Although 2021 is a year of innovation in how to provide care to adapt to the COVID-19 pandemic, major questions remain about how some of these changes affect hospital quality and safety.

Although the pandemic affects every community, many places bear a disproportionate share of COVID-19 hospitalizations, deaths, and unemployment. Dr. Rishi Wadhera, a health policy researcher and assistant professor at Harvard Medical School, said that these factors need to be considered when regulators decide how to measure the hospital performance of a medical insurance star rating program.

“We need to consider how the broader context of public health and economic shocks affects the outcome trajectory of specific communities, and how this affects our assessment of hospital performance,” Wadhera said.

For example, Vizient data from its health system customers show that since the beginning of the pandemic, the number of times the emergency room is used by low-vision patients has decreased, while the number of use of alternate sites has increased. Vice President David Levine (David Levine) said.

“If only the most severe patients come in, they will be easier to come back, and we will definitely see this in 2021,” Levine said. “This will continue. We haven’t seen anything about Medicare and Medicaid Centers. [Services] Measures will be taken to control COVID-19 within the scope of risk adjustment. “

If CMS does incorporate the influencing factors of COVID-19 into the quality measurement, these changes may appear in the next iteration of the proposed rules for the expected hospitalization payment system, which is usually released in the summer.

Telemedicine broke out at the peak of the pandemic. Although the utilization rate has stabilized with the rebound in face-to-face visits, the health system will begin to address safety and quality principles in 2022. The Virginia Mason Francis health department has begun to monitor the quality of telemedicine through a patient satisfaction survey = and will look at other factors next year, said Charleen Tachibana, senior vice president and chief quality, safety and patient experience officer at Seattle Hospital. It is part of the non-profit CommonSpirit Health.

“We have many measurable indicators of population health,” Tachibana said. She said: “If the management of the disease process does not develop in the direction we hope,” the hospital may consider letting patients come back for in-person consultation.

Tachibana said that more hospitals, considering the safety and quality risks associated with staff shortages and short-term or temporary workers, will use virtual nurses to provide second-sight and guidance to frontline professionals.

“You can’t just let a new nurse into an unknown environment and expect them to know what they have to do. An experienced mentor will help you avoid making any mistakes,” said Dr. Brigitta Mueller, Executive Director of Patient Safety, ECRI’s Risk and quality.

The combination of absorbing new employees while maintaining a safety culture in times of chaos has affected the safety of hospitals. According to a Press Ganey survey, last year, hospital employees reported that they were afraid of being punished for reporting safety errors or talking about potential risks.

Press Ganey Chief Security Officer Tejal Gandhi said: “My guess is that the deterioration of the safety culture score will continue in 2021, and due to all the pressure on the system, it will continue to show a downward trend.” Best practices, including leadership behavior, task information transmission and ensuring they are transparent.”

ECRI also expects that natural language processing products will become the preferred way for hospitals, certification agencies and regulatory agencies to mine clinicians’ notes to assess the causes of adverse safety events, which is currently a manual process.