Guest blog by Aline Holmes, RN, DNP, Senior Vice President of Clinical Affairs

It’s hard to miss the news reports about Ebola and enterovirus (EV-D68). People are understandably nervous and anxious. But New Jersey residents can rest assured that our hospitals are well prepared to deal with these types of public health threats. In fact, they have been preparing for months, in close cooperation with public health authorities at the Centers for Disease Control and Prevention and the N.J. Department of Health.

Remember that Ebola actually arrived on U.S. soil almost two months ago when Emory Healthcare leaders in Georgia decided to fly in a pair of missionaries who’d gotten ill treating Ebola patients in Africa.

Ebola is not an air-borne disease. It’s spread through fluids – not casual contact – so that helps limit its spread. Here’s how you can protect yourself:

• Wash hands frequently and use an alcohol-based hand sanitizer.
• Avoid contact with blood and body fluids (sweat, vomit, diarrhea, saliva, semen, etc.) of any person, particularly someone who is sick.
• Do not handle items that may have come in contact with an infected person's blood or body fluids.
• Seek medical care immediately if you develop fever and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.

The enterovirus is different; it’s an airborne virus, meaning that it can be transmitted through contact with an infected person or by touching objects or surfaces that are contaminated with the virus and then touching the mouth, nose or eyes.  EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others. Good hand hygiene is your best defense against getting infected with enterovirus:

• Wash hands with soap and water for 20 seconds, especially after changing diapers. Hand sanitizers are not effective against enteroviruses.
• Avoid touching eyes, nose and mouth with unwashed hands.
• Avoid kissing, hugging and sharing cup or eating utensils with people who are sick.
• Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
• Stay home from work or school if you’re sick or running a fever.

Our hospitals and healthcare providers routinely follow precautionary procedures such as wearing gloves, gowns, masks and other protective gear to prevent spreading infections when caring for patients. All of our hospitals are equipped to isolate patients as needed and help prevent a virus from spreading. And all are well primed by public health officials to be on the watch for Ebola and enterovirus D68, based on many factors including a patient’s recent travels.

Our healthcare system is taking these public health emergencies very seriously. Our healthcare professionals know how to recognize these illnesses. And they know how to care for patients infected with them.

 

Senate President Steve Sweeney has toured some of New Jersey’s hospitals this summer to tout the excellence of healthcare in New Jersey. I was gratified, but not surprised. Why? The measurements are in and they are rock solid:

• New Jersey ranks 9th in the nation for the quality of its hospital care by the U.S. Agency for Healthcare Research and Quality.
• In the most recent rankings from U.S. News and World Report, 21 of the top hospitals in the New York Metro region are actually in New Jersey.
• New Jersey boasts 21 hospitals to achieve the prestigious Magnet award for nursing excellence, one of the highest numbers in the nation.
• New Jersey hospitals met or exceeded national averages in 25 of 26 “process of care” measures, according to the Department of Health’s most recent Hospital Performance Report. Those measures assess how well hospitals adhere to best practices across the industry.

New Jersey healthcare leaders devote a lot of time ensuring that they provide quality healthcare to the patients we serve. It’s the right thing to do for the patient. 

I’ve been doing two different tours myself this summer. First, I resolved to meet with every health system leader in New Jersey and every accountable care organization leader. Great things are happening in our state’s healthcare community, and I learn a tremendous amount during these visits. My second tour is a personal health tour, making sure I do the appropriate primary and preventive care visits. So far so good with both tours.

March 2-8 is the national observance of Patient Safety Awareness Week, and I want to mark the occasion by thanking New Jersey’s dedicated healthcare professionals for ensuring the safety and well-being of New Jersey’s patients. Healthcare is the state’s second largest source of jobs, so there are many of you out there whose constant dedication and commitment creates an environment of caring and healing.

Here in New Jersey, we have plenty of reasons to celebrate this week: All of New Jersey’s acute care hospitals have joined the national Partnership for Patients effort, which is dedicated to improving patient safety and providing quality healthcare. As part of this initiative, New Jersey hospitals have made great strides in attacking the number of adverse events that can sometimes complicate a hospital stay. They’ve reduced infection rates, pressure ulcers, pneumonia rates, medication errors and complications during labor and delivery. In addition, New Jersey has one of the nation’s largest number of hospitals to receive the coveted “Magnet” designation for nursing excellence.

To New Jersey’s healthcare professionals: You should take great pride in the work you do each day, providing high quality, compassionate patient care to those in need.

