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Utilization Indicators Report for 2019 Calendar Year
The report includes summaries of admissions, discharges, patient days, neonatal and newborn admissions and patient days, emergency department visits, and ambulatory surgeries. Inpatient admissions for acute and specialty care remained relatively stable with only slight declines for the year of 1.5% and 1.2% respectively. There was a statistically significant decrease in ED visits in 2019. The principal cause appears to be the closure of the Providence Hospital Emergency Department in April 2019. Other hospitals throughout the city experienced disproportionate changes. When compared with 2018, four hospitals had decreased ED visits and four had increased ED visits. In 2019 there were 470,719 visits – a decrease of 7.2% compared to 2018.
DCHA Statement Regarding Racial Injustice
The events of this past week around racial injustice have weighed heavily on all of us here at the District of Columbia Hospital Association. The tragic loss of George Floyd (MN), Breonna Taylor (KY) and Ahmaud Arbery (GA) weighs heavy on our hearts and the hurt being felt by so many people is palpable. Because of a lack of progressive change when it comes to equity in health care, economic opportunity and other systemic issues of racial disparity, we have reached a tipping point. The root of the injustice and disparities being protested is a reality we must face and work to resolve. We see it, hear it, experience it.
DCHA believes that diversity, equity and inclusion are as important as ever. We support peaceful protests but do not condone intolerance, racism, violence or discrimination. We support our hospitals as places of healing and are committed to the well-being of ALL citizens – no matter their color, race, ethnicity, sexual orientation, gender, background or values.
Each of us must be more vigilant in doing the work of promoting acceptance and being accountable. We cannot and will not accept hate in any form. The senseless killings and day-to-day injustices inflicted upon individuals simply because of their skin color must end now.
Injustice anywhere is a threat to justice everywhere. We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly. — Martin Luther King, Jr.
DCHA Statement Regarding Transgender Nondiscrimination
Recently the Trump Administration rolled back regulations prohibiting discrimination against our transgender patients, family members, associates and friends. The District of Columbia Hospital Association (DCHA) and its member hospitals are committed to treating all individuals that walk through our doors with dignity, respect and compassion no matter their race, religion, ethnicity, sexual orientation, gender, beliefs or values. This commitment to providing a caring environment echoes through our hallways, operating rooms and emergency departments every day of the year.
Fifty-one years after Stonewall, we believe it’s important to make it clear that discrimination has no place in our society and certainly not in our hospitals. Our member hospitals are committed to fostering a safe environment that celebrates the diversity of our LGBTQIA associates and patients.
April 2020 Utilization Report
COVID-19 affected many service lines in DC hospitals during the month of April 2020. The graphs and tables in this report show the impact as reflected in utilization metrics in comparison to previous months. Observing the trends in data reflecting indicators such as admissions, patient days and capacity are helpful in visualizing the impact of COVID-19 on hospitals in the District. Hospitals experienced their lowest volume of admissions, emergency visits and ambulatory surgeries for the time period presented during the month of April 2020. Percentage change for March and April 2020 from the same month in 2019 is depicted in the chart below for reference.
Hospitals changed the distribution of bed-type allocations and added beds to accommodate the potential surge. For example, based on the data reported in April, MedStar Washington Hospital Center expanded ICU bed capacity from 107 to 121 beds (13% increase) and Sibley Memorial Hospital added 137 Med Surg beds (110% increase since February). In addition, several hospitals transferred patient and modified beds for specialty program in preparation for potential surge including Psychiatric Institute of Washington, MedStar National Rehab, United Medical Center and BridgePoint skilled nursing facilities. Although these transitions for specialty care resulted in slightly higher admissions for some specialty care providers, the overall trend showed decreasing volumes.
May 2020 Utilization Report
Destaques
This report summarizes utilization data for DCHA member health care facilities through May 2020 as the COVID-19 peak in April 2020 appeared to wane slightly. This pattern can be seen throughout the report with the exception of newborn and neonatal admissions. The graph below compares the percentage change for April and May from a January 2020 baseline.
Note: The January 2020 volume baseline was selected for pre-COVID impact baseline as earlier comparisons were influenced by Providence Hospital data and other time-sensitive variables. All three metrics (acute care admissions, emergency department visits, and ambulatory surgeries) show modest improvements.
