomes.”
Lower Costs, Big Savings
According to the study’s findings, the typical hospital length of stay dropped from 5.65 days to 2.89 days after implementation of ERACS implemented, the direct variable cost was approximately $3,705 lower with the protocol, and total hospitalization costs were reduced by up to $11,000 per patient. Institutionally, this translated into a savings of around $1 million for the year.
“Before the enhanced recovery pathway, each surgeon had their own way of doing things, such as when patients should start liquids or when they could be discharged home from the hospital,” she said. “Now, care is standardized so that every patient experiences the same pre-, intra-, and postoperative protocol, which leads to better outcomes.”
The patients receive more coaching and education than they did prior to the pathway’s use, Bhat says.
“The patient goes into surgery having a very clear idea of what they can expect, such as how their pain will be controlled, when they can start liquids, and what their expectations are for ambulation,” she says. “By making patients active participants in their own care, they tend to do better.”
After the study’s conclusion, Advocate Illinois Masonic Medical Center adopted the ERACS pathway as standard operating procedure.
The study suggests hospitalization may be a greater risk factor for long-term cognitive decline in older adults than previously recognized, say the project’s researchers.
“We found that those who have non-elective hospitalizations and who have not previously been diagnosed with dementia or Alzheimer’s disease had a rapid decline in cognitive function compared to the prehospital rates,” Bryan James, PhD says in a news release. “By comparison, people who were never hospitalized and those who had elective hospitalizations did not experience the drastic decline in cognitive function.”
James, an epidemiologist and in the Rush Alzheimer’s Disease Center and an assistant professor in the Rush Department of Internal Medicine, and his colleagues presented their findings at the Alzheimer’s Association International Conferencein London on July 17.
Non-Elective Admissions and Cognitive Decline
The study of 930 older adults involved annual cognitive assessments and clinical evaluations. Hospitalization data was assessed by linking participants’ records of 1999 to 2010 Medicare claims with their MAP data. All hospital admissions were designated as elective or non-elective (this category consisted of emergency or urgent admissions).
Over an average of almost five years of observation, 613 of 930 participants were hospitalized at least once. Of those hospitalized, 260 (28%) had at least one elective hospital admission, and 553 (60%) had at least one non-elective hospital admission. These groups included 200 participants (22%) who had both types of hospitalizations.
While elective hospitalizations, were not associated with acceleration in the rate of cognitive decline, non-elective hospitalizations were associated with an approximately 60% acceleration in the rate of cognitive decline from before hospitalization.
“We saw a clear distinction: Nonelective admissions drive the association between hospitalization and long-term changes in cognitive function in later life, while elective admissions do not necessarily carry the same risk of negative cognitive outcomes,” says James. “These findings have important implications for the medical decision making and care of older adults. While recognizing that all medical procedures carry some degree of risk, this study implies that planned hospital encounters may not be as dangerous to the cognitive health of older persons as emergency or urgent situations.”
While it’s known workplace bullying can compromise patient safety, interfere with communication, and hamper employee morale, a new analysis finds bullying behaviors continue in healthcare.
An analysis of the database revealed 44 events associated with bullying behaviors occurred between July 2014 through June 2016. The events occurred among healthcare providers including physicians, nurses, and technicians.
Types of Bullying Behaviors
Analysts searched the database for reports of events that included keywords like bully, cried, disrupt, rude, threat, throw, upset, and yell. They then reviewed the resulting 5,807 event report narratives to identify reports describing behaviors synonymous with the Workplace Bullying Institute definition of bullying.
The institute defines bullying as repeated mistreatment of an intended target in one or more combinations of the following forms—verbal abuse; threatening, humiliating, or intimidating behaviors; or work interference.
Event reports were grouped into related categories by harm score, event type categories, event reporting taxonomy, and care area. Event reports regarding bullying by or toward patients were excluded.
The bullying incidents were reported in five event categories:
1. Error related to procedure/treatment/test
2. Complication of procedure/treatment/test
3. Medication error
4. Transfusion
5. Other/miscellaneous
Most of the 44 bullying incidents occurred in events classified as other/miscellaneous (56.8%), followed by error related to procedure/treatment/test (27.3%). Analysts found 77.3% of events involved a physician engaging in verbally abusive behavior. The remaining events involved a nurse or technician.
