Top 10 De-Escalation Tips for Health Care Professionals

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Every day at the workplace presents new encounters, situations, and challenges for the health care professional. You may find yourself dealing with angry, hostile, or noncompliant behavior every day. Your response to this defensive behavior plays a critical role in determining whether or not the incident will escalate into a crisis situation. These 10 de-escalation tips provide strategies and techniques to help you respond to difficult behavior in the safest, most effective way possible.

  1. Be empathetic and nonjudgmental
  2. Respect personal space
  3. Allow time for decisions
  4. Use nonthreatening nonverbals
  5. Set limits
  6. Focus on feelings
  7. Ignore challenging questions
  8. Avoid overreacting
  9. Choose what you insist upon wisely
  10. Allow silence for reflection

DeEscalation Tips for Health Care

Donate Blood – The Red Cross is Experiencing the Worst Blood Shortage in a Decade

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The Red Cross is experiencing the worst blood shortage in over a decade. Low blood supply levels can force hospitals to defer patients from major surgery. Blood donation is desperately needed.

General Messaging

  • The current blood crisis is the worst in the past 10+ years.
  • The Red Cross continues to have a need for blood donations to ensure hospital patients in our community continue to receive needed care for treatments, such as transfusions for those battling cancer. All blood types are needed, especially types O+ & O-.
  • Please head to RedCrossBlood.org to find the next available appointment to donate.
  • The Red Cross, which supplies 40% of the nation’s blood supply, has had to limit blood product distributions to hospitals as a result of the shortage. In fact, some hospitals may not receive 1 in 4 blood products they need.
  • Blood cannot be manufactured or stockpiled and can only be made available through the kindness of volunteer donors.
  • You can save three lives in 15 minutes.

What is Causing the Blood Shortage Crisis?

  • Overall blood donations have declined by 10% since March 2020.
  • There has been a 62% drop in college and high school blood drives due to the pandemic. Student donors accounted for ~25% of donors in 2019 accounted for just ~10% during the pandemic.
  • There are ongoing blood drive cancellations due to illness, weather-related closures and staffing limitations.

Critically Needed Blood

  • Type O positive is the most transfused blood type and can be transfused to Rh-positive patients of any blood type. 38% of the population has O positive blood, making it the most common type.
  • Type O negative is the universal blood type and what emergency room personnel reach for when there is no time to determine the blood type of patients in the most serious situations.
  • Platelets are the clotting portion of blood, which must be transfused within five days of donation.
    • Nearly half of all platelet donations are given to patients undergoing cancer treatments

Reasons to Give Blood

  1. 1/3 of us will need a blood transfusion in the future
  2. 3 lives can be saved with the amount of blood donated in one sitting
  3. Every two seconds someone in the United States needs blood
  4. 36 hours is the time it takes to naturally replace blood lost from the body

Call to Action

  • Make sure people know where and how to donate blood.
  • Go to redcross.org to learn how to give.

Sources: American Red Cross, Give Blood, One Blood

Sample Graphics

 

 

The Joint Commission Releases Requirements for COVID Vaccination of Health Care Personnel

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On February 16, 2022, The Joint Commission shared required documentation for COVID vaccination among health care staff.  The Joint Commission will now be requiring health care facilities to provide the following documentation:

  1. Overall COVID vaccination rate of eligible staff
  2. A list of all staff, including positions/titles, including COVID vaccination status
  3. All policies regarding health care staff COVID vaccinations
    • Policies for COVID vaccination exemptions
    • Policies for COVID vaccination requirements
    • Policies for mitigation of unvaccinated staff
  4. List of newly hired staff in last 60 days

New Requirements

  • A process for tracking and securely documenting the COVID-19 vaccination status of all staff.
  • A process for tracking and securely documenting the COVID-19 vaccination status of any staff who have obtained any booster doses as recommended by the CDC.
  • A process by which staff may request an exemption from the staff COVID-19 vaccination requirements based on an applicable federal law.
  • A process for tracking and securely documenting information provided by those staff who have requested, and for whom the organization has granted, an exemption from the staff COVID-19 vaccination requirements based on recognized clinical contraindications or applicable federal laws.
    • Surveyors will not assess the appropriateness of clinical contraindications or religious exemptions.
  • A process for ensuring that all documentation that confirms recognized clinical contraindications to COVID-19 vaccines and supports staff requests for medical exemptions from vaccination has been signed and dated by a licensed practitioner who is not the individual requesting the exemption, and who is acting within their respective scope of practice as defined by, and in accordance with, all applicable state and local laws. Such documentation contains:
    • All information specifying which of the authorized COVID-19 vaccines are clinically contraindicated for the staff member to receive the recognized clinical reasons for the contraindications.
    • A statement by the authenticating practitioner recommending that the staff member be exempted from the organization’s COVID-19 vaccination requirements for staff based on the recognized clinical contraindications.
    • Surveyors only evaluate that the documentation is complete; they do not assess the appropriateness of clinical contraindications or religious exemptions.