October 2020 Utilization Report Show Trends in Hospital COVID-19 Data
Destaques
The percent difference in utilization compared to the January pre-COVID baseline continued to show slow recovery from low point during peak COVID surge in April for emergency department visits, acute inpatient admissions, psychiatric admissions, and observation stays (Figure 1).
Although ambulatory surgery utilization as compared to the January baseline remained higher than the low point in April
2020, a slight decline since July 2020 was observed (Figure 2).
November 2020 Utilization Report
Destaques
Monitoring our utilization metrics, emergency department visits remained relatively steady over the last five months as compared to January 2020 pre-COVID baseline utilization. On the other hand, acute care admissions, observation patients and ambulatory surgery fluctuated over this time. All remained below pre-COVID January 2020 baseline, as shown in Figure 1 below. Occupancy rates for psychiatric units in acute care hospitals increased over the past four months for Children’s National Hospital, MedStar Washington Hospital Center, and Howard University Hospital in particular (Figure 2).
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Figure 1: Utilization Metrics Impact from COVID-19 Comparing Recent Months to January 2020
Figure 2: Psychiatric Unit Occupancy Rate by Hospital
District of Columbia Hospitals Call for Employees to Be Vaccinated Against COVID-19
District of Columbia Hospitals Call for Employees to Be Vaccinated Against COVID-19
(WASHINGTON, D.C.) – June 9, 2021
District of Columbia hospitals and health systems call for all employees and clinical team members to be vaccinated against COVID-19. This important step helps ensure the safety and well-being of District hospital employees, patients, and visitors.
Under the District-wide consensus, nearly all health systems and hospitals in the District of Columbia will each set a date after which vaccination against COVID-19 will be a condition of employment (or contract engagement for non-employees who work at hospitals). Hospitals will comply with all federal and District laws in granting appropriate exemptions for medical or religious reasons.
The decision was based on expert guidance and data showing the minimal risk of COVID-19 vaccines, compared to their high rates of effectiveness.
To date, roughly 70% of all DC hospital employees have been fully vaccinated, 52.3% of District residents are partially or fully vaccinated and 42.3% of DC residents are fully vaccinated.
“The District of Columbia is blessed with a hospital workforce of over 30,000 individuals that provided and continue to provide compassionate and quality care throughout the pandemic,” said Jacqueline D. Bowens, President and CEO of the District of Columbia Hospital Association. “This consensus is a reiteration of our hospitals’ commitment to safety by keeping our staff, patients and visitors protected against COVID-19.”
District of Columbia Hospital Worker Mandatory COVID-19 Vaccination
Consensus Statement – June 2021
The District of Columbia’s 14 hospitals and health systems are committed to make the District’s hospitals safe for every patient, every visitor, and every staff member. As part of their commitment to that goal, participating hospitals have, through the auspices of the District of Columbia Hospital Association (DCHA), made a decision to require all employees and clinical team members to be vaccinated against COVID-19. DCHA’s Board of Directors endorses this action.
The District’s hospitals have seen first-hand the devastation COVID-19 has caused to the people of the District and the region. They understand how deadly this disease can be. Leaders at the District’s hospitals and health systems are stepping up to protect the health and wellness of their communities.
Hospitals are confident of both the science and the safety behind the vaccines. To date, roughly 70% of all DC hospital employees have been fully vaccinated, 52.3% of District residents are partially or fully vaccinated and 42.3% of DC residents are fully vaccinated.
There have been minimal side effects and the benefits are great.
Each health system or hospital will set a date after which vaccination against COVID-19 will be a condition of employment (or contract engagement for non-employees who work at hospitals). Medical and religious exemptions will be determined by each health system or hospital.
All hospitals will continue to require other infection controls including wearing masks and other personal protective gear, social distancing, handwashing, and other measures per Centers for Disease Control and Prevention guidance.
Implementation Guidance
The recommendations are not intended to interfere with or supersede the policies adopted at each hospital. No legal proceeding should reference a deviation from any part of this document. Each hospital and health system implementation plan/policy should include:
- A communication plan. Begin early.
