INSIDE THE ISSUE

> AHA Letter to Congress
> Blood & Equipment Shortage
> Pregnancy & Vaccines
> SUD Care
> Transitions

MONDAY REPORT

AHA Letter to Congress Details Areas Where Help is Needed

Hospitals are still full of patients and still facing staffing shortages. While in some areas of the U.S. –including in Massachusetts – COVID-19 cases have ticked down, hospitalizations have not. That’s because hospital admission surges have always lagged total case surges. And ICU cases by all estimates will continue to increase for weeks after the peak of a COVID surge. That has always been the trend during the pandemic.

In light of that, and during the midst of Congressional talks of an omnibus budget agreement, the American Hospital Association last week drafted a letter to Congressional leaders outlining hospital concerns.

“During the past two years, hospitals and health systems have relied on relief provided through the Provider Relief Fund (PRF), temporary elimination of the Medicare sequester cuts, and other important provisions,” AHA wrote. “In addition to those continuing needs, we now need additional support to bolster our stressed and strained workforce.”

MHA has been in contact with the Massachusetts delegation over the issues contained in the AHA letter, especially the need to decisively and quickly release the remaining Provider Relief Fund monies that were appropriated during the start of the pandemic but have not yet been fully expended.

Troubling Concerns: Shortage of Blood and Collection Tubes

The American Red Cross calls it the worst blood shortage in a decade. Currently across the U.S. – and including Massachusetts – blood is in short supply due to a number of reasons. The Red Cross, which gets about 25% of its donations from college and high school blood drives, has seen that percentage to drop to about 10% during the pandemic. Blood drives overall have dropped due to staffing shortages and cancellations due to illness and weather.

The Red Cross supplies 40% of the nation’s blood supply, and has had to limit blood product distributions to hospitals. Hospitals, which conduct their own blood drives, also report massive shortages. While all blood types are urgently needed, Type O positive and negative and platelets are in especially short supply.

To donate blood, book an appointment here.

In a related issue, the U.S. Food and Drug Administration (FDA) announced last week that there is a national shortage of several blood specimen collection (blood draw) tubes due to an increase in demand during the pandemic and vendor supply challenges. The FDA issued guidance to providers on how they can conserve the tubes, including removing duplicate test orders to avoid unnecessary blood draws, and avoiding testing too frequently or extending time intervals between tests.

Vaccines and Pregnancy: Instilling Confidence

Massachusetts recently passed the mark of vaccinating more than 5 million of its citizens, an impressive achievement that places the commonwealth in the top five of the CDC’s list of states by percentage of population fully vaccinated. But one group of people exhibiting persistent reluctance to get vaccinated are those that are pregnant.

While many people have been vaccinated before pregnancy, the percentage of those who received vaccinations during their pregnancy is much smaller than the general vaccination rates, according to the CDC.

The American College of Obstetricians and Gynecologists (ACOG) has throughout the pandemic, attempted to alleviate the fears of pregnant individuals, as well as produce materials to alleviate their concerns. ACOG has produced a conversation guide for clinicians, as well as a new patient website.

On Wednesday, January 26, from noon to 1 p.m., the American Hospital Association is holding a free webinar entitled Building Confidence in the COVID-19 Vaccine During Pregnancy. Members of ACOG, along with hospital leaders, clinicians, and experts from the CDC will discuss how healthcare professionals can work with their patients and communities to build trust in the safety and efficacy of COVID-19 vaccines for pregnant people. The webinar is open to all by registering here.

New Toolkit Attempts to Better Organize SUD Care

The CDC estimates that in 2020, there were 92,000 drug overdose deaths in the U.S., representing a 30% increase from the year before. In 2021, drug deaths continued to rise and they have disproportionately affected Black and Latinx populations.

The response to the crisis across the U.S. has been varied. In Massachusetts, the healthcare community, through MHA’s long-standing work in the substance use disorder field, has instituted programs for Medication for Opioid Use Disorder within the Emergency Department, Opioid Management within a Hospital Setting, Emergency Department Opioid Management, and Preventing Opioid Misuse in Hospitals. Hospital-funded community benefit programs across the state also have focused on substance use disorder (SUD).

Now the American Society of Addiction Medicine (ASAM) is calling attention to the fact that much variability exists across the U.S. in how communities are treating SUD. As a result, ASAM has issued a toolkit entitled “Speaking the Same Language” to strengthen addiction care across the U.S.

“Historically, there has been significant heterogeneity across states and communities in the organization and oversight of addiction treatment systems,” ASAM writes. “This has contributed to high variability in the quality of care and resulting patient outcomes.”

ASAM says that well-structured consistent approaches to care are regularly used to address care for other chronic conditions, but that the stigma surrounding SUD has resulted in “ad hoc treatment” or no care at all. The toolkit focuses on the “ASAM Criteria” that the society calls “evidence-based guidelines for patient placement, continued stay, and transfer of patients with addictive, substance-related and co-occurring conditions.”

Transitions

Chad Wable is the new president of Mount Auburn Hospital, effective immediately. Most recently, Wable was interim CEO of Pipeline Health, which includes seven hospitals and health networks in Los Angeles, Chicago, and Dallas. He is also the founder and past president of Connecticut-based Aspiresults, a healthcare consulting company. Wable takes over from Dr. Ed Huang, who served as Mount Auburn’s interim president for the past six months. Huang will now return his role as chair of the hospital’s Obstetrics & Gynecology department. Wable received his bachelor’s degree in biology and dual master’s degrees in community health education and business administration from West Virginia University.

Andrew Dreyfus, the CEO of Blue Cross Blue Shield of Massachusetts for the past 12 years, said this week he is stepping down from the role by year’s end. Previous to his role at the health insurance company, Dreyfus was the president of the BCBSMA Foundation, and before that he was executive vice president of MHA.

John LoDico, Editor