RSV, Other Viruses Making it Hard to Find a Bed in Children’s Hospitals 

Washington Post | By Fenit Nirappil and Ariana Eunjung Cha

Children’s hospitals are under strain in the United States as they care for unusually high numbers of kids infected with RSV and other respiratory viruses.

It’s the latest example of how the pandemic has upended the usual seasonal patterns of respiratory illnesses, denying a respite for health-care professionals ahead of a potential hectic winter as the coronavirus, influenza and other viruses collide.

Respiratory syncytial virus, a common cause of cold-like illness in young children known as RSV, started surging in late summer, months before its typical season from November to early spring. This month, the United States has been recording about 5,000 cases per week, according to federal data, which is on par with last year but far higher than October 2020, when more coronavirus restrictions were in effect and very few people were getting RSV.

“It’s very hard to find a bed in a children’s hospital — specifically an intensive care unit bed for a kid with bad pneumonia or bad RSV because they are so full,” said Jesse Hackell, a doctor who chairs the committee on practice and ambulatory medicine for the American Academy of Pediatrics.

Nearly three-quarters of pediatric hospital beds are occupied, according to federal health data. Rhode Island, the District of Columbia and Delaware report more than 94 percent of pediatric beds occupied. Maine, Arizona, Texas, Kentucky, Oklahoma and Missouri reported between 85 and 90 percent of beds occupied. The data is limited to facilities that report the information.

Several children’s hospitals in the D.C. area have been at capacity for weeks; 18 children were waiting for a room in the ICU on Tuesday at Children’s National in the District.

D.C. Realtor Kate Foster-Bankey was more attuned to RSV after she started hearing from clients whose children were afflicted with the virus in recent weeks, including one whose child was admitted to Children’s National.

Then her 3-year-old daughter Isabelle fell ill, becoming lethargic, complaining of a fast heartbeat and not eating. They waited two hours in the packed waiting room of a pediatric urgent-care center where Foster-Bankey, a mother of four, was used to seeing only a handful of patients.

During a follow-up visit Tuesday, Isabelle was transported by ambulance to the emergency room of a children’s hospital, where she tested positive for RSV and had to wait until the following morning for a bed.

“It sounds like in covid, we gutted our pediatric care,” said Foster-Bankey, 41. “Kids shouldn’t have to wait in a waiting room with a bunch of other sick kids for hours.”

At Connecticut Children’s Hospital, the emergency room is so full that patients are being triaged in hallways. Teens with bone fractures and appendicitis are being diverted or transferred to adult-care centers to create additional space for respiratory patients. Hospital officials are considering the possibility of enlisting the National Guard to set up tents and care for the influx of patients.

Over the past nine days, 110 children with RSV have come in to the emergency room, and at times as many as 25 children with RSV were waiting for an inpatient bed, said Juan Salazar, physician in chief at Connecticut Children’s. He said that for the first time in his career he has had to mandate doctors in other specialties such as endocrinology and rheumatology work with RSV patients — a situation reminiscent of the “all hands on deck” approach many adult hospitals took in March 2020, when the coronavirus began to sweep through the United States.

“During my tenure here I haven’t seen anything like this,” said Salazar, who has worked in infectious diseases for 30 years.

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Informal Caregiver Hours On The Rise, Highlighting Need For Home Care, Respite Services

Home Health Care News | By Joyce Famakinwa

More individuals are having to take on what’s known as the second or third shift — caregiving duties in addition to being employed.
 
At the same time, there has been an increase in Medicare Advantage (MA) plans offering home-based care, including respite services, coinciding with this rise of informal caregivers.
 
For context, informal caregivers are spouses, partners, friends or family members who assist with activities of daily living (ADLs) and possibly even medical tasks, according to San Francisco-based nonprofit Family Caregiver Alliance.
 
A new survey from Homethrive found that there has been a 151% increase in the number of employees spending more than 9 work hours weekly on caregiving compared to its last survey in 2021.
 
Homethrive’s survey examines how informal caregivers are balancing work life and their additional caregiving responsibilities. Two hundred informal caregivers — working in a variety of industries in the U.S. — were surveyed for the report.
 
“Unpaid family caregivers are unsung heroes,” Bonni Kaplan DeWoskin, vice president of marketing at Homethrive, said in a statement. “Our second annual ‘Employee Caregiving Survey’ reveals their workloads show no signs of letting up, and this underserved, yet growing population, is demanding help from their employers; they’re willing to leave their jobs unless they get it.”
 
The survey also found that there’s been a 79% increase in the number of employees spending more than five hours weekly on caregiving compared to last year.
 