- Consider how to maximize trust in the way education is conducted
- Meet in-person with hesitant employee groups
- Share facts behind the science, safety, and efficacy of the COVID-19 vaccine
- Conduct ongoing education sessions/town halls on the vaccine
- Provide physicians, nurses and pharmacists to speak one-on-one with employees who request more information via phone, text, email or in-person
- Scope of policy to apply to all categories of health care worker (Ex: employees, contractors, volunteers, medical staff members, students, vendors, etc.)
- Inclusion of those who work remotely to promote safety of the community in accordance with U.S. Equal Employment Opportunity Commission guidance
- Delineation of roles and responsibilities related to the implementation and management of the vaccination policy
- Availability of vaccine and prioritization in the event of shortages
- Mechanism to make the vaccine available to target groups
- A means to track and record compliance
- Including documentation for those who receive vaccinations outside the hospital or health system
- A process to define and evaluate requests for medical and religious exemptions
- Considerations for new hires
- Ex: Must provide evidence of prior completion of the vaccination series; If not previously vaccinated, share a specific timeframe for new employees to complete vaccination
- Outline the consequences of non-compliance
Additional opportunities:
- Offer vaccine to employees’ family members
- Identify and empower vaccine “Ambassadors” who can influence their colleagues
- Bring vaccine clinics to the cafeteria, break rooms, and other gathering spots
- Register employee for vaccination at new hire orientation
DCHA Acknowledges the Tremendous Work Being Done at Each Member Hospital During National Safety Month
In recognition of National Safety Month’s Week 4: Advancing Your Safety Journey, DCHA would like to highlight a safety initiative that demonstrates a commitment to continuous improvement in order to ensure a safe working environment for staff, patients and the community across all District hospitals. In 2019, DCHA’s Emergency Management Committee (EMC) identified a collective strategy to standardize a series of emergency codes related to a select list of emergency events (natural and human-made) across all member hospitals.
Emergency codes are important announcements to ensure facilities operate in accordance with their mission and to the best of their capabilities. The Department of Homeland Security released a report citing the importance of using standardized plain language codes. The report writes, “The use of plain language (clear text) in emergency management and incident response is a matter of public safety, especially the safety of emergency management/response personnel and those affected by the incident. It is critical that all those involved with an incident know and use commonly established operational structures, terminology, policies and procedures. This will facilitate interoperability across agencies, organizations, jurisdictions and disciplines.” The guidelines for standardized emergency codes have also been promoted by The Joint Commission for events or threats that can inflict harm on hospital staff, patients and visitors.
Leveraging the collective expertise, the EMC reviewed all member hospital codes for a series of emergency events/alerts. The Committee agreed to use a combination of color and plain language following national trends and best practices. It was further determined the minimum requirement for implementation would be to standardize the nomenclature (with a focus on plain language) and definition for the select emergency codes across the hospitals. Each facility would be given the flexibility to designate their color code for the specific emergency as they deemed appropriate.
DCHA hospital leaders see the value in creating uniform systems that enable their staff to be adequately informed during an emergency as well as equipping visitors with adequate information to protect themselves. This was important for the District’s hospitals as many of our staff are employed by multiple hospitals and often work between facilities. The EMC completed a standardization initiative to enhance the emergency preparedness and response efforts for District hospitals’ staff, the patients they serve, and the communities they protect.
As of 2021, EMC has prioritized this initiative as core activity of the Committee to be reviewed annually to ensure the standardized codes are accurate, complete, and relevant to industry best practice (both clinical and operational perspective). The commitment to regularly reviewing the series of emergency codes supports the process for continuous improvement especially when it comes to developing best practices regarding code implementation within each hospital. In addition, DCHA has provided education and technical assistance for other healthcare stakeholders who are seeking support for the implementation of similar initiatives. Those key stakeholders include but are not limited to community health centers, nursing homes and long-term care facilities.
DCHA hospitals remain poised to serve as an industry leader by championing excellence in safety. During the final week of National Safety Month, DCHA is pleased to promote the efforts made by the EMC members as they continue to build sustainable safety programs within their respective hospitals. For more information about the DCHA EMC or if you are interested in learning more about this safety initiative, please contact bsinatro@dcha.org or info@dcha.org.