Modern Practice Podcast

In this re-air of our two-part, award-winning podcast series, we discuss how physical violence in the healthcare workplace is on the rise. Healthcare workers are more in danger of violence than are police officers or prison guards. Looking at the labor force in general, healthcare workers have five times the likelihood of facing violence than workers across all other industries. And that doesn’t include the verbal abuse. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. On this episode, Tomas and Cecilia finish their discussion with some helpful tips. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem Show Notes: [01:10] Influences and attitudes from culture/media [02:45] The pandemic factor; example from CoxHealth [04:45] Prevalence of incivility [06:23] Paying attention to the signs; observation skills to use; actions to take [09:30] Give the situation the same importance that patients and families give it [10:16] Tools clinicians can use – Marpe’s role in alleviating violence [12:05] A symptom of the healthcare crisis Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Cruz’s email: ceciliacruz@marpejourney.com Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn MARPE, LLC website: https://www.marpejourney.com/ Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Hermes award-winner! In a special re-air of this award-winning episode, we discuss how the hospital is increasingly becoming a hostile environment, with clinicians facing verbal abuse and physical violence from patients and their families. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. If calming hostilities is not possible, they need to know what to do in the face of violent confrontation. Tomas discusses patient hostility with a leading expert on the topic. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem Show Notes: [02:15] Patient hostility on the rise [03:16] Verbal violence is most prevalent, and the most unreported [04:05] Cleveland Clinic: violence four times more prevalent in health care [04:40] Health care workers more exposed than prison guards and police officers [05:12] Higher risk of assaults for nurses [05:59] Biggest risk in high-acuity settings – ambulances, EDs, ICUs, psych units [06:44] Reasons/origins [09:25] Patient families as source of conflict Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Cruz’s email: ceciliacruz@marpejourney.com Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn MARPE, LLC website: https://www.marpejourney.com/ Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

This episode of our award-winning podcast finishes our discussion on the state of research today. Despite proven benefits, enrollment in clinical trials is sparse across the country, but participation can positively impact patients and organizations alike. Two experts in research lay out all the facts. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Performance Improvement Consulting Vizient Guests: Dylan Steen, MD, MS Chief Executive Officer and Co-founder High Enroll Cardiologist, UC Health Adjunct Associate Professor, UC College of Medicine Daniel Flora, MD, PharmD Medical Director, Oncology Research Hematologist/Oncologist St. Elizabeth Healthcare Show Notes: [01:32] Market research at St. Elizabeth Healthcare [02:58] Benefits and advantages of clinical research to practices and organizations [04:50] Background for High Enroll and the program’s value: opportunities offered [06:20] Getting High Enroll started [08:39] Vision for research at St. Elizabeth Healthcare – approaching a cure Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Steen’s email: steendy@gmail.com Dr. Flora’s email: daniel.flora@stelizabeth.com High Enroll website: https://www.highenroll.org (513) 993-0330 Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Despite proven benefits, enrollment in clinical trials is sparse across the country. This episode of our award-winning podcast continues our discussion on the state of research today and how participation can positively impact patients and organizations alike. Two experts in research lay out all the facts. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Performance Improvement Consulting Vizient Guests: Dylan Steen, MD, MS Chief Executive Officer and Co-founder High Enroll Cardiologist, UC Health Adjunct Associate Professor, UC College of Medicine Daniel Flora, MD, PharmD Medical Director, Oncology Research Hematologist/Oncologist St. Elizabeth Healthcare Show Notes: [01:31] Lack of inclusivity in trials – need for “real-world” participants [04:05] Research organizations give standard of care that is lacking elsewhere [04:50] Background for High Enroll and the program’s value: opportunities offered [07:40] Latest generation of technology and information availability [08:20] Improvement over other research sites (such as clinicaltrials.gov) Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Steen’s email: steendy@gmail.com Dr. Flora’s email: daniel.flora@stelizabeth.com High Enroll website: https://www.highenroll.org (513) 993-0330 Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

The truth is: patients enrolled in clinical trials fare better than patients who are not. Participating in research can be a boon to a practice or organization and its patients. Yet, enrollment in clinical trials is still sparse across the country and part of the reason is organizations don’t realize the value research can bring. On the next three episodes of this award-winning podcast, two experts in research lay out the benefits in participating in clinical trials. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Performance Improvement Consulting Vizient Guests: Dylan Steen, MD, MS Chief Executive Officer and Co-founder High Enroll Cardiologist, UC Health Adjunct Associate Professor, UC College of Medicine Daniel Flora, MD, PharmD Medical Director, Oncology Research Hematologist/Oncologist St. Elizabeth Healthcare Show Notes: [02:16] Research marketing [03:20] Background: how High Enroll got started [04:05] Number one problem in research [05:20] Problem is still unsolved [07:07] Need for cancer research at community level [08:18] Look at research as a valuable product for the organization/practice [09:03] Moving medicine forward: the value of clinical trials to the patient [09:52] How to boost research participants for an organization Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Steen’s email: steendy@gmail.com Dr. Flora’s email: daniel.flora@stelizabeth.com High Enroll website: https://www.highenroll.org (513) 993-0330 Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this episode of our award-winning podcast, we continue discussing the impact and benefits of the latest generation of single-use endoscopes, which promise a revolutionary role in surgery. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Performance Improvement Consulting Vizient Guest: Andrew Bruenderman, MHA Category Manager Surgical Services Vizient Show Notes: [00:44] Circumstances calling for single-use scopes [03:19] Financial considerations [04:37] ROI possibilities [06:05] Environmental impact [07:17] Final thoughts to consider Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Andrew’s email: andrew.bruenderman@vizientinc.com Vizient TechWatch article on single-use ureteroscopes: Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