Vaccination Rate Calculation

  • Numerator Includes
    • Pending religious or medical exemption (during first 30 days of implementation)
    • Approved religious or medical exemption
    • Persons having an approved CDC temporary delay for vaccination
    • Persons with clinical contraindication to receiving COVID vaccine
    • Staff who have received at least one dose of a vaccine should be placed in the numerator of the calculation during first 30 days
  • Who Must be Vaccinated?
    • Facility employees
    • Licensed practitioners
    • Students
    • Trainees
    • Volunteers
    • Contracted staff
    • Staff who perform duties offsite (e.g., home health) and to individuals who enter CMS regulated facilities (i.e., a physician with privileges in a hospital who is admitting and/or treating patients onsite)

DCHA Partners with XFERALL to Provide DC Hospitals Access to a Solution to Accelerate Transfers of Medical and Behavioral Health Patients

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The District of Columbia Hospital Association (DCHA) and XFERALL, the nation’s leading mobile patient transfer platform, have entered a partnership that offers DC hospitals a new process for transferring acute and behavioral health patients to clinically appropriate health care facilities.

The District, as is the country, is experiencing a high volume of behavioral health patients, which results in an increased need for crisis services. DCHA and XFERRAL both recognize the importance of a collaborative approach to creating innovative solutions with diverse partners to support behavioral health access.

XFERALL reduces transfer times for medical and behavioral health patients between health care facilities.

This is one of many projects DCHA works on to ensure behavioral health needs are being met. DCHA works on many initiatives that focus on serving the behavioral health community.

“Partnering with XFERALL on this important effort provides our members with an additional tool to continue our commitment to safe, high-quality patient care for all of the individuals our hospitals serve,” said Jacqueline D. Bowens, President & CEO, DCHA.

XFERALL’s partners in other states have achieved reductions in wait times for transfer to appropriate care by as much as 86 percent.

“We’re excited to bring our innovative platform to DC hospitals to help reduce wait times for essential medical and behavioral health care,” said Nathan Read, CEO, XFERALL. “Too many patients in crisis are waiting too long for care. We know that outcomes are better when patients care is not delayed and is accessible in their community. In partnership with XFERALL, DC hospitals are working to deliver solutions that address the serious challenges of crowded emergency departments, clinician burnout, and delays in care.”

DCHA is the unifying voice for hospitals and health systems in the District of Columbia and works to advance health policy to strengthen the District’s world-class health care system to ensure that it is equitable and accessible to all.

Reducing ED Board Times and Improving Placement, Even During the Pandemic

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The American College of Emergency Physicians (ACEP) in August last year identified boarding times for patients in hospital emergency departments as at an “all-time high.” This is for all patients waiting to be transferred to a different facility for needed treatment, whether a behavioral health facility or hospital providing a higher level of acute care.

ACEP identified two reasons for increasing boarding times: 1) hospital staffing shortages and 2) influx of seriously ill patients, with COVID-19 and with other emergent conditions, in part due to patients’ delaying necessary medical care during the pandemic.

For patients needing behavioral health treatment, even prior to the COVID-19 pandemic, the average wait time in an acute hospital ED conservatively was estimated at eight hours. Anecdotally, however, hospitals across the country often reported much longer wait times as clinically appropriate, available psychiatric beds were hard to identify, particularly for certain populations, such as children and adolescents, older patients, and those with co-occurring conditions.

Today, just five months after ACEP raised concerns about all-time high boarding times, the problem is yet more serious as the country is experiencing an even-higher number of COVID-19 cases, fueled by the Omicron variant, and even more acute staffing shortages.

For hospitals using XFERALL to automate and expedite acute medical and behavioral health patient transfers, the picture is not as bleak. In Texas alone, hospitals using XFERALL to transfer medical patients between August 2020 and July 2021 got a response from a receiving hospital to their transfer request in less than 1 minute, 18 seconds and secured acceptance for patient transfer in less than 20 minutes. Over the last two years, even during the pandemic, XFERALL’s partners reduced behavioral health patient transfer times by 86%.

