AOHP 2020 National Virtual Conference

Topic Overview:
Within healthcare safety, stagnant hazards can be controlled the same way as time goes on, while dynamic hazards require situational awareness to identify and control them in real time. Infectious disease exposures are among the most dynamic of all and, among them, have multiple different hazards and risk groups. In early 2020, the United States began battling one of the most dynamic infectious disease hazards ever, one that is testing healthcare’s ability to define those at risk, prepare the most effective policies and procedures, assess and procure PPE, respirators and disinfectants, communicate expectations and needs, and follow up in real time before exposures occur. There are many lessons to be learned from the U.S. COVID-19 responses, lessons that have the potential to improve many healthcare safety tenets and potentially prevent future exposures to not only COVID-19, but also to influenza, tuberculosis, and other infectious diseases. This AOHP panel discussion brings together subject matter experts from different functionalities involved in the COVID-19 response and aggregates their input, feedback, lessons learned, and advice for the benefit of all healthcare workers and patients alike. A panel discussion and Q&A will follow the speaker presentations.

Objectives:

• Name the different at-risk groups pertaining to COVID-19.
• Determine the hazard control needs, shortfalls, and limiting factors for COVID-19 responses.
• Describe local system-wide occupational health surveillance tools.
• Discuss logistics for occupational infection prevention and control.
• Review the facilitation of successful elastomeric respiratory protection programs.
• Ascertain communication methods for COVID-19 safety messaging.
• Identify lessons learned from COVID-19’s leading and lagging indicators and investigations.

Topic Overview:
Hospital-based Employee Health Services (EHS) are on the front line for community-based outbreaks. It is important to note that some of the appropriate control measures, immunizations practices, and infection control recommendations are similar for different outbreaks, but not all control measures are the same; this is where the challenge arises for an EHS. In the case of measles, not since 1992 has there been a greater number of measles cases in the United States. The principle risk factor was a person not being vaccinated against measles. For the whole of 2019, the Centers for Disease Control and Prevention (CDC) reported 1,282 individual cases of measles in the United States, where 128 of these cases (approximately 10%) were hospitalized. In the case of COVID-19, as of mid-May 2020, there were nearly4.5 million cases and over 303,000 deaths identified on an international level. This presentation will report on the experiences, findings, and outcomes of control interventions for these community-based outbreaks. Specific limitations of the EHS are reviewed, along with implemented solutions.
 
Objectives:

• Review national trends related to measles and coronavirus outbreaks.
• Review the healthcare system’s baseline measures based on established Employee Health Service policies and practices.
• Outline the healthcare system’s recommended changes.
• List the overall outcome measures.
• Discuss recommendations for an Employee Health Service when addressing community-based outbreaks.

Topic Overview:
The role and responsibilities for employee health professionals during disasters is critical in planning communication, care, and coordinated response for employer work populations. This not only conserves critical external resources, but supplements public health and emergency response efforts for the community. Upholding the OSHA General Duty Clause means responsible employee health professionals must prepare response plans in collaboration with other designated emergency response professionals during those times when providing a “safe and healthful work environment” extends into worksite or community catastrophic events. Creating plans and testing them in advance will help ensure successful outcomes for employees, employers, and communities. The purpose of this presentation is to offer occupational and employee health workers an entry-level, build-it-from-the-bottom-up process for establishing a worksite emergency response program. Too often, entry-level employee health professionals are thrown into the much larger role and responsibility of developing a disaster response program for their worksite. And, too many times, it almost seems like just another "box to check" in the development of a worksite emergency response program. Understanding the scope of what needs to happen when a catastrophic event occurs in the community, and for what size population, can potentially diminish casualty outcomes. By following a few simple steps, and being accountable and responsible for our own worksites, occupational and employee health professionals can strategize, prepare, and develop not only a strong, well-prepared worksite emergency response program, but a solid program that sustains the employer and employees with minimal, if any, drain on community services.
 
Objectives:

• Identify three worksite departments to partner with in developing a worksite disaster response program.
• Describe two areas an Emergency Response Team should be "up to date on" and why.
• Specify three takeaways from the "Critical 10,"  and explain the importance of each.