The latest generation of single-use endoscopes promises a revolutionary role in surgery. On this episode of our award-winning podcast, we discuss the impact and benefits of single-use ureteroscopes. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Performance Improvement Consulting Vizient Guest: Andrew Bruenderman, MHA Category Manager Surgical Services Vizient Show Notes: [01:48] Early models were lacking; new models are advanced and improved [02:49] Cross-contamination and adverse events from multiuse scopes [04:15] Safety approaches with single-use scopes [05:21] Wave of the future? [06:20] Shelf life of single-use ureteroscopes and associated efficiencies [07:37] Problems with early models may cause reluctance to use later models Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Andrew’s email: andrew.bruenderman@vizientinc.com Vizient TechWatch article on single-use ureteroscopes: Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this episode, we finish the discussion about the challenges and issues involving documenting elective surgeries in order to improve care and maximize reimbursement. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Improvement Vizient Show Notes: [00:37] Anticoagulation – often overlooked in documentation [01:30] PSI 9 [02:20] Thrombocytopenia [03:57] Antiplatelets and elective surgeries [05:56] Every PSI reported means money lost to the practice Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com “Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

This episode continues the series on challenges and issues involving correctly documenting elective surgeries. A leading expert provides practical guidance and considerations that enable you to be correct in documenting these patients in order to improve care and maximize reimbursement. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Improvement Vizient Show Notes: [00:34] Dealing with preoperative infections [01:56] Percentage of elective surgery patients who develop sepsis—with 25% mortality [03:45] Accurately coding to avoid a PSI 13 being charged to your practice/organization [05:34] Do not miss a Present on Admission case [07:30] Need for CDI specialists to collaborate with quality (the “dotted line”) [08:50] Issues around PSI 7 Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com “Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Elective surgeries are on the rise again following a downswing during the COVID era. Yet, with this rise in these procedures, there are challenges and issues involving correctly documenting elective surgeries that practices and organizations need to consider and address. On this episode, a leading expert on clinical documentation covers this difficult area. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Improvement Vizient Show Notes: [01:21] Planned surgeries [02:26] Five most common elective surgeries and who has them [04:15] Why elective surgeries are unique [05:44] What you need to document – examples [09:13] Obesity and documentation—capturing a CC Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

A safe culture is a key factor in developing a highly reliable organization, or HRO, and ensuring a healthy workplace. It means fostering psychological safety in that culture. On this episode, we continue our discussion on psychological safety and a healthy workplace. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Kristina Kelada, PHR, CHRE, CHRS Associate Principal, Reliability and Management Systems Vizient Elizabeth Mack, MD, MS Principal, Reliability and Management Systems Vizient Show Notes: [00:47] Psych safety and fostering recruitment and retention [03:33] What to do to develop safety in the workplace [04:35] Culture of safety and return on investment: what the data shows [06:17] Bad culture: a “thief in the night” [09:09] Design systems that make sense for patients and families Links | Resources: How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Mack’s email: elizabeth.mack@vizientinc.com Kristina Kelada’s email: kristina.kelada@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