Bullying Hotspots
After examining the event descriptions, analysts sorted the events into five categories of bullying behaviors based on the Workplace Bullying Institute definition. These were:
1. Verbal abuse
2. Intimidating behavior
3. Work Interference
4. Humiliating behaviors
5. Threatening behaviors
The top two events based on frequency were verbal abuse and intimidating behavior. The top three care areas where the events took place were perioperative care areas (29.5%), medical/surgical units (25%), and the emergency department (15.9%).
Orlando Health's corporate manager of emergency preparedness talks about his experience with the Pulse nightclub shooting and how healthcare leaders can better prepare their organizations to handle disasters.
Last week it rained hard here in northern Illinois. Many homes and towns flooded, and patients at Northwestern Lake Forest Hospital had to be transferred to nearby facilities due to a power outage and standing water inside the building.
As of Friday, July 14, (two days after the rain began) the hospital was still closed.
While this incident is nowhere near the size and scale of the flooding that took place after Hurricane Katrina, Mother Nature makes a point—emergencies and disasters know no bounds.
"This stuff's happening all over the place in different venues and at different times," says Eric Alberts, corporate manager, emergency preparedness at Orlando Health.
"A fertilizer plant explosion or a train derailment with chemicals or a vehicle that crashes into a building or a shooting. These things are happening everywhere, and you can't predict it."
But hospitals and health systems can, and should, prepare for it, he says. And administrative leaders should lead the charge.
Alberts says this from experience.
Just over a year ago, a few blocks from Orlando Health Medical Center, 49 people were killed and more than 50 were injured during a mass shooting at Pulse nightclub. Recently, he spoke with HealthLeaders to share insights he gained from the incident.
Know Your Neighbors
"When we did our planning efforts, we often had been thinking that something bad was going to happen at the big venues—like a big stadium with a bowl game, at a concert, at a fair, at a parade," Alberts says.
"We can no longer think that something bad's [only] going to happen at some big mass gathering. It could be the night club down the street. It could be the taxi waiting area. It could be at a convenience store. It could be at an apartment complex. Hospitals really need to take diligence now to be prepared."
He suggests hospital leaders type their facility's location into an aerial map on the Internet, and look at what is surrounding it. Ask staff members if they've noticed anything on their way to and from work that could be an issue.
"Oftentimes people don't think that way, but what I'm saying is it's time to be cognizant and vigilant to what is surrounding you," he says.
Take Practice Seriously
About three months prior to the Pulse incident, ORMC took part in a full-scale community exercise with 57 agencies, 533 volunteer victims, and 15 hospitals.The drill scenario was an active shooter at a local elementary school.
"Going through as realistic as possible an exercise, like we did, puts the people in the same locations and gives them proper training," he says. "During the Pulse situation, it enabled them to get away from the flight mentality and go into fight mode."
After the incident, clinical staff told Alberts that without the realistic drill, "they would have been too scared and not known what to do in that stressful chaotic situation. But because of the training, they were able to stop themselves and just go into the moment and care for the patients."
Unfortunately, as Alberts travels the country speaking about the incident, he finds that many hospitals either do not have or do not practice their emergency plans.
"If they do practice it, they're not really practicing it. They're just doing a flu shot campaign and calling it an exercise," he says.
Being Unprepared is Costly
"If you don't properly respond during an emergency, it can, and does, shut down entire hospitals," Alberts says. Not to mention the cost of legal fees and to reputation when an emergency or disaster is mishandled.
Additionally, the Centers for Medicare & Medicaid Services final rule on emergency preparedness must be implemented by November 15 of this year.
"In there, it talks to healthcare facilities having to have a risk assessment, emergency planning policy and procedures, an emergency communication plan, and training and testing," he says.
CMS regulators can arrive unannounced and can pull funding from a hospital that is not in compliance with the rule, Alberts says.
Most importantly, being unprepared can cost lives.
"I had a lot of people tell me that that [large-scale community] exercise really did help save lives in Pulse," he says.
"To me that's extremely humbling because I'm not a clinician. I'm an administrative person. For the clinicians to tell me that those efforts helped save lives in Pulse, that means the world to me. It really fuels my fire to want to do this and to do a whole lot more to help the hospitals be better prepared."