This year’s Patient Safety Awareness Week theme is Navigate Your Health…Safely, reminding us all that providing safe patient care requires our commitment 365 days a year. And patients are an important part of that equation. We encourage you to be engaged in your healthcare: Be active, ask questions, keep notes. It’s all part of the very important partnership between providers and the people they serve.

They say that timing is everything. This seems to be the time to criticize the U.S. Department of Health and Human Services on implementation issues surrounding the Affordable Care Act, but I want to buck that trend. I want to thank HHS and the Centers for Medicare and Medicaid Services for funding  my association for a project that has yielded some very real and tangible results. 

Under the ACA, NJHA was awarded about $7 million for a two-year project to help our hospitals improve quality of care and patient safety. It’s part of the nationwide Partnership for Patients initiative; you can read more about New Jersey’s efforts here. A portion of that federal money was used to help 14 hospitals with a project to work on patient flow and work flow reforms in their operating and emergency departments. We are proud of the results: reduced wait times and shorter hospital stays for patients, reduced operating costs and increased revenues for hospitals. Those results were achieved in a 15-month collaborative between our hospitals and the Boston-based Institute for Healthcare Optimization.

The results show great promise for both improving patient care and reducing long-term healthcare costs. Data from our 14 participating hospitals showed projected summary results of:

• 11,800 to 17,300 additional patients that could be treated without adding inpatient beds or operating rooms
• Roughly 20,000 additional patients that could be accommodated in hospital emergency departments
• 21 percent to 85 percent decrease in wait times for emergency department patients to be admitted to a hospital bed
• Reductions in the length of hospital stays ranging from 3 percent to 47 percent for certain groups of patients.

Those results are based on the collective data from CentraState Medical Center, Cooper University Hospital, HackensackUMC Mountainside, Inspira Health Network Woodbury, Jersey Shore University Medical Center, Monmouth Medical Center, Morristown Medical Center, Newark Beth Israel Medical Center, Ocean Medical Center, Overlook Medical Center, Robert Wood Johnson University Hospital, St. Joseph’s Regional Medical Center, University Hospital and The Valley Hospital.

How’d they do it? Working closely with Eugene Litvak, PhD, a Harvard professor and a specialist in operations management in healthcare, hospitals analyzed the inefficiencies in their operations, which included uneven usage of operating rooms, which led to long waits, overtime costs and cancellation of procedures at peak times. Other problems included bottlenecks in admitting patients to inpatient beds which forced many patients to wait long periods in the emergency department or in post-surgery units.

To address these problems, hospitals redesigned OR space, scheduling and staffing, including the creation of designated blocks for emergency urgent surgeries. Others adopted new standardized discharge processes to increase bed availability. It was a team effort that included both the hospitals’ administrators and managers, but also the physicians who provide care within the hospitals.

This initiative is part of the often-overlooked part of the ACA – the effort to redesign healthcare so that it provides quality care at lower costs. So while I know that people feel strongly about the ACA, both positive and negative, I just want to thank HHS and CMS for funding this important initiative. I also thank our member hospitals and their staffs. A lot of hard work went into it – and now we’ve been rewarded with some truly impressive results.

This week is National Patient Safety Awareness Week – “awareness” being the key word. Because for all the work the healthcare industry has done in the past decade to improve patient safety, it’s you, the individual, who has perhaps the most important role.

Patient safety is a partnership between healthcare professionals and the people they care for. We want you to feel empowered to ask questions and raise concerns with your clinicians. And you hold the key to your own well-being and safety through a healthy diet and exercise, preventive care and managing chronic conditions like diabetes or high blood pressure.

The National Patient Safety Foundation provides resources and information for patients and healthcare consumers to contribute to making healthcare safer. The U.S. Agency for Healthcare Research and Quality also offers a wealth of information, including tips to help patients ask the right questions of their doctor or nurse.

And NJHA’s Institute for Quality and Patient Safety – which recently celebrated its 10th anniversary in working to improve healthcare – has led several initiatives, including statewide efforts to prevent patient falls and reduce infections. In keeping with the “awareness” theme, one of our resources is a medication safety effort called “It’s Your Healthcare: Be Involved,” which helps individuals manage their medications and prevent any unintended drug interactions. You can find out more here, and even download a personal medication safety card.

This year’s observance of Patient Safety Awareness Week officially ends March 10, but the work does not. We encourage you to be a partner with your healthcare provider in promoting safer, better healthcare.