A healthy culture is a key factor in developing a highly reliable organization, or HRO. For a culture to be healthy depends on the existence of psychological safety in that culture. In this new series of our award-winning podcast, we discuss how to develop a healthy workplace as we continue our examination of HROs and the practices that lead to them. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Kristina Kelada, PHR, CHRE, CHRS Associate Principal, Reliability and Management Systems Vizient Elizabeth Mack, MD, MS Principal, Reliability and Management Systems Vizient Show Notes: [02:28] Importance of building a culture on trust and respect [03:38] Psych safety defined [05:30] It is dangerous when employees are quiet [07:18] How to know you have psych safety in your practice [09:19] What leaders can do [10:14] We’re in healthcare, for goodness sakes! Links | Resources: How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Mack’s email: elizabeth.mack@vizientinc.com Kristina Kelada’s email: kristina.kelada@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this episode, we continue our discussion about the need to provide a transition for advanced practice providers (APPs – nurse practitioners, physician assistants) from the academic setting to clinical practice, similar to the residencies and fellowships provided to physicians. You’ll learn how this transition can be a huge benefit to your practice or organization. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guest: Christen Hunt, DNP, FNP-C, CPNP-AC Associate Vice President, Workforce Consulting Vizient Show Notes: [00:41] Fitting organizational needs – no cookie-cutter [02:25] Provide a safe space; provide what the organization needs [03:37] Not a burden but an opportunity [04:42] Bringing APPs fully into the organization for greater productivity [05:51] Example: ROI and a cost avoidance of over $2 million [06:52] More ROI examples Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Christen Hunt’s email: christen.hunt@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Advanced Practice Providers, or APPs, have taken on an increasingly important role in patient care over the years. Comprised of nurse practitioners and physician assistants, APPs receive advanced education and clinical training for performing a wide range of care services, many of which were traditionally carried out by physicians. Yet, there are no residencies or fellowships to transition APPs from the academic to the clinical realm. On the next two episodes, this award-winning podcast examines how organizations and practices can address this gap. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guest: Christen Hunt, DNP, FNP-C, CPNP-AC Associate Vice President, Workforce Consulting Vizient Show Notes: [02:02] Residencies and fellowships and what they mean for APPs [04:41] APPs and orientation – need for a deeper dive [05:13] Growth of APP positions and necessity for new care models [06:44] Fostering the business side of healthcare [07:14] Integrating APPs into the team [08:13] Bringing APPs into the culture Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Christen Hunt’s email: christen.hunt@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this final episode of a three-part series, Tomas finishes his discussion with two experts on high-reliability organizations who examine the crucial role of learning areas in the success of top performers. High-performing organizations take care of not only their patients but their staff and indeed enable staff to be at their best. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Suzanne Miller, MSN, RN Senior Consulting Director, Reliability and Management Systems Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [00:54] Need for change-ready units in the organization [01:32] Overcome the perception “this is one more thing” [03:17] Example: skeptical ICU nurse – “This is going to fail” [04:56] Taking a phased approach [05:37] Measuring success of learning areas: the benchmarks to use 06:22] Excited staff members Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this episode, Tomas continues his discussion with two expert guests about learning areas and how they are proving effective and essential in developing high-reliability organizations. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Suzanne Miller, MSN, RN Senior Consulting Director, Reliability and Management Systems Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [00:41] Who engages in learning areas? [03:17] A flood of kudos in the ED – an example of lifting morale [05:10] Team participation in barcode scanning – an example of improving compliance [07:02] A resource for senior leaders [07:55] A safety concern that, once identified, was quickly corrected [08:44] Real-time nature of rounding and issue resolution Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Learning areas have become an effective aspect of high-reliability organizations in healthcare. Employing floor or departmental huddles as the focal point for these learning areas, the experience of the huddles has been augmented and reinforced by bulletin boards and whiteboards. Even more effective is the newest wrinkle in the experience – LENS (Learning & Engagement System) boards, which are dynamic, digitally-based visual boards that can transmit messaging on a 24/7 basis in a designated learning area. On the next three episodes, Tomas discusses learning areas with two expert guests, who will share the rationale behind them and how to make them work for you. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient Guests: Suzanne Miller, MSN, RN Senior Consulting Director, Reliability and Management Systems Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [01:58] Developing and sustaining learning areas [03:02] Elements employed in a learning area [05:00] The cornerstone of high reliability [06:07] The visual management role [07:37] Advantages of the LENS board [09:07] Selecting a unit to be a learning area Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

This episode finishes our discussion on how organizations can tackle persistent quality, safety and workplace challenges on the way to becoming high reliability organizations (HROs). Tomas engages with two expert guests on what constitutes an HRO and how to make that journey to better performance. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient Guests: Allan Frankel, MD Executive Principal, Safe and Reliable Healthcare Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [00:42] Dealing with burnout [02:51] Culture and high reliability [05:06] Assessing organizations [08:25] Just Culture Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Allan’s email: allan.frankel@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

On this episode, we continue our discussion on how organizations can tackle persistent quality, safety and workplace challenges on the way to becoming high reliability organizations (HROs). Tomas discusses with two expert guests on what constitutes an HRO and how to make that journey to better performance. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient Guests: Allan Frankel, MD Executive Principal, Safe and Reliable Healthcare Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [00:46] Areas to address and challenges to meet [01:52] Examples of challenges to high reliability [03:47] Complex processes that can undermine reliability [05:20] Sustaining improvement [07:49] Vizient’s Safe and Reliable Healthcare: a force multiplier [11:41] Burnout Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Allan’s email: allan.frankel@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed

Reducing patient harm, team burnout and waste in healthcare requires organizations to tackle persistent quality, safety and workplace challenges. This work is what leads to becoming a high reliability organization (HRO). On the next three episodes, Tomas discusses with two expert guests on what constitutes an HRO and how to make that journey to better performance. Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient Guests: Allan Frankel, MD Executive Principal, Safe and Reliable Healthcare Vizient Katerie Chapman, MHA Senior Principal, Safe and Reliable Healthcare Vizient Show Notes: [02:37] High reliability defined five key practices [06:22] Origins of high reliability [07:49] Combining complexity and human cognition Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site Click here Allan’s email: allan.frankel@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com Subscribe Today! Apple Podcasts Amazon Podcasts Android Google Podcasts Spotify RSS Feed