eFocus – February 2022
Welcome to eFocus. Our goal is to provide you with timely, informative and useful short summaries and links about UM UCH related news, issues, or events. Feel free to contact us if you have news to share, story ideas or any other feedback. As always, your comments are welcome.
eFocus, February 2022 topics include:
- Welcome Message
- COVID Updates
- Safety Updates
- Wellness Updates
- Upcoming Meetings and Events
February will be the month that we begin the repair and recovery from this past winter's COVID surge. The UM UCH team has performed valiantly and I could not be more proud of how everyone has come together to care for our community. Our COVID volume continues to decline and HMH has now transitioned out of Crisis Standards of Care (UCMC will likely do the same on Wednesday, Feb. 9). We are also opening back up for elective surgeries at both campuses on February 7.
We need to be purposeful in helping our teams recover from the stress and burnout. Making sure we consistently provide EAP resources and referral to the support line are some tools. We cannot lose sight that as the COVID crisis abates, our staffing crisis will persist and we will have to remain in a state of readiness for COVID. Outpatient COVID therapeutic options are now available; please check out the summary below in Dr. Leo's COVID Corner, article 13, which features a great "Numbers to Treat" table.
Lastly, we must ensure that we garner the valuable lessons learned from this past COVID surge and optimize initiatives related to the PACE center and "One Day Earlier" discharges. The acts of courage, teamwork and dedication displayed by the UM UCH will propel us to future success. Thank you for all that you have done and will continue to do for our patients and community. Enjoy this month's eFocus and Happy Valentine's Day!Fermin Barrueto, Jr., M.D., M.B.A.
Senior Vice President/CMO
Medical Staff Affairs
Reopening of Operating Rooms: After reviewing the data related to staffing, ICU/IMC trends, ventilators, ED boarders and other operational metrics and trends, it was decided collectively to begin reopening our operating rooms February 7. What this means is the following:
- The PACU will stop admitting medical IMC/ICU/MS patients/boarders to the SAU and PACU leading up to Feb 7 (date determined by Ops/PACE)
- Perioperative Services will return to standard staffing (OR will not surge as helping hands; PACU will schedule only 2 RNs per night and will close 7p Sat to 7p Sun with on call staffing only)
- The OR will open 8 ORs plus 1 GI suite Mon thru Friday; 1 OR Saturday and Sundays with 1 additional team on call for emergencies
- We will resume all outpatient surgeries at UCMC and HMH
- TBAs (To be admitted) will be capped at 4 scheduled per day at UCMC (we will continue to do add on TBAs from the ED 2-4/patients per day) utilizing the same prioritization criteria
- The PACU will continue to hold/board 2-3 surgery patients per night in PACU primarily focusing on 23 hours stay patients
- Anesthesiologist providers will no longer support ICU and ED
Understand this is still a ramp up period. As the situation improves we will regularly re-evaluate the TBA cap and depending on staffing will open more OR rooms.
New Director of Pharmacy: Please join us in welcoming Jennifer Majchrzak as the new Director for UM UCH Pharmacy. Jennifer joins us from the Johns Hopkins Hospital as its Pediatric Operations Manager, with over 13 years pharmacy experience. Jennifer holds her Doctorate of Pharmacy from University of Maryland School of Pharmacy, and is completing her MBA from the Johns Hopkins Carey Business School. She has a wealth of knowledge and leadership experience regarding pharmacy and pediatric pharmacy operations. Jennifer has also co-authored several publications and presentations on pharmacy safety throughout her career and lives in Bel Air with her family. She will be making introductions to the UM UCH leadership and will also be orienting with UMMS Pharmacy leads.
Construction Updates: Check out our latest construction and expansion progress on our Bel Air and Aberdeen campuses.
Transition out of Crisis Standards of Care: Effective February 4, UM HMH is no longer operating under CSC. As with the decision to implement, the decision to rescind CSC was made following a thorough and thoughtful evaluation of our hospital operations. Our Hospital Incident Command Structure (HICS) has been regularly reviewing metrics—such as patient volumes, staffing and bed capacity—and after a sustained period, we are confident that UM HMH no longer fulfills the requirements to operate under CSC. The triggers presently in place to determine the need to implement and subsequently rescind CSC were established by the University of Maryland Medical System (UMMS) in collaboration with our colleagues at Johns Hopkins Medicine. These criteria are broadly supported by the state and the Maryland Hospital Association (MHA), and are in use at other hospitals within our System and statewide. We expect UCMC to transition out of CSC on Wednesday, February 9. For our UM HMH care teams, this means we will be removing some of the processes put in place over the past several weeks. Some changes we will be making include:
- Improving nurse-to-patient ratios
- Resuming non-emergent surgeries on Monday, February 7
- Removing the COVID-19 medical tent outside UM HMH
- Ending Shared Services redeployment efforts today
- Reducing team member COVID-19 testing to three days a week and vaccinations to one day a week—all centralized at UM Upper Chesapeake Medical Center (UM UCMC)
Dr. Leo's COVID Corner: View this month's full library of articles and resources HERE. Of particular interest is article 13 which includes the numbers needed to treat (NNT) outpatient therapies for COVID. Other topics include: effectiveness of third dose of mRNA vaccine; clinical outcomes of patients one year after ICU treatment for COVID; and trends in disease severity during Omicron.
Journey to Zero Harm: Below is the current Infection Prevention healthcare-associated infection (HAI) graph. The IP Team continues to round, educate and work to assure our team members are knowledgeable about Infection Prevention basics and the bundle-best practices to target prevention of specific HAIs. If you have any question, concerns or needs, please reach out!
The Giraffe Newsletter: eFocus will now share the monthly edition of the patient safety newsletter, the Giraffe. Why "Giraffe"? Because giraffes have their heads above the trees when they eat; it's also when they are most vulnerable so they can see what's going on around them. It reminds us in healthcare that we need to see the forest and not the trees. Check out the latest issue here!
Physician Support Line: The Physician Support Line is a free, confidential peer support line staffed by volunteer psychiatrists helping physician colleagues navigate the many intersections of their personal and professional lives. For support, please call 1-888-409-0141, 7 days a week, from 8 a.m. to 1 a.m. EST. You can also visit www.physiciansupportline.com to learn more.
EAP Virtual Orientations: BHS, our Employee Assistance Program (EAP), will hold 15-minute virtual orientation sessions. BHS offers a confidential counseling and referral program for team members and household members.
Mark your calendars for important standing meetings and special events.
- Multidisciplinary Thoracic and General Conferences: 12 Noon, Alternates Every Thursday (e.g., Thoracic is 11/3, General is 11/10)
UM UCMC, KCC Streett Conference Room
- Multidisciplinary Breast Conference: 8 a.m., Every Tuesday
Radiology/Oncology Conference Room
- Pharmacy &Therapeutics (P & T) Committee: 7:30 a.m., Third Tuesday of each month
UM UCMC Maryland Room
- Credentials Committee: 7:30 - 9 a.m., First Friday of each month
UM UCMC, MSCR
- Medical Staff Leadership: 8 - 9 a.m., Fourth Thursday of each month
UM UCMC, Fallston Room/UM HMH, MSCR
Metabolic Bariatric Surgery Committee: 5 p.m., Quarterly, Wednesdays
HMH MSCR and UCMC Fallston Room
Advanced Practice Providers (APP) Review Committee: First Tuesday of each month