Episoder
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This episode of the award-winning podcast examines the importance of risk adjustment. Dr. Tomas Villanueva leads the discussion on the impact of this crucial aspect of documentation that can affect hospital outcomes.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Erica Braun, MS, RN, CCDS
Senior Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[01:29] Defining risk adjustment â maintaining an apples to apples comparison
[02:41] Capturing comorbid conditions to the highest level of specificity
[04:08] Capturing the low-hanging fruit
[05:47] Case mix index issues
[07:44] Severity of illness and risk of mortality
[08:52] Addressing query fatigue
Resources:
To contact Modern Practice: [email protected]
Erica Braunâs email: [email protected]
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Screening for colorectal cancer (CRC) has seen a lot of innovations, but there is still the conventional gold standard. On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, and the options available to patients.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Abdul Aziz Aadam, MD
Interventional Gastroenterologist
Director, Interventional Endoscopy
Medical Director, International Patient Services
Northwestern Medicine
Show Notes:
[01:05] CRC screening options
[02:40] Colonoscopy advantages and disadvantages
[03:35] Virtual colonoscopies
[04:14] Artificial intelligence enhancement
[04:54] Improvements in the future
[07:10] No tests are foolproof
[07:50] Need to improve access
Resources:
To contact Modern Practice: [email protected]
Dr. Aadamâs email: [email protected]
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Manglende episoder?
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In this episode of the award-winning podcast Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, which drastically increases the rate of survival, and how improvements in CRC screening are giving patients better options.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Abdul Aziz Aadam, MDInterventional GastroenterologistDirector, Interventional EndoscopyMedical Director, International Patient ServicesNorthwestern Medicine
Show Notes:
[01:11] Endoscopic submucosal dissection
[02:10] Prevalence of colorectal cancer
[02:38] Risk factors
[05:10] Reason for the need of early detection
[06:35] Challenges for screening
[07:56] Rise in younger patients
[09:11] Screening of the elderly
[09:54] Increasing screening rates
[11:09] Additional screening options
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Aadamâs email: [email protected]
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On this episode, we continue our discussion on preventing surgical smoke in the OR.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Rachel Medina, BSBASenior Category Manager, Surgical ServicesVizient
Show Notes:
[00:29] Regulation and legislation around surgical smoke
[03:04] Best practices
[04:09] Sustaining efforts on smoke prevention
[05:01] Technological advances in prevention
[06:15] Financial costs and learning curve â outweighed by benefits
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Medinaâs email: [email protected]
âAs important as the air you breatheâ (Vizient Tech Watch, p 38): Tech Watch Medical Device - Volume 2, 2022
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The daily smoke produced in an operating room is the equivalent of 27-30 cigarettes, and the OR staff breathes this in five days a week. When tools in the OR cut and cauterize human tissue, they generate a plume of smoke containing toxic chemicals, carcinogens, malignant cells and viruses. Surgical smoke can cause a host of conditions, anything from headaches and sore throat to lung disease and lung cancer. On this episode, a Vizient expert discusses the ramifications of surgical smoke and how to begin preventing it.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Rachel Medina, BSBASenior Category Manager, Surgical ServicesVizient
Show Notes:
[01:27] Surgical smoke: a byproduct of surgical procedures
[01:51] Health issues from surgical smoke
[02:15] Not considered seriously over the decades
[02:47] Lung disease in physicians and OR staff
[03:34] Financial implications
[04:47] Growing awareness and the role of AORN
[06:33] Toxic materials and the effects of smoke plumes in the OR
[08:30] Vizient platform developing on surgical smoke
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Medinaâs email: [email protected]
âAs important as the air you breatheâ (Vizient Tech Watch, p 38): Tech Watch Medical Device - Volume 2, 2022
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On this episode of our award-winning podcast, we finish our feature on an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system. We will discuss the phenomenal results of the initiative so far and what is planned for the near future at Sanford Health.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety â FargoSanford Health
Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital â Fargo
Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health
Show Notes:
[00:39] Use of data in managing PSI reduction
[03:14] Results of a successful program
[04:05] Lessons learned
[08:15] Expanding and standardizing throughout the enterprise
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Leykâs email: [email protected]
Dr. Mannuruâs email: [email protected]
Dr. Zreikâs email: [email protected]
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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On this episode of Modern Practice, we continue highlighting an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety â FargoSanford Health
Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital â Fargo
Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health
Show Notes:
[01:06] Managing PSI notifications to staff â keeping it non-punitive
[03:46 Escalation process versus peer review â addressing practice variation
[05:12] Keys to achieving collaboration
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Leykâs email: [email protected]
Dr. Mannuruâs email: [email protected]
Dr. Zreikâs email: [email protected]
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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This episode of our award-winning podcast continues the success story of how Sanford Health has reduced PSIs through a concerted, multifaceted effort throughout the organization. Tomas interviews members of the clinical team that guided the way.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety â FargoSanford Health
Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital â Fargo
Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health
Show Notes:
[00:34] Surgeonâs perspective
[02:04 Role of nurse reviewer
[03:18] Necessities for success
[04:05] Importance of executive leadership; need to be non-punitive (the âgold nuggetâ)
[06:37] Reliable software and establishing the stop bill process
[08:15] Involving HIM, coding and the CDI team
[10:36] Engaging the clinical staff
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Leykâs email: [email protected]
Dr. Mannuruâs email: [email protected]
Dr. Zreikâs email: [email protected]
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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Developed by the Agency for Healthcare Research and Quality (AHRQ), Patient Safety Indicators, or PSIs, represent measurements of adverse events that enable healthcare organizations to gauge how they compare to others regarding patient safety. In addition, CMS looks at PSIs in scoring and penalizing organizations. In this series, Tomas talks with members of a clinical team that has seen great results in reducing PSIs throughout the organization.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety â FargoSanford Health
Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital â Fargo
Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health
Show Notes:
[02:00] Patient Safety Indicators (PSIs) defined
[02:46] PSI-90 and individual PSIs
[03:43] Hospital Acquired Conditions Reduction Program (HACRP)
[05:06] Documentation and the âdotted lineâ to quality
[05:44] Benchmarking with the Vizient Clinical Data Base
[06:23] Focused objectives for the PSI reduction program
[07:34] Steps in building the program structure
[09:35] Addressing gaps in education â once clinicians know what to do, they donât fail
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Leykâs email: [email protected]
Dr. Mannuruâs email: [email protected]
Dr. Zreikâs email: [email protected]
PSI ACS Poster: PSI ACS Poster
2023 Quality and Safety Conference presentation: 2023 QSC presentation
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On this episode of our award-winning podcast, a leading expert in electrophysiology concludes our discussion on pulsed field ablation as the newest approach to treating atrial fibrillation.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[00:48] New energy source
[01:40] Current electroporation is more controlled
[06:30] Anticoagulation and pulse field ablation
[08:42] Be sure to work with colleagues when wanted to adopt PF ablation
[09:05] Exciting development in electrophysiology
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Mungerâs email: [email protected]
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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On this episode of our award-winning podcast, a leading expert in electrophysiology explains the pathophysiology of atrial fibrillation and how therapies for it have evolved over the years, with pulsed field ablation emerging as the newest approach.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[00:50] Atrial fibrillation: pathophysiology and risk factors
[03:20] Treating rhythm and treating rate
[07:01] Efficacy of ablation and other treatments
[09:40] Pulse field ablation
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Mungerâs email: [email protected]
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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Atrial fibrillation ablation therapies have progressed from rather primitive approaches to improved treatments that have emerged in recent years. In this series of our award-winning podcast, we discuss the history of the practice of electrophysiology and improvements that field has experienced.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Thomas Munger, MDChair, Heart Rhythm DivisionAssociate Professor of MedicineMayo Clinic
Show Notes:
[01:06] History of electrophysiology
[01:55] Training to become an electrophysiologist
[02:44] Electrophysiology and the only organ that moves constantly
[04:22] Seizure of the heart
[05:22] The discipline of electrophysiology and evolving practice of ablation
[07:47) The types of ablation
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Mungerâs email: [email protected]
More information (Vizient): Additional pulsed field ablation resources
Information on improving an electrophysiology program (Vizient):
Optimizing your EP program
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Simon Henley was on a video call with his manager when he suddenly disappeared from the screen. He had fallen to the floor with a cardiac arrest. Not to be confused with an acute myocardial infarction, cardiac arrest is usually fatal, requiring a defibrillator and immediate CPR to revive the patient. On this episode, Simon tells his harrowing story, one with a touch of the miraculous, in how he survived those crucial first minutes and embarked on the road to recovery.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Simon Henley, MBA, CMBBDirector, Global Market GrowthDefibrillator SolutionsMedtronic
Show Notes:
[00:51] Simonâs background
[01:25] An avid runner
[01:49] The call
[03:23] Every minute a cardiac arrest goes untreated drops survival rate by 10%
[04:23] No previous symptoms
[05:57] Rehabilitation
[06:55] Dealing with emotions and with recurring cardiac events
[10:19] Changed perspective
[11:12] No guarantees
Links | Resources:
To contact Modern Practice: [email protected]
Simonâs email: [email protected]
Sudden cardiac arrest: symptoms and causes (Mayo Clinic):
Click Here
Heart attack and cardiac arrest (American Heart Association):
Click Here
Cardiac care management (Medtronic):
Click Here
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This episode of our award-winning podcast concludes our discussion on a new approach for medical groups in this time of drastic change. Only those models undergoing change will succeed.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalPerformance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare Delivery TransformationStrategy ConsultingVizient
Show Notes:
[01:09] Current state of medical groups
[03:12] Issues around the surgical practice model
[05:01] Sustainability of the group practice model
[06:35] Finding a medical group strategy
Links | Resources:
To contact Modern Practice: [email protected]
Michael Strileskyâs email: [email protected]
âGrow hospital market share by integrating ambulatory care across acute service linesâ (Vizient publication): Click Here
