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| The Monthly Pulse |
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| Seven Things Healthcare Employers Should Expect in 2023
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| The Story |
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| As we move further into 2023, healthcare employers should be on the lookout for several major trends. While it’s no surprise that staffing challenges are expected to persist, employers will also likely have to navigate ongoing cybersecurity threats, increased scrutiny from regulators when it comes to telemedicine, increased strikes, and unionization among residents and interns. Additionally, there will be an increased focus on Title IX in medical residency and other educational programs, and a permanent rule on OSHA standards covering COVID-19 for healthcare workers will likely become effective early in the year. |
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| What You Should Know |
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| Clearly, healthcare employers will have many important issues to address throughout the year. Staying up-to-date with regulatory changes and pursuing strike contingency planning can help healthcare leaders stay prepared for what could come. Yet, it may also be possible to address some challenges with a more proactive approach; for example, prioritizing efforts to improve employee satisfaction could help with both labor strikes and staffing challenges.
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| The impact of a postoperative multimodal analgesia pathway on opioid use and outcomes after cardiothoracic surgery
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| The Story |
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| While multimodal analgesia (MMA) is recommended for postoperative pain by the Enhanced Recovery After Cardiac Surgery (ERACS) Society, we have yet to see evidence-based guidelines for its use. Recently, a study was published in the Journal of Cardiothoracic Surgery which aimed to identify the impact of a standardized postoperative MMA pathway as a means of reducing opioid consumption and postoperative complications following cardiothoracic surgery.
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| What You Should Know |
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| The study included data from 762 adults broken out into two groups: one received a newly implemented MMA pathway, while the other received the existing opioid-based pathway. Contrary to the study’s hypothesis, the use of the MMA pathway didn’t reduce opioid consumption, though patients in the MMA pathway did have earlier mobility. Nonetheless, the study’s authors believe that the development of a standardized perioperative MMA approach is still warranted.
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| Comparison of Evaluations for Heart Transplant Before Durable Left Ventricular Assist Device and Subsequent Receipt of Transplant at Transplant vs Nontransplant Centers |
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| The Story |
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| According to a cohort study of more than 22,000 left ventricular assist device (LVAD) recipients from the Society of Thoracic Surgeons Intermacs Database, patients who received durable LVAD in centers that also perform heart transplants were much more likely to receive an LVAD as a bridge to a transplant. Moreover, patients who received treatment at combined LVAD/transplant centers were more likely to have a heart transplant within two years. |
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| What You Should Know |
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| According to the study’s findings, the increased use of LVAD at nontransplant centers could contribute to inequities in patients’ access to heart transplant. Within two years, the transplant rate for patients who had received LVAD was 25.6% for LVAD/transplant centers, versus just 11.9% at LVAD-only facilities. The study authors note that recent Centers for Medicare & Medicaid Services policy changes, which remove the requirement to obtain review from a heart transplant center for LVAD implantation, could inadvertently increase inequities among patients’ access to heart transplant.
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| Leadership Reflections |
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Grit: The Power of Passion and Perseverance
How long does it take to make a new behavior automatic? Some say it takes a consistent twenty-one days to form a new habit, while others believe it’s closer to three months. No matter the time frame, each habit formation starts with day one. Our potential is one thing, but how we act on it, is another.
Psychiatrist Angela Duckworth shares the secret characteristic of achieving long term goals in her TED talk, Grit: The Power of Passion and Perseverance. Indeed, grit is one of the most desirable traits of a leader. It is something everyone can learn as it does not rely on talent or I.Q., rather, it is determined by effort and consistency toward your goals. A leader with grit seeks inspiration in the face of adversity and has the power to create a culture centered on resilience. How does one become “gritty?” What does it take to grow your grit in leadership? Here are some core principles to consider:
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- Clarify your goals – Identify clear, simple goals to encourage focus.
- Discover your interest - Interest is your source of passion to keep the care-factor involved.
- Practice deliberately - Practice repetition with reflection and refinement.
- Find your “why?” – Discover your purpose.
- Use optimistic self-talk – If you think you can, you will.
- Create a gritty culture – Surround yourself with energy you want to identity with.
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| A leader with grit is contagious and uplifts those around them to stay relentless in their goals. I challenge you to grow your grit in 2023. |
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| AAPA Executive Leadership Conference |
| Mon. Mar. 6 - Wed. Mar. 8 |
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| The General Thoracic Surgical Club 2023 Annual Meeting |
| Thurs., Mar 9 - Sun., Mar 12 |
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| Houston Aortic Symposium |
| Thurs., Mar. 16 - Sat., Mar. 18 |
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| AmSECT 61st International Conference |
| Fri. Mar. 24 - Sun. Mar. 26 |
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