RISE looks at recent headlines concerning social determinants of health (SDoH).
Nationwide survey finds nurses are experiencing increased workplace violence
There is a concerning spike in workplace violence among health care workers, according to National Nurses United’s (NNU) 2023 survey data. For the survey, NNU surveyed nearly 1,000 nurses across 48 states and the District of Columbia as well as conducted in-depth focus group discussions with 31 NNU members from seven states for more detailed accounts of workplace violence.
The survey found:
- Eight in 10 nurses (81.6 percent) have experienced at least one type of workplace violence in the last year.
- Nearly half of nurses across the country (45.4 percent) reported an increase in workplace violence in the previous year.
- Only 3.8 percent of nurses have reported workplace violence decreasing on their unit in the previous year.
- Incidents of violence commonly occurred in patient rooms and units, however, there were also “striking” incidents that occurred outside of typical patient care areas, such as parking lots, hallways, and administrative offices.
- Only 62.8 percent of nurses said their employer provides training on workplace violence prevention.
- Only about one in three nurses (31.7 percent) said their employer provides a clear way to report incidents.
- Few employers were said to have implemented prevention measures such as chart or room-flagging systems to indicate patients with an increased risk for violence (26.8 percent), security cameras (24.8 percent), metal detectors (7.1 percent), and limiting visitor hours (15.4 percent).
- Less than half of nurses (41.6 percent) said their employer investigates further following a workplace violence incident and only one in five (21.2 percent) said changes in practices were implemented following an incident.
- Only 27.7 percent of nurses said their employer provided access to counseling services following an incident.
- Most nurses (65.3 percent) reported feeling anxiety, fear, or increased vigilance following experiences with workplace violence.
While NNU has advocated for occupational health and safety standards to require employers to prevent violence in health care settings for years, and made significant strides, further clear requirements for employers surrounding prevention measures are critical to protect the health care workforce, explained NNU study authors.
“Despite these strides, protections for nurses and other health care workers will remain piecemeal in light of the Occupational Safety and Health Administration’s (OSHA) exclusive jurisdiction in 24 states, making a state OSHA standard impossible in those states,” they wrote. “Only a federal OSHA standard on preventing workplace violence in health care will ensure that all nurses and other health care workers are protected.”
HHS final rule aims to improve confidentiality for patients with substance use disorder
The U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR) and the Substance Abuse and Mental Health Services Administration (SAMHSA), finalized a rule this week to better protect the privacy of medical records for patients who receive treatment for substance use disorder.
The modifications to the Confidentiality of Substance Use Disorder (SUD) Patient Records regulations at 42 CFR part 2 (“Part 2”) will increase coordination among providers treating patients for SUD, strengthen confidentiality protections through civil enforcement, and improve the integration of behavioral health information with other medical records.
“People who are struggling with substance use disorders must have the same ability to keep their information private as anyone else. This new rule helps to ensure that happens, by strengthening confidentiality protections and improving the integration of behavioral health with other medical records,” said HHS Secretary Xavier Becerra in a statement. “The Biden-Harris Administration has made it a priority to end the stigmatization of those living with substance use disorders and give health care providers the tools they need so they can treat the whole patient while continuing to protect patient privacy. We will not rest until behavioral health is fully integrated into health care and those struggling with behavioral health challenges get the best treatment available.”
Click here for a detailed list of the modifications.
California county declares loneliness as a state of emergency
San Mateo County, located in the San Francisco Bay area, has become the first U.S. county to declare loneliness as a public health emergency, according to NBC News. While the resolution, passed by the county’s Board of Supervisors last week, does not directly allocate funds for efforts addressing loneliness, it underscores the county’s commitment to solving the issue.
"What we're trying to do is to really get people out of the corners and say, 'Hey, look, there are a lot of people who are feeling like you. You're not alone. And moving forward, here are some of the things that we can do to support you,'" David Canepa, the Board of Supervisors’ vice president, told NBC News.
Surgeon General Vivek Murthy applauded the county’s declaration in a post on X. “When I released my Surgeon General’s Advisory on loneliness, I outlined what localities can do to promote connection,” he wrote. “Grateful to San Mateo County for becoming the first county in America to recognize loneliness as a public health emergency.”
Community Health Systems announces completion of data migration, new generative AI with Google Cloud
Community Health Systems (CHS), and Google Cloud have announced that CHS has completed a data migration project, the Fast Healthcare Interoperability Resources 1 (FHIR)-based clinical data platform. CHS said it is also implementing a new generative AI innovation leveraging Google Cloud.
The FHIR standardized system will outline how health care information can be exchanged between different computer systems regardless of how it’s stored in different systems, simplifying how health care professionals can access the information.
"The goal of this migration extends well beyond modernizing our data infrastructure," said Miguel S. Benet, M.D., senior vice president of clinical operations, Community Health Systems, in the announcement. "By building a secure foundation to take advantage of new innovations in AI, we're able to streamline our clinical providers' workflow and advance the way we deliver patient care."
CHS is in the process of implementing the new Google Cloud generative AI technologies and large language models which aim to further advance administrative efficiencies and improve patient health outcomes.
HHS approves New Mexico’s proposal to expand behavioral health care services
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced this week it has approved New Mexico’s request for community-based mobile crisis intervention teams to provide Medicaid crisis services. New Mexico is the 15th states to implement the option under President Biden’s American Rescue Plan.
New Mexico will now be able to provide Medicaid services through mobile crisis teams by connecting eligible individuals in crisis with a behavioral health provider 24 hours per day, every day.
“The Biden-Harris Administration has worked to make mental health and substance use crisis care more accessible to all Americans in need,” said HHS Secretary Xavier Becerra in a statement. “Expanding mobile crisis intervention teams across New Mexico will ensure more New Mexicans get the treatment they need when they need it, and I encourage other states to take similar steps. Whether it’s mobile crisis intervention teams, certified community behavioral health clinics, or 988 the national suicide and crisis lifeline – investing in our nation’s crisis continuum of care is critical to saving lives and making our communities healthier.”