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All the drastic changes occurring in healthcare, particularly in the way it is delivered, necessitate corresponding changes in how we structure medical groups. This episode of our award-winning podcast continues the discussion on the need for a new strategy for medical groups, and an expert returns to consider what that strategy might be.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare Delivery TransformationStrategy ConsultingVizient
Show Notes:
[01:11] Academic medical centers and the need for innovation
[02:46] Meeting the physician shortage challenge
[04:51] Resistance to a new care model
[06:23] Reimbursement, technology and consumer desires will drive the new model
[07:06] The physician compensation factor in the new model
Links | Resources:
To contact Modern Practice: [email protected]
Michael Strileskyâs email: [email protected]
âGrow hospital market share by integrating ambulatory care across acute service linesâ (Vizient publication): Click Here
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The huge flurry of changes in how we deliver healthcare have brought into question the viability of the conventional medical group model, whether itâs sustainable and gives us a competitive advantage or whether we need to invest in something else. On the next three episodes of this award-winning podcast, an expert joins Tomas to consider the future of medical group practices.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare Delivery TransformationStrategy ConsultingVizient
Show Notes:
[01:46] Current medical group model
[02:58] Impact and role of medical groups
[04:12] Drawbacks and limitations of current model
[06:13] Different care and practice models emerging
[07:49] The disruptors have been fantastic
[09:47] Different approach for medical groups affiliated with academic medical centers
Resources:
To contact Modern Practice: [email protected]
Michael Strileskyâs email: [email protected]
âGrow hospital market share by integrating ambulatory care across acute service linesâ (Vizient publication): Click Here
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In this re-air of our two-part, award-winning podcast series, we discuss how physical violence in the healthcare workplace is on the rise. Healthcare workers are more in danger of violence than are police officers or prison guards. Looking at the labor force in general, healthcare workers have five times the likelihood of facing violence than workers across all other industries. And that doesnât include the verbal abuse. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. On this episode, Tomas and Cecilia finish their discussion with some helpful tips.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem
Show Notes:
[01:10] Influences and attitudes from culture/media
[02:45] The pandemic factor; example from CoxHealth
[04:45] Prevalence of incivility
[06:23] Paying attention to the signs; observation skills to use; actions to take
[09:30] Give the situation the same importance that patients and families give it
[10:16] Tools clinicians can use â Marpeâs role in alleviating violence
[12:05] A symptom of the healthcare crisis
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Cruzâs email: [email protected]
Dr Cruzâs Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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Hermes award-winner!
In a special re-air of this award-winning episode, we discuss how the hospital is increasingly becoming a hostile environment, with clinicians facing verbal abuse and physical violence from patients and their families. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. If calming hostilities is not possible, they need to know what to do in the face of violent confrontation. Tomas discusses patient hostility with a leading expert on the topic.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem
Show Notes:
[02:15] Patient hostility on the rise
[03:16] Verbal violence is most prevalent, and the most unreported
[04:05] Cleveland Clinic: violence four times more prevalent in health care
[04:40] Health care workers more exposed than prison guards and police officers
[05:12] Higher risk of assaults for nurses
[05:59] Biggest risk in high-acuity settings â ambulances, EDs, ICUs, psych units
[06:44] Reasons/origins
[09:25] Patient families as source of conflict
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Cruzâs email: [email protected]
Dr Cruzâs Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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This episode of our award-winning podcast finishes our discussion on the state of research today. Despite proven benefits, enrollment in clinical trials is sparse across the country, but participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:
Dylan Steen, MD, MSChief Executive Officer and Co-founderHigh EnrollCardiologist, UC HealthAdjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmDMedical Director, Oncology ResearchHematologist/OncologistSt. Elizabeth Healthcare
Show Notes:[01:32] Market research at St. Elizabeth Healthcare
[02:58] Benefits and advantages of clinical research to practices and organizations
[04:50] Background for High Enroll and the programâs value: opportunities offered
[06:20] Getting High Enroll started
[08:39] Vision for research at St. Elizabeth Healthcare â approaching a cure
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Steenâs email: [email protected]
Dr. Floraâs email: [email protected]
High Enroll website: https://www.highenroll.org
(513) 993-0330
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Despite proven benefits, enrollment in clinical trials is sparse across the country. This episode of our award-winning podcast continues our discussion on the state of research today and how participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Dylan Steen, MD, MSChief Executive Officer and Co-founderHigh EnrollCardiologist, UC HealthAdjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmDMedical Director, Oncology ResearchHematologist/OncologistSt. Elizabeth Healthcare
Show Notes:[01:31] Lack of inclusivity in trials â need for âreal-worldâ participants
[04:05] Research organizations give standard of care that is lacking elsewhere
[04:50] Background for High Enroll and the programâs value: opportunities offered
[07:40] Latest generation of technology and information availability
[08:20] Improvement over other research sites (such as clinicaltrials.gov)
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Steenâs email: [email protected]
Dr. Floraâs email: [email protected]
High Enroll website: https://www.highenroll.org
(513) 993-0330
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