The types of caregiving responsibilities that the survey respondents were taking on included grocery shopping, driving to doctor’s appointments or other services, housekeeping tasks, arranging or preparing meals and assisting with medications.
 
Additionally, more than a third of respondents either left work early, missed work days or had to change their work schedule to accommodate their caregiving duties.
 
Over half of respondents said they are concerned about the negative impact caregiving will have on their job performance.
 
In addition to those findings, surveyed individuals also expressed an interest in switching jobs if it would give them access to caregiving-coordination benefits, as two-thirds of respondents said they currently don’t have access to a caregiving support benefit.
 
Home care operators should view the Homethrive survey results as another proof point for their services. Professional caregivers can help family members care for loved ones and focus on their careers.

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A Closer Look at the Tech Needed for New Care-At-Home and Aging-In-Place Models

Healthcare IT News | By Bill Siwicki
 
Connecting care teams and enabling information sharing among hospitals, group practices and, most importantly, families is crucial to helping more senior citizens get healthcare at home.
 
As people age, the subject of caring for loved ones enters the conversation. Most find this discussion escalating while events are already in motion.
 
Ashish V. Shah experienced this firsthand with his aging father. And after his dad's death, he learned how pockets of information among care teams were not shared in a meaningful way that might have delayed the fateful event.
 
Shah realized there was no easy mechanism for care teams from different providers to share information that could help patients age in place, so he set out to create one. Now he is CEO of Dina, which makes an AI-powered platform for care-at-home models.
 
Seven out of 10 people require assisted living care in their lifetimes. Studies show that most elderly people would prefer to stay at home and age rather than be moved to an assisted living facility.
 
Healthcare IT News sat down with Shah to discuss health IT's role in aging in place.
 
Q. Please describe the experience you had with caring for your aging father, and what you learned about information not being shared in a meaningful way.
 
A. Anyone who has cared for an aging parent knows it can be a challenging experience. Shortly after my previous company, Medicity, was acquired by Aetna, my father suddenly passed away. Unfortunately, this is something that you hear a lot in healthcare ventures – there's often a personal connection.
 
In my case, I'm trying to solve a problem that our family experienced. My dad was a senior citizen. He was being seen by in-home caregivers and in and out of senior centers.
 
After he passed unexpectedly, we spent time with those folks who saw a meaningful decline coming, and yet that information wasn't being shared with the formal healthcare team, definitely not his insurance company, and not with his family in a way that we could intervene to try to change his care trajectory. They were an untapped resource with a critical and objective perspective.
 
At Medicity, we were serving 1,300 hospitals, facilitating lots of data exchange across hospitals, primary care and labs, but nothing we were doing was ever going to touch the home and community. And as I dug into it more and more, I found that my story, unfortunately, is not unique. It's going to be one that grows in nature.
 
So, both out of professional and personal need, we looked for an opportunity to organize the home and community-based care ecosystem and make it easier for health systems, ACOs and health plans to extend their reach and visibility into the home, in an effort to help people maximize their healthy days at home. We launched Dina in 2015, and we've been very focused and committed to bringing the vision to life.
 
As an industry, we have two problems to solve. One is when you are a really engaged family caregiver. How do we make life easier for that person? The second is, how do we give less-engaged family members the visibility into what's happening with a loved one?
 
For us at Dina, that means how do we activate and coordinate the very best in-home care, and how do we unlock visibility into how that care is progressing to the people who are typically not part of that process, such as insurance companies, physicians, health systems, etc.

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Expanded HHVBP Model: New Resources Now Available

New Resource Now Available – Quality Improvement Self-Assessment for Your HHA 

The Home Health Value-Based Purchasing (HHVBP) Technical Assistance (TA) Team is pleased to announce the availability of a new organizational self-assessment resource, available on the Expanded HHVBP Model webpage under the “Quality Improvement” section:

Quality Assessment and Performance Improvement (QAPI) Program Self-Assessment: For use by home health agency (HHA) teams as a brief, self-guided, performance improvement activity based on structured review of expanded HHVBP Model performance data by measure category. The forms included in the workbook create simple data visualizations that will allow teams to see patterns in measure performance by category. Teams will self-assess their HHA’s performance by measure category for use in planning performance improvement activities.

For questions, please email the HHVBP Model Help Desk at [email protected].

September FAQs Available

The September edition of the Expanded HHVBP Model Frequently Asked Questions (FAQs) is now available to assist HHAs in understanding common terms used in the expanded Model and requirements under the Calendar Year (CY) 2022 Home Health Prospective Payment System (HH PPS) final rule. The document is available for viewing and download on the Expanded HHVBP Model webpage.