COVID-19 Executive Dialogue March 25, 2020 nhpco.org/coronavirus Your line has been muted upon entry. If you need assistance, please use the Q&A tool. Leading Person-Centered Care
Today’s Agenda and Faculty Edo Banach, JD President and Chief Executive Officer NHPCO Jennifer L. Kennedy, BSN, CHC, EDD, MA, RN Senior Director, Regulatory and Quality NHPCO Judi Lund Person, CHC, MPH Vice President, Regulatory and Compliance NHPCO Leading Person-Centered Care
Today’s Agenda and Faculty Lori Bishop, BSN, MHA, RN Vice President, Palliative and Advanced Care Robert Parker, CENP, CHP, CHPN, DNP, RN NHPCO Chief Clinical Officer, Chief Compliance Officer Intrepid USA Healthcare Services Carrollton, TX Sandi Cassese, RN, MSN, CNS Vice President and Chief Operating Officer Terri Warren, MSW Hospice of Orange and Sullivan Counties, Inc. Chief, Hospice and Palliative Care Providence Newburgh, NY TrinityCare Hospice Torrance, CA Paul A. Ledford, CAE, DPL President and Chief Executive Officer Florida Hospice and Palliative Care Association Tallahassee, FL Leading Person-Centered Care
Disclosures The faculty and planners for today’s webinar have no relevant financial relationships with commercial interests to disclose. Leading Person-Centered Care
Edo Banach, JD President and Chief Executive Officer NHPCO Leading Person-Centered Care
Jennifer L. Kennedy, BSN, CHC, EDD, MA, RN Senior Director, Regulatory and Quality NHPCO Leading Person-Centered Care
Judi Lund Person, MPH, CHC Vice President, Regulatory and Compliance NHPCO Leading Person-Centered Care
NHPCO Executive Dialogue: COVID-19 Pandemic Leading Person-Centered Care 9
COVID-19 Pandemic • New territory for all providers. • Even the best provider emergency preparedness plans did not account for the issues arising related to the COVID-19 pandemic. • Priority – prevent/control transmission of the virus to maintain safety for patients, their families, and healthcare staff. Leading Person-Centered Care 10
COVID-19 Current Outlook Total cases 44,183 Leading Person-Centered Care 11
COVID-19 Testing Issues • Test availability is challenged • Lack of widespread testing for COVID-19 in the United States • The federal government is developing more testing through public-private partnerships which will increase the number of available tests. • When more tests kits become available, the demand for testing will also increase. • More testing will likely increase the number of cases. Leading Person-Centered Care 12
It is Time to Be a Partner in Your Community • Emergency events level the playing field. • Everyone is affected in a pandemic situation. • We must deal with the reality we have each day and work with what we have. • Collaborate and share resources if possible, with other providers. • Emergency events are a team sport. • It is a time to share best practices with others to improve response and outcomes. Leading Person-Centered Care 13
COVID-19 Infection Guidance • Follow the Centers for Disease Control and Prevention (CDC). • https://www.cdc.gov/coronavirus/2019-nCoV/index.html • Be plugged into your local health departments. • Monitor information consistently from these entities to be aware of infection surge areas • Many local health departments may be posting daily updates • State & Territorial Health Department Websites • https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html Leading Person-Centered Care 14
State Emergency Management Agencies • A state Emergency Management Agency (EMA) is the connection to the federal emergency management entities. • U.S Department of Health and Human Services • FEMA • Make sure they know who you are, who your patients are, and the extent of your needs. • List of Emergency Management Agencies • FEMA Regional Contacts • You do not want to be exchanging business cards during a disaster. Leading Person-Centered Care 15
Patients & Families Leading Person-Centered Care 16
Protecting Patients and Families from COVID-19 • Screen patients and families. • Include COVID-19 education information to all patients and their families. • Provide education about infection control and prevention and ensure understanding. • Discuss goals for care for the patient during this crises. • Ensure that your patient/family continue to feel supported. • Some patient/families may have increased fear and anxiety related to virus in tandem with their fear and anxiety related to death of the patient. • Utilize all members of the IDT to meet patient/family needs. Leading Person-Centered Care 17