XFERALL empowers health care systems and providers to quickly identify medical and behavioral hospitals with the capacity and capability to accept patients for transfer. The XFERALL technology automates the patient transfer process, creating less work for the health care provider and improving emergency department capacity by reducing transfer times. By automating the patient transfer process and increasing visibility into a wider network of potentially available beds, XFERALL eliminates the need for nurses and other clinicians to make labor-intensive phone calls and faxes to identify clinically appropriate care for patients needing transfer.

There is no easy fix to the nation’s health care staffing crisis, and the end to COVID-19 remains elusive. The good news is that hospitals nonetheless can reduce care delays and mitigate the consequences of the staffing shortage by implementing internal logistics and operations that accelerate the effective and efficient transition of patients to appropriate treatment. Improvement starts with questioning old habits of picking up the phone and faxing clinical information and being open to modernizing the patient transfer process. There’s never been a more urgent time to do so.

To learn more about the work with DC-area hospitals and behavioral health teams, contact Jennifer Witten, senior vice president, government affairs and policy, at Jennifer.Witten@xferall.com.

DCHA Announces 2022 Slate of Board of Director Officers

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The District of Columbia Hospital Association (DCHA) at its December 15 Board of Directors Annual Meeting, voted to elect a new slate of Board officers for terms beginning in January 2022. DCHA is the unifying voice for hospitals and health systems in the District of Columbia and works to advance health policy to strengthen the District’s world-class health care system to ensure that it is equitable and accessible to all. The DCHA Board of Directors sets the strategic direction for the association. The 2022 Board Officers are:

Dr. Hasan Zia, Board Chair
President & Chief Operating Officer, Sibley Memorial Hospital

Anita Jenkins, Vice Chair
Chief Executive Officer, Howard University Hospital

Dr. Christopher King, Secretary
Associate Professor, Georgetown University Medical Center

Dania O’Connor, Treasurer
Chief Executive Officer, Psychiatric Institute of Washington

John Rockwood, Immediate Past Chair
President, MedStar National Rehabilitation Hospital & Senior Vice President, MedStar Health

Jacqueline D. Bowens, President & Chief Executive Officer
District of Columbia Hospital Association

In addition to the new Board of Directors, DCHA appointed one At-Large member and welcomed a new addition to the Board with the departure of James Linhares from BridgePoint Hospital Capitol Hill:

Kathy Hollinger, At-Large Board Member
President & Chief Executive Officer, Restaurant Association of Metropolitan Washington

Ryan Zumalt, Board Director Chief Executive Officer, BridgePoint Hospital Capitol Hill

“DCHA is privileged to have such an esteemed group of individuals serve the association, our hospitals and the residents of the District of Columbia,” said Jacqueline D. Bowens, President and CEO of DCHA.

 

 

DC Hospitals Are Removing Barriers to Substance Use Treatment Through Community Collaboration

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Peer recovery and outreach coaches from five District hospitals gathered for an in-person meeting at Unity Health Care, a community health center, on September 9. The group met to discuss strategies for eliminating barriers and increasing community support for patients entering substance use treatment programs. For the peers, having a strong relationship with community partners is a key component of the referral process, and often determines whether a patient is linked to treatment.

“I loved putting a face to the name of providers we talk to every week,” said Veronica Williams, a hospital-based peer recovery coach from United Medical Center. “The in-person meeting was great because we got to experience the facility first-hand and got to interact with the people who we are sending our patients to, to help them know what to expect when they arrive.”

Community-based coaches also reiterate the importance of community collaboration in supporting patients in finding long-term recovery.  “It was an amazing experience to meet the people at Unity, see their facility and discuss our roles in health care together. It really adds to the sense of community we are trying to establish as peers when we can get together to have a discussion on how to best serve our patient population and community at large!” said Thaddeus Wientzen, an outreach coach from MedStar Georgetown University Hospital.

A patient’s experience at a treatment center has a strong impact on their overall recovery and a negative experience can deter a patient from wanting to enter treatment again. Part of the role of the hospital-based peers is to motivate patients to enter treatment and that includes finding the right treatment provider for each individual. Face-to-face meetings and facility tours help the coaches determine the right place for each patient.

