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FAST STATS


NEWSWIRE


The Strategic Marketplace Initiative (SMI) recently conducted a survey of their


provider members to collect key information about the return to elective surgeries as they move into the recovery phase of the COVID-19 pandemic. SMI’s members are


executives from providers and suppliers in the U.S., and their members are on the front lines providing the critical supplies to help combat COVID-19.


90%


of the respondents answered they would be ready to resume elective cases in


May/June, with 10% pushing that timeframe out to August.


100%


selected orthopedic surgery #1 of the top 5 specialties they would start fi rst, with cardiothoracic surgery #2 at 90%, and general surgery #3 at 70%.


70%


said they would resume elective procedures in their ambulatory surgery center and their hospital simultaneously.


10%


anticipated resuming elective procedures in their ambulatory surgery center before starting procedures in the hospital.


75 TO 100%


of hospitals who responded anticipate a gradual ramp-up in elective procedure volume, with volumes approaching or exceeding their pre-COVID-19 baseline by early 2021.


75%


of hospitals anticipate return to baseline capital expenditure in 12 to 24 months. Capital investment in equipment has taken a signifi cant downturn during the COVID crisis and the ramp-up to full capital spending will be slow.


You can fi nd the results in the SMI COVID-19 Toolkit at SMI: https://www.smisupplychain.com/tools


6


SHEA outlines legal considerations for antibiotic stewardship The Society for Healthcare Epidemiology of America (SHEA) released a white paper outlining strategies for documenting the recommendations of antibiotic steward- ship programs (ASP) and clarifying the stewardship team’s role in patient care from a legal and quality improvement standpoint. The white paper, titled “Legal Implications of Antibiotic Stewardship Programs,” was published in the journal, Infection Control and Hospital Epidemiology. “Antibiotic stewardship has become


a critical tool for healthcare systems to slow the emergence of antibiotic resistant bacteria and to improve patient outcomes and safety,” said Keith Hamilton, MD, a member of the SHEA Antimicrobial Stewardship Committee and author of the white paper. “However, it is important to address the legal implications of antibi- otic stewardship programs, particularly around concerns about professional li- ability stewards may have to patients that they do not see or examine with the goal of disseminating best practices and reinforcing the essential roles that these programs play in all healthcare settings.” The paper provides strategies to ad- dress common concerns and perceptions surrounding the legal implications of stewardship programs with the goal of improving the structure and function of the programs, as well as the benefi ts they provide to patients and patient care. The guidance, based on expert con- sensus and a review of case law, ad- dresses documentation, clinical training of stewardship program personnel, tele- stewardship, the use of clinical practice guidelines, and antibiotic stop orders. The authors surveyed SHEA members about concerns around the structure of antibiotic stewardship programs, interventions, and documentation to ensure the guidance refl ected realities and concerns from the fi eld.


While there have been no specifi c law-


suits fi led involving AP, the authors note three important components that should be included in hospitals’ programs to reduce liability and further advance the goals of ASP strategies.


1. Protocols to communicate and resolve differences with treating teams or other stakeholders to help achieve agree- ment on treatment strategy whenever possible.


2. Documentation practices in electronic health records to provide the basis of recommendations as well as preserve the record of ASP involvement.


June 2020 • HEALTHCARE PURCHASING NEWS • hpnonline.com


3. Standards for credentialing ASP team members based on experience or formal training to ensure team member roles are aligned with expertise, licensure, and scope of practice regulations. Visit Shea-online.org for the paper.


Stroke evaluations drop by nearly 40% during COVID-19 pandemic


The number of people evaluated for signs of stroke at U.S. hospitals has dropped by nearly 40% during the COVID-19 pandemic, according to a study led by researchers from Washington University School of Medicine in St. Louis who ana- lyzed stroke evaluations at more than 800 hospitals across 49 states and the District of Columbia. he fi ndings, published in The New England Journal of Medicine, are a troubling indication that many people who experience strokes may not be seeking potentially life-saving medical care. “Our stroke team has maintained full


capacity to provide emergency stroke treat- ment at all times, even during the height of the pandemic,” said lead author Akash Kansagra, MD, an assistant professor of radiology at Washington University’s Mallinckrodt Institute of Radiology (MIR). Kansagra sees stroke patients at Barnes- Jewish Hospital. “Nevertheless, we have seen a smaller number of stroke patients coming to the hospital and some patients arriving at the hospital after a considerable delay. It is absolutely heartbreaking to meet a patient who might have recovered from a stroke but, for whatever reason, waited too long to seek treatment.”


Nearly 800,000 people in the U.S. experi-


ence a stroke every year. It is the fi fth lead- ing cause of death and the leading cause of long-term disability. With advances in stroke care such as better diagnostic tools, surgeries to remove blood clots or repair broken blood vessels, and clot-busting drugs, people have a better chance of recovering from a stroke today than ever before – as long as they receive treatment promptly. Clot-busting drugs are generally safe only within 4½ hours of symptom on- set, and surgeries are only possible within 24 hours of symptom onset. The earlier the treatment is started, the more successful it is likely to be.


Worried by the low numbers of stroke patients being evaluated at Barnes-Jewish Hospital and hearing similar reports from colleagues at other institutions, Kansagra – along with co-authors Manu Goyal, MD, a Washington University assistant professor of radiology and neurology, and statisti- cian Scott Hamilton, PhD, and neurologist Gregory Albers, MD, both of Stanford Uni-


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