Protecting Staff Members from COVID-19 • Screen your staff. • Review your infection control program policies and procedures. • Validate competency for each staff member who have contact with patients/families. • Educate your staff about COVID-19 transmission and prevention measures. • Consider virtual visits when appropriate related to prevention and control of the virus. • Continuously evaluate your supply of Personal Protective Equipment (PPE). Leading Person-Centered Care 18
Care Delivery Challenges during COVID-19 Pandemic • Lack of current and specific hospice guidance from CMS • Absence of blanket 1135 waivers for regulatory flexibilities for hospice • Severe shortages of Personal Protective Equipment (PPE) • Staff shortages • Etc…. Remember – our mission and commitment has not changed to support seriously ill/terminally patients and their families Leading Person-Centered Care 19
Let’s Not Forget Our Patients • They are among the most vulnerable individuals in this crises. • Their fear and anxiety about death & dying is now compounded by fear and anxiety related to the virus. • Separation between the patient and their loved ones may be needed related to virus exposure or contraction. • Reduced visitation from the hospice provider may increase fear and anxiety of the patient/family. • Family grief issues may be increased due to events related to the COVID-19 crises in your community. Leading Person-Centered Care 20
Patients Who Contract the Virus • Isolation issues • Location of patient may be an access issue • Infection control issue if patient is the home – Keeping family safe • Decisions about treatment • COVID-19 Shared Decision-Making Tool – NHPCO resource • COVID-19 may accelerate the patient’s death • Symptom management issues • Preparing patient and family Leading Person-Centered Care 21
Quality of Care • How do we ensure quality of care for patients and families during this crises? • Care delivery innovation (i.e. telehealth) • Increase contact with patient & family to ensure they feel cared for and to determine their status and needs. • Volunteers may be able to make phone calls for this purpose • Utilize all resources • All IDT members can/should be involved • Can the SW or SCC function a in a greater capacity as staffing allows Leading Person-Centered Care 22
• Caring for a patient diagnosed with COVID-19. Clinical • Admitting a patient diagnosed with COVID-19. Decision • Caring for a patient exposed to COVID-19. Points • Caring for a patient with a compromised caregiver. 23
HQRP Data Submission • CMS waived the requirement to submit HQRP data for hospice providers. • Data from January 1, 2020 through June 30, 2020 (Q1-Q2) does not need to be submitted to CMS for purposes of complying with quality reporting program requirements. • Many providers are opting to continue submission of CAHPS data to their vendor for performance assessment and improvement purposes. Leading Person-Centered Care 24
Emergency Management Leading Person-Centered Care 25
Don’t Forget to Work Your Plan • This is an emergency event, so don’t forget about your plan. • Communicate with staff, patient/family, healthcare partners, community partners, etc… • Revise/develop policies and procedures along the way. • Train staff and evaluate competency • Initially and ongoing as necessary • Evaluate your response and revise your plan along the way Leading Person-Centered Care 26
Don’t Forget to Plan for What Is To Come • Tornadoes • Hurricanes • Floods • Earthquakes • Fire • Heat events • Chemical spills • Etc… Leading Person-Centered Care 27
This i s is s a marathon, n , not ot a spr prin int… Provider ers s shou ould p prep epar are f e for or the l long g g game. We are a all i in t the sa same b boa oat, so so we must r row t tog ogether... ... 28
Resources • The Centers for Disease Control and Prevention • Coronavirus (COVID-19) • FEMA • Coronavirus (COVID-19) Response • U.S. Department of Health and Human Services • HHS Coronavirus Disease 2019 (COVID-19) Updates Leading Person-Centered Care 29
COVID-19 Coordinated Legislative and Regulatory Response to the Coronavirus Pandemic by the Hospice Community Leading Person-Centered Care 30
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