10 recommendations to improve pandemic preparedness

If your hospital or skilled nursing facility has faced an OSHA citation or even a complaint investigation because of possible employee exposures to COVID-19, get ready: OSHA may be coming back soon.

The United States was inadequately prepared to respond to the coronavirus pandemic such as insufficient supplies of personal protective equipment (PPE). The country leads the world in COVID-19 deaths, with 991,260 lives lost as of today, according to worldometer.

The Department of Labor’s (DOL) Occupational Safety and Health Administration (OSHA) has announced an enforcement memorandum for a short-term increase in highly focused inspections directed at hospitals and skilled nursing care facilities that treat or handle COVID-19 patients.

I guess this is all part of the “return to normalcy” program upon which we are (seemingly) currently embarked, but it does appear that the regulatory “sticks” are being brought to bear (how come they never come bearing carrots – sigh!) as our adherence to the various mandates, disputed mandates, mandates that aren’t mandates at the moment, but could become mandates in the future, etc., is being assessed for compliance.

Lauris Freidenfelds has been in the healthcare security arena long enough to recognize it’s not about turning security team members into law enforcement agents. The two aren’t equivalent and never will be.

“Security has a role, and I've always looked at this as a continuum,” says Freidenfelds, senior project manager for Wilmington, Delaware–based Telgian Engineering & Consulting. “Law enforcement is great at responding and arresting and prosecuting and all that other kind of stuff. Security's role overlaps a little bit of that, but they're primarily involved in preventing these things from happening.

Reconciliation wouldn’t be much of an issue if a patient only went to a single provider for care, or if information was transferred seamlessly. However, this is rarely the case.

Patients move or change doctors, go to nearby ERs or urgent care clinics for emergencies, and can be prescribed medicines from various healthcare specialists. And even within an organization, medication reconciliation can fail when a patient is handed off between providers or if someone doesn’t correctly input the information in the electronic health record.

More than 2.8 million AMR infections occur in the U.S. each year, and more than 35,000 people die as a result. Globally, 700,000 people die each year due to AMR diseases, with the WHO estimating that number could increase to 10 million deaths annually by 2050. The WHO estimates those additional deaths could be as catastrophic to the world economy as the 2008–2009 global financial crisis.

With few new antibiotics on the horizon, our best bet to keep our existing medicines working for as long as possible is through antibiotic stewardship programs (ASP), says Amanda Beaudoin, DVM, PhD, director of the One Health Antibiotic Stewardship Collaborative at the Minnesota Department of Health.

One way or another, CMS is promising states that it will enforce its recent interim final rule requiring hospital and other healthcare staff caring for COVID-19 patients to be fully vaccinated. CMS published a warning to states February 9 that if they are contracted with the federal agency to carry out health and safety surveys, failure to carry out their responsibilities (including enforcing the new vaccine requirement) will result in a reduction of federal funds to the state’s survey offices.

Remind staff that they must initiate a fire alarm if they see evidence of a fire—even if they don’t see any active flames.