Bracing for the Perfect Storm in Healthcare: Flu Season, COVID-19 and the Return of Electives

 

Update: As of September 16, 2020, CMS has announced the launch of its 2020 flu season campaign. Learn how to protect yourself this flu season. 

 

Each year, we talk about the importance of flu prevention. This year, we need to shout about it.

The CDC believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading this fall and winter.

CDC Director Robert Redfield has advised:

“In November, December, January we’re going to have Covid again, I am pretty confident of that, and unfortunately we’re going to have flu at the same time…The more we can prevent flu from causing hospitalizations, the more we can prevent people with flu from filling up our ICUs, the more probability that there is going to be a hospital bed for people with Covid.” – CDC Director, Robert Redfield

COVID-19 and the flu are not the only challenges taxing our overburdened healthcare workers. Bringing back patients who deferred elective care during the COVID-19 outbreak is essential to avoiding another health crisis in which chronic conditions are untreated and life-threatening illnesses go undiagnosed. 

While your patients may be concerned about COVID-19 exposure or safely returning for their elective procedures, it’s important to ensure they understand the heightened importance of getting a flu shot this year.    

Why is the flu a greater concern during COVID-19?

The flu vaccine is not something to be deprioritized because of the coronavirus; rather, the opposite is true. According to Dr. Rachel Levine, Pennsylvania’s Secretary of Health, “No one knows what happens if you get influenza and COVID [simultaneously] because it’s never happened before.” Both can be extremely serious conditions on their own – even among otherwise “healthy” people with no chronic conditions or comorbidities. We don’t want to exacerbate the pandemic, nor do we want people who have the flu to contract COVID-19.

But there’s another important reason to limit the number of flu cases this season – hospital capacity. We saw hospitals reach surge capacity during the first wave of COVID-19 and over the summer months, “hot spots” emerged in some parts of the country and the number of cases continues to climb.   

Hospital beds, ventilators, and PPE became scarce soon after COVID-19 emerged. Exhausted staff members are continuing their heroic efforts but we must do all we can to ensure staffing levels remain adequate and that we keep our staff healthy both emotionally and physically. If hospitals are battling an influx of influenza cases while treating COVID-19 patients, as well as patients whose conditions worsened because their treatment was deferred, we could be in for another very dangerous situation.

What message should hospitals and health systems  communicate about flu prevention this season? 

This risk for another unprecedented healthcare crisis is real. In an interview with WebMD, Robert Redfield warned that the combination of COVID-19 and influenza could result in the “worst fall we’ve ever had” from a health perspective and that people “shouldn’t leave this important accomplishment of American medicine on the shelf for yourself, your family, your church, your workforce.”

Hospitals and health systems need to be even more diligent about encouraging their populations to get the flu vaccine this year. A few simple steps can help:

  • Make sure patients  know the vaccine is available.
  • Assure them that the vaccine is safe. (It won’t “give them the flu”.)
  • Tell them how they can make an appointment to get vaccinated at your facility or elsewhere. (Many pharmacies such as CVS, Walgreens, and Walmart offer free or low-cost flu vaccines).
  • Don’t get the vaccine “too early”. Medical experts advise getting the vaccine by the end of October, but vaccination should continue to be offered as long as influenza viruses are circulating locally. Vaccination too early in the season (e.g., July or August) may lead to suboptimal immunity later in the season, particularly among older adults.

How can hospitals and health systems get the message out?

For UCSF Health, increasing the volume of flu vaccinations administered has been an important and longstanding initiative. Past outreach efforts have included partnering with Walgreens to provide flu vaccine vouchers, offering flu vaccination clinics, and sending out postcards for vaccination reminders.

Working with CipherHealth, UCSF Health took these initiatives one step further and instituted automated patient outreach to create a campaign specifically targeted at patients not already vaccinated at a Primary Care clinic. They developed a program that would educate patients about the benefits of vaccinations while also capturing data on whether patients had been vaccinated outside of UCSF Health. This method would allow UCSF Health to update its charts and encourage patients to receive their flu shots.

Automated messages needed to be engaging, concise, and effective. Calls included a question about flu shot history and the patient’s next flu shot. By reminding patients how, where, and why to get vaccinated, staff at UCSF Health clinics noted a marked increase in the number of walk-in visits requesting flu vaccinations. Over a period of six months, UCSF Health increased its percentage of Primary Care flu vaccination rates for eligible patients to 63.4%.

UCSF Health 

Graph of flu vaccination rates

Source: CipherHealth Whitepaper, “Increasing Flu Vaccination Rates with Proactive Outreach”

The outreach program not only helped UCSF Health to increase vaccination rates but also gave them the ability to understand patients’ actions outside of the hospital and inform future population health initiatives. 

Preparing for a “perfect storm” in healthcare 

As your team braces for the next wave, here are some steps you can take to prepare:

  • Have your surge capacity plan in place.
  • Identify overflow areas.
  • Have PPE preventive measures in place.
  • Assess equipment supply availability and readiness.
  • Use “enterprise visibility” to determine, at a glance, which beds are clean and available for incoming patients, as well as which are staffed, and for which nursing units and levels of care.
  • Ensure that essential process changes are operationalized and hardwired into the organization (visitation policies, patient isolation effects, resuming elective procedures safely).
  • Have a consistent and frequent communication strategy in place.

 This flu season we’ve got to do all we can to make sure the perfect storm in healthcare doesn’t hit us head on.

Contact us to learn how CipherHealth can help with preventive outreach to your population for flu vaccinations and more. 

As CipherHealth’s Chief Nursing Officer, Lisa Romano, MSN, RN brings more than 25 years of experience in clinical practice, healthcare IT strategy, and healthcare operations to her current role. Prior to previous CNO roles, Lisa spent 19 years as a nurse and hospital administrator at Lehigh Valley Hospital and Health Network in Allentown, PA, where she was responsible for all patient flow and transfer center operations as well as numerous quality and patient satisfaction initiatives. Lisa is passionate about improving the health of patients across the healthcare continuum.