Weekly Report for February 19, 2015 – Why Nurses Need Flu Vaccines: Guest Message From Carol Wagner, RN

February 19, 2015

On Sunday, Seattle Times columnist Danny Westneat wrote about vaccines, and whether groups such as foster parents and nurses should be required to get them. Here is an excerpt:

“For at least a decade, nurses, both locally and nationally, have been fighting attempts to force them to get the flu shot. Just last month a nurses’ association sued to block two hospitals in Tacoma from making them choose between getting the shot or potentially losing their jobs….The Nurses Association says it isn’t anti-vaccine, and it recommends everyone get the flu shot. But it draws the line at forcing (or what amounts to a forcing, as their jobs are on the line if they refuse).”

You can read the whole column here.

We feel strongly about the risk to patients, and we know how hard hospital, health system and clinic staff members are working to reduce the spread of hospital-acquired infections. We sent the following response, but we also wanted to share that response with you.

Mr. Westneat,

In response to your column yesterday, and as a nurse and a parent, it’s my recommendation that all parents get the flu shot to protect themselves from their children (rather than the other way around). However, the question of mandated flu shots for foster parents is not my professional issue.

What is my issue, and it is for all the hospitals in our state, is the question of flu vaccines for nurses and physicians. Nurses and physicians are in constant close proximity to the elderly, newborns, people undergoing chemotherapy, and other patients with compromised immune systems. These are the people who are most likely to catch the flu and suffer its worst effects—serious illness and death.

We are working every day to eliminate hospital-acquired infections. We require hand washing and gloves and masks and countless other procedures to stop the spread of disease, and these are not optional measures. Vaccines are easy and cheap ways to reduce the spread of infectious disease, and patients have the right to expect their providers will not give them a deadly disease. Patients should know:

  • Hospitals are evaluated on the percentage of workers who get immunized from flu, and we report our vaccination rates publicly at www.WAHospitalQuality.org;
  • Patients can and should ask their providers about their vaccination status and can ask for a nurse or physician who is properly vaccinated;
  • Influenza kills thousands of people every year, and both self-interest and compassion require vaccines.

Nurses are the most trusted profession because of the care they provide. Fortunately, the vast majority of nurses make the caring and responsible choice to be fully vaccinated when caring for patients. But those who put their personal preferences above the needs of their patients should reconsider the impact of their choice.  It is reasonable for the hospitals and clinics they work for to ensure patients are protected.


If you have any questions, please visit our webpage or contact me directly at carolw@wsha.org or 206/577-1831.



CHI Franciscan Recognized by Washington Health Alliance for Work to Reduce Costly ER Visits

WSHA member CHI Franciscan, which includes hospitals in Pierce, Kitsap and south King counties, was recently featured by Washington Health Alliance for work to reduce costly ER visits.

An Alliance report showed CHI Franciscan is reducing health care spending improving patients’ access to and awareness of care settings outside the emergency department.

“CHI Franciscan’s success has focused on providing patients alternatives to more costly ER visits, including prompt care locations, patient-centered medical home clinics, patient education materials, care management, virtual urgent care and efforts to reduce hospital readmissions,” said WHA Executive Director Nancy Giunto.

“Since this information has practical applications for hospitals and medical groups that want to be more competitive and efficient, we were happy to recognize CHI Franciscan’s quality improvement efforts, which required leadership commitment, engaged and caring providers, integrated care and strong partnerships.”

WSHA, our members and several of our partners have been working to reduce unnecessary ER utilization since 2012. The most recent report from fiscal year 2013, showed:

  • The rate of emergency department visits declined by 9.9%.
  • The rate of “frequent visitors” (five or more visits annually) dropped by 10.7%.
  • The rate of visits resulting in a scheduled drug prescription fell by 24%.
  • The rate of visits with a low-acuity (less serious) diagnosis decreased by 14.2%.
  • A savings of $33.6 million in Medicaid fee-for-service emergency care costs.

For more information, visit WSHA’s ER is for Emergencies webpage and the Alliance’s Spotlight on Improvement webpage.

WSHA and WSPA Surface Concerns with Pharmacy Compounding Rules

On February 15, WSHA and Washington State Pharmacy Association (WSPA) submitted joint comments to the Department of Health expressing strong concerns with the Pharmacy Quality Assurance Commission’s draft “Compounding Practice Rule.”

WSHA is concerned that the draft rule is not fully aligned with national standards, will unnecessarily increase the burden and cost to hospital pharmacies, and has the potential to limit access to drug products in rural communities. The two associations collaborated to convene members and submit joint comments reflecting our mutual interests and common concerns. WSHA and WSPA will continue to work collaboratively to address the concerns around pharmacy compounding practice rules in Washington State.

More information on the draft rules and comments can be accessed on the WSHA Regulatory Issues page. (Ian Corbridge, ianc@wsha.org)

Inside Olympia: Prohibiting Certificate of Need for Washington State Hospitals

Representatives Joe Schmick and Eileen Cody have introduced a bill that would prohibit the Department of Health from giving a Certificate of Need (CN) for a purchase, sale, or lease of a hospital to any entity that already owns a hospital in Washington State.

