The onset of flu season is never welcome, but this year's outbreak has been particularly virulent, leaving emergency departments (ED) in many states filled – and in many cases, overflowing.
The "flu is everywhere in the U.S. right now" Dr. Dan Jernigan, director of the influenza division in CDC’s National Center for Immunization and Respiratory Diseases, said in a statement to the media, and is not going away anytime soon.
The surge in patient volume is so bad that in Alabama the governor has called a state of emergency. Some EDs have become so overrun staff are treating patients in recovery rooms and hallways. In California, another hard-hit state, at least one hospital was forced to set up tents outside the ED due to the excess volume.
Aside from the obvious challenge regarding physical capacity, there are ED staffing issues. Even if beds are available, there may not be enough medical staff to care for the patients who need them. Add to that the fact doctors and nurses are not immune to getting sick themselves, and you have a major challenge.
There's also the problem of hospital overcrowding: more patients coming into the ED with the flu mean more are admitted to the hospital. In fact, the CDC reported influenza hospitalizations this flu season are the highest in nearly a decade. One nurse even told Time magazine that almost every patient in her facility had the flu.
Source: Centers for Disease Control and Prevention
And while it can be a sensitive subject, the harsh reality is that the dramatic surge in low-acuity patients like those with the flu puts considerably more strain on already thin financial margins. A report by Moody's Investors Service (as reported by Becker’s Hospital Review) cites the fact reimbursement for flu-related services often fail to cover the cost of treatment.
While we don't always know how bad the flu season will be in a given year, we do know there will be some escalation in the number of patients visiting the ED, which means hospitals need to prepare for the inevitable.
“We’ve developed systems to help mitigate the toll that the flu season can exert on a hospital’s resources, but it's a burden on everyone when we have a season this bad,” Dr. Stephen Nichols, Schumacher Clinical Partners (SCP) Chief Medical Officer, said. “It’s important that as a true clinical partner, we recognize the impact something like a severe flu season can have on our teams and do what we can to help.”
How are we addressing these specific needs? Three areas, in particular, are worth noting: surge planning, alignment between your ED providers and hospitalists, and innovative communication.
One step we take when working with all new clients is to build in surge staffing plans to address the need for increased coverage at certain times of the year whenever possible. We collect data over a 12- to 24-month period looking at peaks and valleys in the average daily census to see the busy times and analyze the factors involved. We then ensure we have appropriate staffing contingency plans during those periods.
Having a surge plan reduces our reliance on locums and places less impact on providers, both of which have a financial impact and adversely affect the time a physician has to take care of patients, as well as increases the level of stress and fatigue on hard-working caregivers.
An issue like a flu epidemic can create a lot of disruption in your facility. If your EM and HM programs are aligned, you should have little trouble with providers working together to properly address volume changes and patient flow. With better collaboration, both teams can be acutely aware of, and prepared for, any staffing issues and volume surges. Having predetermined joint process standards and shared goals between your EM and HM providers could increase the willingness to offer mutually beneficial assistance during times of crisis.
Hospitals are extremely busy during flu season, making it harder for doctors to chart patient encounters as efficiently and thoroughly as possible. If charting is incomplete (and it sometimes is in such circumstances), it affects billing and coding, leading to reimbursement delays and denials.
That’s where our Provider Portal — a central hub SCP providers have access to at their fingertips — plays a vital role. Using the portal, our billing and coding specialists can flag charts for review and notify doctors regarding those needing attention. The portal also serves as a messaging center to pass along critical information quickly — an especially important feature during this flu season.
In addition, our newly introduced mobile app, mySCP, gives current providers an instant, secure communication platform to address scheduling changes, shift questions, important alerts, or other one-to-one or group broadcast messaging needs.
The flu season is upon us in full force, and if CDC estimates are correct, it’s not abating anytime soon. The best hospitals can do is weather the storm until it passes (they will and it will), and make sure their teams are accurately prepared for whatever the next season may bring.
Contact us to learn about the many ways Schumacher Clinical Partners can help your hospital manage its EM and HM services this flu season and throughout the year.