This session included:
004-1 Chronic Pain and Addiction: How We Missed the Boat (30 min)
Mel Pohl, MD, DFASAM
004-2 Multiple Levels of Prevention in the Community and with Individuals (30 min)
Nancy Yuill, PhD, RN
004-3 Narcotics in America: An Expert Panel and Open Forum on a Multi-Dimensional Crisis (30 min)
Mel Pohl, MD, DFASAM, Nancy Yuill, PhD, RN and Kevin F. Smith, MD, MPH
Moderator: Lydia Crutchfield, MA, BSN, RN, CLC 

Topic Overview:
Over 47,000 people died from an overdose of opioids in the United States in 2017. The prescription of, misuse, and addiction to these drugs are decimating a generation of Americans. Heroin use and fentanyl overdose deaths are on the rise. This epidemic was born in another epidemic: chronic pain. This session will review how we got to this point, the nature of the epidemic, pain treatment and addiction, and solutions for changing course at this crucial time.
Objectives:

• Describe principles of chronic pain, including central nervous system processing and the brain’s response to pain and suffering.
• Identify the effects of emotional distress on increasing chronic pain.
• Discuss techniques to manage opioid dependence and the experience of recovery from chronic pain with clinical methods including mindfulness, CBT, DBT and ACT.

Topic Overview:
This presentation reflects challenges, activities, and opportunities for promoting primary, secondary, and tertiary prevention of substance use disorders in the community and in individuals. National and state efforts to prevent the crisis in communities will be examined. Secondary and tertiary prevention efforts for individuals with substance use disorders will be discussed, including interventions to prevent suicide from accidental overdose based on risk factors and vulnerable populations. Further dialogue will be featured in the Narcotics in America Panel Discussion, which will immediately follow this presentation.
Objectives:

• Identity how Health and Human Services (HHS) and the National Institutes of Health (NIH) are addressing the opioid crisis.
• Examine primary prevention efforts to reduce opioid use and substance use disorder.
• Explore secondary and tertiary prevention of opioid misuse and substance use disorder.
• Discuss the implications of healthcare provider attitudes toward addiction and treatment.
• Determine educational efforts needed for patients and healthcare providers in relation to the opioid use and substance use disorder.

Topic Overview:
With years of data and case studies detailing the opioid crisis, THC legalization, and other narcotics issues in the United States, these situations have become more dynamic than ever. As occupational health professionals, the reality is upon us that these issues affect patients, society at large, and healthcare professionals equally. Changes in policies and perceptions by providers, insurers, pharmacies, pharmaceutical manufacturers, law enforcement, researchers, and all levels of government have held offenders accountable and created distress for patients at the same time, with many other situations occurring in between. To discuss these dynamics, we've convened an expert panel with physician, occupational health, academic, and even patient perspectives. Audience questions are welcome.

Objectives:
1. Identify details surrounding the nationwide opioid crisis.
2. Review issues regarding the limited legalization of THC in the United States.
3. Consider legal implications of opioid and THC prescriptions and procurement in the United States.
4. Discuss medical uses of opioid and THC medication.

Topic Overview:
Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC (MMWR May 17, 2019) is still new, and the nation is undergoing a shift in its approach to tuberculosis (TB) testing and treatment of healthcare personnel (HCP). These recommendations from the Centers for Disease Control and Prevention (CDC) empower practitioners, in most cases, to eliminate annual TB testing while maintaining pre-placement and post-exposure testing, as well as to advocate for treatment of those with latent TB infection. Dr. Wendy Thanassi, a co-author of the guidance, will compare the 2005 and 2019 CDC guidelines to explain the current recommendations and provide implementation tools. She will share examples of successes and failures, along with resources occupational health providers can turn to and an update of state-based processes. The presentation will conclude with a Q&A session to address specific concerns from attendees.
Objectives:

• Explain current CDC recommendations for TB testing of healthcare personnel.
• Identify documents that control the guidelines for TB testing and treatment.
• Provide adequate time for questions so direct concerns can be answered.