Under the current CN law, this would only apply to true sales, purchases and leases of hospitals. This would be bad enough. Some hospitals may only have long-term viability if they are purchased by another hospital (e.g., the purchase of Auburn Medical Center by MultiCare). If they can’t sell to a Washington State-based hospital or system, the only choice for some endangered hospitals would be an out-of-state owner or closure.

For the rest of this article, and information about the telemedicine bill passed by the Senate, non-compete clauses for physicians and more, read Tuesday’s Inside Olympia.

Tomorrow is the first big cut-off, so on Monday, Inside Olympia subscribers will get an update on all the bills we’ve been tracking thus far. (Mary Kay Clunies-Ross)

Population Health: Focus on Diabetes

Washington State recently released its report to the legislature on the diabetes epidemic in Washington State. The report calls for 10 goals, including ensuring all appropriate populations have access to chronic disease self-management education programs. This benefit, already included in Apple Health and the state employee benefit plan, is a way to work across silos on health improvement activities. As the report notes, public/private partnerships can also be used to increase appropriate use of other essential preventive care services for people with diabetes, such as routine eye screening to diagnose diabetic retinopathy and screening for end-stage renal disease.

Learn more about diabetes prevention work at one of the break-out sessions at our upcoming March 6 summit on Population Health Meets Medical Care.

Joan Brewster, Director of Grays Harbor County Public Health & Social Services Department and Andrew Fresco, Administrator, Yakima Health District, will discuss with participants how to launch initiatives in their areas. It’s not too late to register! Diabetes prevention in rural areas is also a focus of the WSHA patient safety work. (Claudia Sanders, claudias@wsha.org)

Washington Healthplanfinder Announces Enrollment Extension for 2015 Coverage

In an effort to provide individuals seeking coverage additional time to complete their applications, and avoid a new tax penalty for not having health insurance, the Exchange has announced a special enrollment period from February 17th to April 17th, 2015.

This is the first year Washington state residents can incur a tax penalty for not having health insurance under the Affordable Care Act, with those who are not covered in 2015 facing a penalty of up to $325 per person, or 2 percent of personal income, whichever is greater.

With nearly 160,000 residents enrolled in a Qualified Health Plan through the Exchange by February 15th, this extension will allow for other customers experiencing technical issues or unaware of the penalty to get coverage.

To enroll in 2015 coverage by April 17, 2015, complete an online application at www.wahealthplanfinder.org or call 1-855-923-4633 to request a special enrollment. For technical issues you can also email customersupport@wahbexchange.org. For more information read this FAQ or visit the Special Enrollment Period webpage.(Mary Kay Clunies-Ross)

CFO Advisory Committee Selected to Guide Flex Work

A CFO Advisory Committee has recently been named to help develop, advise and guide the Financial and Operational Improvement work outlined in this year’s Flex grant contract. The purpose of this work is to assess the financial and operational improvement needs and opportunities of critical access hospitals, and then provide the training and tools to address them.

Committee members include:  Hilary Whittington, Jefferson Healthcare; Libby Allgood, Kittitas Valley Healthcare; Tyson Lacy, Lincoln Hospital; Helen Verhasselt, North Valley Hospital; Steven Febus, Pullman Regional Hospital; William Callicoat, Summit Pacific Medical Center; Alex Town, Tri-State Memorial Hospital; Jim Heilsberg, Whitman Hospital and Medical Center; Kim Kelley, DOH; Tom Evert, WSHA; and Rich Boucher, WSHA. If you have any questions about the advisory committee or its work, please contact Rich Boucher (richb@wsha.org).

Industry Partner Spotlight: Incyte Diagnostics Brings the Laboratory into Collaborative Patient Care

Incyte Diagnostics LogoWashington Hospital Services Industry Partner Incyte Diagnostics provides thoughts about how lab can help deliver greater value to patients and decrease costs.

Laboratory professionals are increasing value by working in new ways including forming diagnostic management teams (DMT’s) to assist with lab test selection and getting out of the lab to directly help in the clinical environment. At Overlake Hospital in Bellevue, laboratory technologists and pathologists from Incyte Diagnostics attend clinical rounds and work with their clinical colleagues to interpret and integrate lab results, answer clinical questions, and improve patient care. As members of more thirty hospital medical staffs throughout Washington and Idaho, Incyte’s board-certified pathologists actively consult on a broad variety of physician specialties and participate in numerous hospital committees. Incyte pathologists have chaired Tumor Board discussions and serve as key members of specialist teams to help determine the best treatment options for patients in their community. Their expertise as laboratory medical directors is a crucial component to improving patient safety and patient care while reducing healthcare costs. To learn more about the innovative ways Incyte’s laboratory medical directors collaborate on patient care, please visit www.incytediagnostics.com.


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