The practice of medicine has seen a wide array of challenges over the last two years. As a thought leader and expert when it comes to health care in the region, what is your outlook for the future of the healthcare system as we move into the second half of 2022?
CLAUSEN: Like many leaders, I am focused on exceeding the expectations of our Kaiser Permanente members and achieving high quality outcomes for the communities we serve. However, as the COVID-19 virus is still surging in parts of the world and the US, our future is not fully predictable. Therefore, I anticipate we will still see patients with a higher acuity entering hospitals. Based on the lessons learned from the pandemic, we must remain ready to pivot to meet the needs of our patients who will continue to seek and demand care when and where they want it.
MAYES: The outlook for the future of the healthcare system has many opportunities for growth and expansion of service lines. One clinical area of need within the patient community is services to support mental health issues from the acute hospital to outpatient and community-based programs.
What are the strategic goals of hospitals and health systems post-COVID-19?
CLAUSEN: When listing the strategic goals for both hospitals and health systems post COVID-19, we must first meet consumer expectations and make care convenient and easy to access. Next, we must remember to foster healthier communities by driving equitable health outcomes and delivering superior quality. We must renew our focus on technological advancements while remaining affordable for our members. Finally, we need to implement a people strategy which includes among other things a focus on equity, diversity and inclusion. What steps are clinics and hospitals taking to ensure
‘The outlook for the future of the healthcare system has many opportunities for growth and expansion of service lines.’
CLAUSEN: When it comes to patient safety, we are using a TeamSTEPPS approach, which fosters staff/physician engagement to ensure patient safety. This is an organized program that promotes communication and teamwork among all healthcare providers. We also evaluate the number of staff and hire different disciplines identified to fulfill care needs. Lastly, competency assessment and ongoing training are key to promoting patient safety.
How dramatically have the healthcare business and operational landscapes changed in the wake of the COVID-19 pandemic?
MAYES: Hospitals are still in recovery mode from the height of the pandemic. The most significant operational and financial impact is the staffing shortage. During the pandemic, 84% of our staff was out sick. Temporary staffing agencies increased their rates up to 300 400%. Many agencies still have their temporary staffing rates as high as they were during 2020-2021. Because of the pandemic, many healthcare workers resigned from nursing, which is causing a decrease in the staffing pool.
CLAUSEN: The COVID-19 pandemic has served as a disruptor to the healthcare and operational landscapes. Every healthcare business has been affected, with the majority trying to navigate through continual changes. In addition, the stresses on healthcare workers remains very real. Workforce challenges are vast as staff resign, resulting in an overall shortage of staff as the more experienced workers look for new opportunities. Supply chain limitations remain and we are constantly looking for ways to locate substitute supplies when necessary. A strain has been put on financial viability for many businesses as well. I anticipate we will see more health systems failing to recover from the financial impact, leading to an economic void for patients that live in those areas. On the bright side, the result of many operational changes paved the way for a time of quick innovation. We have learned to approve new processes and implement more digital solutions that will be useful moving forward. The pandemic has also given us an opportunity to encourage cross functional collaboration with other sectors to resolve future disruptions.
Will outpatient care continue to trend upwards?
CLAUSEN: Yes, ambulatory practices, home health and remote patient monitoring are all areas that we see growing. Today we perform many procedures safely in the outpatient settings that once required hospitalization. Now that we know what we know, what can the healthcare sector do to better prepare for a potential future crisis?
CLAUSEN: In the future, with hospitals seeing higher acuity patients, we may experience a need for fewer hospital beds. Therefore, a focus on the ambulatory arena should be embraced. By shifting to ambulatory surgery centers and the like, many procedures can be done as an outpatient service, thus decreasing the need for long hospital stays. Simultaneously, we must modify the training of our workforce, so there are always care teams in the pipeline available to work in the community and ambulatory settings. Finally, we need to keep performing environmental scans and pursue community health initiatives to remove disparities.
MAYES: We have survived through the worst of the pandemic in 2020-2021. As a result, hospitals now have mitigation plans in place to promote early preparation, and assertive implementation of strategies to position themselves to be over-prepared for the next COVID-19 upsurge or any other type of mass emergency. Telehealth is transforming care delivery. Are there specific practices, protocols or innovations developing that can eliminate barriers to care?
CLAUSEN: Throughout the pandemic a rise in telehealth usage, especially televisits for behavioral health, was noted and continues to eliminate barriers to delivering care. Televisits for primary care and many specialty services (which do not require an examination of the patient) also continues. By utilizing remote patient monitoring and teleradiology we are able to monitor, report, and analyze a patient’s acute or chronic conditions from outside the hospital or clinic setting. This gives us the possibility for a real time understanding of our patient’s disease state, affording us the opportunity to make proactive clinical decisions. How is digital innovation revolutionizing healthcare?
CLAUSEN: Digital innovation in the health field is constantly changing. There are a multitude of apps and devices in place currently, with more on the horizon. We are capable of offering many services through digital innovation, and looking at ways for patients who choose to use digital platforms to have access to care at their fingertips.
For many years we’ve been hearing how data and analytics can improve the quality of patient care. In your view, how is data being used to improve health and prevent people from getting seriously ill?
CLAUSEN: Currently we are using cognitive computing algorithms. When the algorithms are applied properly to data, we are able to predict future, geo data, community level data, wrap around services and much more. What are some of the issues you feel may have been overlooked while we were battling the pandemic over the last two years?
MAYES: The federal stimulus funding for small to medium-sized hospital providers was not at the same level of support that was distributed to much larger hospitals and health systems. Unfortunately, the calculation created to decide distribution of available stimulus funds favored the larger hospitals rather than the small to medium – and even the always struggling safety net hospitals. Safety net hospitals are essential and vital healthcare service providers to the communities they serve, as these communities tend to provide care for the underserved or disenfranchised population. As president/CEO, I have been actively in constant communication with our local legislators at the city council, assembly, senate, and congress levels. Gratefully, we have received the backing and support of our local officials to advocate for hospital providers and to ensure that we are prioritizing the public’s healthcare needs. Our strong political relationships have played a significant role in the support of our safety net hospital, Pacifica Hospital of the Valley.
Are wellness programs worthwhile investments for employers in 2022?
CLAUSEN: Yes, while the pandemic has affected everyone differently— no one has escaped it. Prioritizing the well-being of our workforce leads to increased staff retention and ultimately, better health outcomes all around. With the increase of remote workers, a wellness program will also assist with employee engagement. Implementing health risk assessment and biometric screening drive programs will help colleagues identify and monitor health conditions. Some examples are diabetes prevention, healthy back, healthy joints and other programs. What is your organization doing to ensure we close the health equity gap in our communities?
CLAUSEN: We continue to offer community programs that focus on diabetes, blood pressure, and vaccinations in areas where there is a high need. We are working on closing disparities for those with mental health issues — focusing on equity, diversity and inclusion with any group that has barriers to care, such as using digital platforms to reach populations that have challenges with transportation.
‘We must remain ready to pivot to meet the needs of
our patients who will continue to seek and demand
care when and where they want it.’
PATRICIA CLAUSEN, RN