Topic Overview:
Virginia Mason Medical Center has seen rising numbers of employees reporting workforce violence since 2016. In 2019, workplace violence was the leading workplace safety concern and was selected as an organizational goal. A programmatic exploration of multi-modal strategies to prevent workforce violence was initiated. This presentation will focus on the methods Employee Health applied to weave the voice of the team member throughout each stage of program development, including: development and implementation of a centralized reporting form; an organization-wide, in-person, open forum for employees to share their experiences; an all-employee anonymous online survey; multidisciplinary employee focus groups; and frontline participation in Rapid Process Improvement Workshops. As the organization received increasing reports of employees experiencing workforce violence, the need for an improved reporting mechanism was clear. A Workplace Safety Alert system streamlined the process for employees to report health and safety concerns or injuries. The new system allows for employees, managers, patient safety, employee health, human resources, and security to collaborate on identifying cause and corrective actions. Knowing that many employee health and safety concerns go unreported, there was an additional need to understand and learn from frontline team members regarding their experiences with workforce violence. Open forum discussion sessions were held in all Virginia Mason locations, including 10 regional medical centers. The information was themed and systematized into a driver diagram to identify areas of focus. To include all employees in the story-sharing opportunity, a system-wide survey was distributed. An analysis of these team member experiences is driving the second phase of program development work. Frontline employees will continue to participate in events to refine ideas and shape processes that will be used to prevent and manage violent events.
 
Objectives:

• Describe the impact of listening to and incorporating the ideas of frontline staff in the development of a workforce violence program.
• Identify three methods for collecting information from frontline staff regarding their experiences and needs in the event of workforce violence.
• Identify key strategies for organizational culture change related to workforce violence prevention.

Topic Overview:
The Occupational Health Department plays a pivotal role in the ongoing safety of the work environment. As members of the management team, it is essential for occupational health professionals to know and understand the potential changes in the regulatory environment caused by the passage of newly-introduced legislation. This general session will review the pertinent and germane bills introduced in the 116th Congress and give highlights into the reasons behind the issues. The Department of Labor’s most recent regulatory agenda, initiatives being pursued by the Department of Health and Human Services, and recent Supreme Court (and Circuit Court) decisions will be reviewed and dissected to determine their potential impact on occupational health responsibilities. Participants will learn strategies to address changes brought on by new legislation.
Objectives:

• Learn which new legislation forwarded by President Trump and introduced into the 116th Congress may impact occupational health.
• Describe the issues behind newly-introduced legislation and the potential for passage due to the new composition of the House of Representatives.
• Initiate strategies to address workplace changes brought on by newly-introduced legislation and agency policies.

Employees often make light of how little sleep they get on a regular basis. An over-worked, over-tired condition has become the norm for many employees in the workplace. Getting a good night's sleep is not just a novelty; it's a necessity. The effects of fatigue are far-reaching and can have an adverse impact on our work output, as well all areas of our lives. This class will enhance the knowledge of the occupational health professional to detect work fatigue symptoms before a bad outcome occurs.

Objectives:
Identify three fatigue-related incidents for which people are at risk.
Name two effects that fatigue has in the workplace.
Identify the signs and symptoms of sleep apnea in employees.
Identify three symptoms of fatigue.
Describe sleep physiology and how alterations in sleep patterns change over an individual’s lifespan.

Topic Overview:
Do employees perform well because you inspire them to or because they are fearful? Do you want a culture of have-to or want-to? The answer is obvious. However, at all levels, many leaders unintentionally make some common mistakes that undermine what they are trying to accomplish. Some actually harm their own efforts while trying to improve performance and culture. Good intentions are not enough! To create sustainable, above-and-beyond performance in others, you must create an environment in which individuals feel motivated to provide critical discretionary effort. Learn how in this engaging keynote presentation by bestselling author Shawn Michael Galloway.
 
Objectives:

• Mature safety excellence thinking.
• Understand influence and motivation.
• Think strategically, and keep the most important thing the most important thing.