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Saturday, January 23, 2021
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Compassion and innovation in the workplace

Cardiology   Patient Care   Innovation  Staffing Grids

Today’s Read: 3.5 minutes

Today we explore how we can innovate more, how we can help bring patients relief, and how NPs and PAs contribute to the productivity of the emergency department. Plus, Florence Health is making some news of our own.

We’re starting a rewards program. If you really enjoy The Daily Huddle and want to share it with your colleagues, we want to thank you for doing so.

At the bottom of every newsletter, you’ll find a personalized link to recommend the newsletter to your friends and colleagues. The more people who subscribe, the more goodies for you. Here’s what’s awaiting you based on the number of people who subscribe:

  • 3 → A mention in The Daily Huddle Editor’s note
  • 5 → A Florence Health face mask
  • 10 → A Florence Health travel mug
  • 25 → Sleep kit with eye mask, ear plugs, and aromatherapy
  • 50 → Care basket for your team (or not, up to you) 
  • 100 → $100 gift card
  • 1000 → We’ll send you to a US-based medical conference of your choice

MORNING BRIEF

Innovate! The mind trick that will help spark ideas

The world of nursing is changing, and the ways to solve the problems that the pandemic has revealed in public health, nursing, and patient care will be to create new processes and tools. The best way for you to participate in this brave new world is to set your brain up to think differently. Drawing upon and integrating seemingly contrasting areas of knowledge, such as the arts and the sciences, is critical for generating effective, innovative solutions to tackle local and global problems, suggests a study published in Organizational Behavior and Human Decision Processes.

This integrative thinking comes from having a growth mindset of interest, which means that you believe that interests can be developed and cultivated. Find out three ways to cultivate a growth mindset of interest, and start innovating today.

The impact of PAs and NPs on emergency department productivity

Using national emergency medicine group data, researchers assessed the relationship between advance practice provider (APP) coverage and outcomes on productivity, workflow, safety, and experience to determine how they impacted emergency departments.

There were 13.02 million patient visits in 105,863 ED‐days across 94 EDs from 2014 to 2018. Nurse practitioners and physician assistants managed 5.4 and 18.6% of visits independently, emergency physicians managed 74.6% of visits alone, and 1.4% of the cases were managed jointly. The researchers found:

  • APP visits had lower relative value units (RVU) per visit (2.8 vs. 3.7) and lower patients per hour (1.1 vs. 2.2) compared to physician visits.
  • Increasing APP coverage by 10% at the ED‐day level was associated with lower patients per clinician hour and lower RVUs per clinician hour.
  • Finally, there wasn’t any impact of increasing APP coverage on RVUs per salary‐adjusted hour or RVUs per visit. There was also no effect of increasing APP coverage on flow, safety, or patient experience.

The APPs in this study treated less complex cases, which freed physicians to handle more complex cases. Writing in Academic Emergency Medicine, the researchers concluded: “We found no economies of scale for APP coverage, suggesting that increasing APP staffing may not lower staffing costs. However, there were also no adverse observed effects of APP coverage on ED flow, clinical safety, or patient experience, suggesting little risk of increased APP coverage on clinical care delivery.”

Warning, don’t read this while eating

For seven days, researchers compared the use of Senokot or Thai massage for the treatment of constipation. They reported in the Journal of Evidence-Based Integrative Medicine that both work equally as well at increasing the frequency of bowel movements, except that the Thai massage seemed better. The reason: it led to normal bowel movements compared to the watery or liquid passes that are void of any solid pieces that Senokot tends to produce.

If you’re unfamiliar with Thai massage, here is a quick tutorial from the University of Michigan Health System Bowel Control Program:

  • Place your fingers on the right side of the stomach near the pelvic bone.
  • Lightly rub in a clockwise, circular motion, moving up the right side until you reach the ribs, then straight across to the left side and the rib bones, down to the left hip bone, and then move to the belly button.
  • Spend about 1 minute moving from the right hip bone to the right ribs then 1 minute across the middle (gently) and then 1 minute down to the left bone by your pelvis to the belly button where you can massage for 2-3 minutes. Repeat rub for 10 minutes.

ONE BIG NUMBER

20%

The percentage of increased risk that women face relative to men for developing heart failure or dying within five years after their first severe heart attack, according to new research published Monday in Circulation.

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