“Visiting Unity Health Care’s East of the River location was very insightful. I personally did not know all the different aspects of the center and learned that there were walk-in hours for MAT patients. I have always had an excellent experience whenever I have used Unity’s services for referrals,” said William Ellis, an outreach coach from Howard University Hospital.

Providing accessible community support is something Unity Health Care does every day by providing a full range of health and human services to meet community needs throughout the District. Nine Unity Health Care sites are fast-track providers for hospital referrals, working with peers to provide same-day or next-day appointments for substance use patients.

Unity Health Care’s Behavioral Health Program Manager Mary Wozniak shared that “meeting with the hospital peers was valuable to understand their perspectives and to reiterate the need for improved access to care with no barriers. When a patient is ready to access treatment, it’s best to connect them immediately, or you risk them returning to drug use. We hope that our open access model will help address some of that need.”

Note: All participants received a COVID-19 screening upon entry and followed CDC guidance on vaccination, mask wearing and social distancing.

L-R: Corrine Simons, William Ellis, Mary Wozniak, Dr. Andrew Robie, Ean Bond, Thaddeus Wientzen, Veronica Williams

#Treatment
#Substance Use Disorder
#DCHA
#Collaboration
#Community
#Hospitals
#Sustainability

DCHA Patient Safety Summit

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On Tuesday, June 20th, the District of Columbia Hospital Association held its inaugural Patient Safety Summit, Back to Basics: Creating a Community Culture of Safety at the Milken Institute School of Public Health on the campus of The George Washington University.  The event was an overwhelming success.  With over 150 registrants and a robust and content rich agenda, attendees were provided the opportunity to collaborate, share best practices, and network, highlighting their continued commitment to providing safe and high quality patient care here in the District.

Auditorium

“The DCHA’s inaugural Patient Safety Summit was a spectacular success and I was extremely pleased to see so many healthcare leaders joining forces to focus on patient safety and learn from one another how best to do address this critical issue.  This meeting laid the foundation for continued collaboration amongst the hospitals to improve healthcare in our great city. For me, one of the highlights of the summit was identifying and agreeing on the need for – and commitment to – data transparency. This transparency will mobilize us and help us reach our goal of making the District’s hospitals among the safest in the nation. As I look to the future, I eagerly welcome our new collaboration with the D.C. Health Department, we all share the same vision for the citizens of the District and are now on the road to turning that vision into reality.” Chip Davis, PhD, President & CEO, Sibley Memorial Hospital – Johns Hopkins Medicine; Chair, DCHA Board of Directors

During the program, DCHA presented Kathleen Chavanu Gorman, MSN, RN, FAAN, the Chief Operating Officer at Children’s National Health System, with the 2017 American Hospital Association Grassroots Advocacy Award for her dedication and commitment to the mission of hospitals on both the local and the national level.

Kathy Gorman Award Picture

Throughout the day, participants heard from national leaders, local officials, and hospital experts – including the majority of the District of Columbia hospital’s CEOs, who participated in a session entitled, “CEOs: Paving the Way for a Patient Safety Culture.”  The session featured two panels that focused on the topics of Leadership and Collaboration.

Leadership Panel CEO Panel on Collaboration from left: Mark Chastang, CEO, Saint Elizabeths Hospital; Jim Linhares, CEO, BridgePoint Hospital Capitol Hill; Darcy Burthay, MSN, RN, President & CEO, Providence Health System – Ascension Health; Kurt Newman, MD, President & CEO, Children’s National Health System; Jim Diegel, CEO, Howard University Hospital

Leadership Panel CEO Panel on Leadership from left: John Rockwood, President, MedStar National Rehabilitation Hospital; Kimberly Russo, CEO, The George Washington University Hospital; Richard “Chip” David, PhD, Sibley Memorial Hospital – Johns Hopkins Medicine

“I was honored to serve on the CEO Leadership panel at DCHA’s first Patient Safety Summit which provided a valuable opportunity for healthcare leaders to collaborate on best practices in quality and safety,” said Kimberly Russo, Chief Executive Officer at The George Washington University Hospital. “Individuals across the DC region should have access to high-quality, safe healthcare no matter where they choose to receive it. By increasing transparency across organizations, we are able to work together to not only promote safety but ensure consistent, excellent medical care in the District of Columbia.”

A special thanks to those who presented at the Patient Safety Summit, including Dr. David Henderson of the National Institutes of Health Clinical Center who presented on “The Changing Landscape of Patient Safety,” Charisse Coulombe, MS, MBA, CPHQ of the Health Research and Educational Trust (HRET) at the American Hospital Association who spoke on “The Path Forward for Patient Safety,” and Dr. LaQuandra Nesbitt, MPH, the Director of the D.C. Department of Health, who spoke about, “The Intersection of Health Equity & Patient Safety and Quality.”

J. Bowens DCHA Patient Safety Summit

“While this event is just a first step in our collective quality journey, it was an impactful one. DCHA looks forward to continuing our work with our hospitals and their teams as we further our commitment to putting safe, high quality patient care first in the District of Columbia.” – Jacqueline D. Bowens, President & CEO, District of Columbia Hospital Association

The association already has plans underway for the next Patient Safety Summit, which they hope will take place in the early winter of 2018.

This live event was designated by The George Washington University School of Medicine and Health Sciences for a maximum of 5 AMA PRA Category 1 credits.  Those who attended the event have received an e-mail from GWU with information on how to claim those credits. 

DCHA would like to again express our gratitude for our Summit sponsors.  With almost unanimous sponsorship support from our member hospitals, their contributions and support provided the means for such a successful event.

 

DCHA Patient Safety Summit

 

Patient Safety Summit Sponsors:

Children’s National

The George Washington University Hospital

Howard University Hospital

MedStar Health

Providence Hospital

Sibley Memorial Hospital

#Headlines
#Patient
#Safety
#Sibley
#Providence
#Summit
#Medstar
#Howard
#Childrens

DCHA Now Participating in Sugary Beverage Healthier Hospitals Initiative with DOH

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Chronic diseases are a serious problem for District of Columbia residents and health care providers.  With residents’ rates of obesity and diabetes at a critical high (Obesity: Adults 22%, High School Students 15%, Diabetes: 8.5%, At-Risk for Diabetes 6.55%), the linkage between sugar consumption and chronic disease can no longer be ignored.  Reduction and elimination of sugary beverages, as well as public education on healthier dietary options, is an imperative to moving the needle on a healthier community.

To that end, DCHA has been working with the DC Department of Health (DOH) on an initiative to reduce the availability of sugary beverages, and promote healthier options within the District’s hospitals.  Through the program, DCHA will be asking the District’s hospitals to commit to:

  • Making healthy changes to vending machines, cafeterias, meetings, events, and other sources of sugary beverages in the workplace.
  • Identifying and utilizing vendors, caterers, and other food providers that offer healthier beverage choices.
  • Having leadership support and model reduction of sugary beverages in the facility.
  • Educating employees about health consumption and promotion of healthier alternatives.
  • Reducing, and ultimately eliminating, sugar-sweetened beverages.

Sibley Memorial Hospital, part of Johns Hopkins Medicine, was the first hospital in the District to create and implement a reduction and elimination program, but several others are not far behind.  For those interested and able, DCHA plans to assist our members on implementation of sugary beverage reduction programs at their facility.  In doing our part, the Association has also eliminated the availability of sugary-beverages to staff and meeting attendees in our office.

DCHA will be updating our website to include information on the sugary beverage healthier hospitals initiative, including tools and resources for your facility.

You can follow DCHA’s Kick the Can campaign by searching #RethinkYourDrink on twitter.

#Headlines
#DCHA
#Announcement
#Sugar
#Beverage​​​
#DOH
#RethinkYourDrink
#Healthy

District of Columbia Association’s Statement on Providence Health System’s Announcement

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Washington, DC – July 25, 2018 – Today, the District of Columbia Hospital Association (DCHA) released a statement on Providence Health System’s announcement regarding their pending service changes.

“Hospitals and health systems across the country have been adapting to the future delivery of health care and the District’s hospitals have not been immune from these changes,” said Jacqueline D. Bowens, President & CEO of the District of Columbia Hospital Association. “As the industry shifts toward a population health focus, health systems continue to identify ways to strengthen collaborations between acute care and community-based services, to meet people where they are and ultimately improve health outcomes”.

The Association is pleased that Providence, while making a transition out of acute care, remains fully dedicated to the residents of the District of Columbia. This new community-focused model represents a unique opportunity for Providence and the District’s community of hospitals to work in concert to transform health delivery —- keeping the patient at the center of everything we do.

DCHA will be working with all our members, including Providence, to engage key stakeholders both inside and outside the hospital industry to ensure that District residents continue to have access to high-quality health services ranging from acute care to primary care.

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