A recent study co-authored by AMSURG Medical Director Dr. Jay Popp and researchers at the Icahn School of Medicine at Mount Sinai shows an increase in early-onset colorectal cancer in patients under age 50.
Envision Healthcare Shares Resources to Support Clinician Mental Health
National Medical Group Uses Systematic Professional Well-Being Approach to Support Clinicians’ Wellness
NASHVILLE, Tenn. — Envision Healthcare, a leading national medical group, is providing best practices on how to improve the professional well-being of clinicians and mitigate burnout. To help the more than 50 percent of clinicians who experience symptoms of burnout,[1] Envision is sharing its mental health resources with the entire medical community.
Throughout the pandemic, clinicians have dealt with similar life stressors that everyone is facing – illness and death of loved ones, child-rearing responsibilities and overall uncertainty – compounded by the trauma and fatigue of fighting a deadly disease for more than 18 months. The post-traumatic stress of the pandemic has and will continue to impact clinicians in the months and years to come.
To help clinicians navigate the many challenges they face in the U.S. healthcare system, Envision has enhanced the wellness resources it provides clinicians and efforts to reduce stigma around mental health, including:
- Advocating for the Dr. Lorna Breen Health Care Provider Protection Act and public policy changes to promote the study of professional mental, behavioral health and burnout among healthcare professionals
- Providing additional crisis peer support and free mental health support services to clinicians as they continue to care for critically ill COVID-19 patients
- Enhancing its wellness program to address the psychological and emotional needs of clinicians, including peer-to-peer support, leadership training and counseling
“As a national medical group, it is a core tenet of our mission to care for and foster an environment that supports the professional well-being of clinicians; however, clinician well-being can’t solely focus on the individual – it must encompass personal, organizational, healthcare system and policy interventions,” said Stefanie Simmons, MD, FACEP, Vice President of Clinician Engagement at Envision Healthcare. “We must ensure all clinicians have the resources necessary to support their mental health and well-being. Clinicians are there when we need them most – we must be there for them.”
To further support clinician well-being, Envision supports organizational and healthcare system policy improvements, such as improving practice schedule flexibility, reforming tort laws and providing student loan relief. While individual well-being and resiliency are important, addressing professional well-being as a systemic issue that is actionable will lead to positive, lasting change.
Read the full clinician professional well-being white paper here.
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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a market leader in ambulatory surgical care, the medical group owns and operates 255 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.
[1] National Academies of Sciences, Engineering, and Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521
COVID Booster Shots to Begin in September As Delta Variant Fills Hospitals and Breakthrough Infections Rise
Then Dr. Adam Brown, an emergency physician and the COVID-19 National Task Force Chair at Envision Healthcare, joins CBSN’s Lana Zak to discuss the latest on vaccines and the risk of “breakthrough” infections.
Need a Gastroenterologist? Look Past Average
The U.S. Preventive Services Task Force, an independent panel of primary care and prevention experts, recently issued new guidelines that recommend individuals of average risk begin colorectal cancer (CRC) screenings at age 45 instead of age 50.
The Task Force said its recommendation was prompted by an increase in the CRC rate in younger people. Colorectal cancer is the second leading cause of U.S. cancer death, and more than 10 percent of all new CRC cases are diagnosed in patients under age 50.
While colorectal cancer screenings are essential, clinicians and patients should understand that not all colonoscopies are equal. In particular, to ensure they receive quality care, before scheduling an appointment, patients should ask their gastroenterologist about the gastroenterologist’s adenoma detection rate (ADR) – a measurement that indicates how often precancerous polyps are found during exams and that contributes to how carefully colonoscopies are performed.
A study by the Polish Ministry of Health recently published in the Annals of Internal Medicine separated colonoscopies into high- and low- quality exams, with a 20 percent ADR as the dividing line. The goal for the GI Quality Improvement Consortium (GIQuIC), which sets the standard in the collection and reporting of quality measures for the practice of gastrointestinal endoscopy, is a 25 percent ADR. The study, the first to include baseline examination quality in the analysis of long-term risk for CRC and mortality after a negative colonoscopy, also defined high-quality colonoscopies as those that include cecal intubation (a term that means the entire colon was examined) and adequate bowel preparation.
The Polish researchers found patients who received just one negative colonoscopy were at a lower risk for colorectal cancer for up to 17.4 years – but only if the patient had a high-quality exam. The study concluded colonoscopies with ADRs higher than 20 percent “provided a profound and stable reduction in both CRC incidence and mortality throughout follow-up.” In other words, if the negative screening came from a clinician with an ADR below 20 percent, future CRC risk was higher.
Specifically, the researchers found high-quality exams resulted in a two-fold reduction in the colorectal cancer incidence rate and a two-fold lower mortality rate. With a low-quality colonoscopy, mortality already was significantly higher the first five years after examination. The researchers determined, “Many cases of CRC arise from lesions missed at baseline examination rather than from newly developed lesions.”
An analysis of U.S. patients by Kaiser Permanente in 2014 resulted in similar findings. Specifically, Kaiser found for each one percent increase in ADR, there was a three percent decrease in colorectal cancer risk. That study, published in The New England Journal of Medicine, said the ADR “was inversely associated with the risks of interval colorectal cancer, advanced-stage interval cancer, and fatal interval cancer.”
The Polish study also concluded high-quality colonoscopies are perhaps even more important for women. “Examination quality particularly affected CRC incidence and mortality in women,” the researchers said. “After low-quality colonoscopy, incidence rates in women were significantly higher than the rates observed in men throughout follow-up.”
In 2019, AMSURG ambulatory surgery centers (ASCs) completed more than 938,000 colonoscopies and identified nearly 360,000 patients with adenomas/cancers. The ADR for AMSURG clinicians participating in GIQuIC is 38.37 percent – nearly double the ADR the Polish study rated as high-quality. (About three-quarters of all AMSURG ASCs participate in GIQuIC.)
“In 2019 AMSURG clinicians identified more than 125,000 additional cancers and adenomas than would be expected if their ADR was simply equal to the national benchmark,” said Dr. Jay Popp, AMSURG Medical Staff Development Lead. “When it comes to colonoscopies, quality can be a life or death matter. By tracking ADR through GIQuIC, our centers provide the information patients need to make informed decisions that will reduce their risk of developing colorectal cancer and will protect their long-term health.”
Envision Healthcare Supports Clinician Well-Being During National Mental Health Awareness Month
NASHVILLE, Tenn. — Envision Healthcare, a leading national medical group, continues its commitment to clinician well-being as the nation observes National Mental Health Awareness Month this May. Recognizing the impact of the COVID-19 pandemic on frontline healthcare professionals’ mental health, Envision has taken comprehensive actions during the past year to enhance the wellness resources it provides clinicians, including peer-to-peer support, leadership training and universal counseling and therapy resources.
“Clinicians have given all of themselves to fight COVID-19, and they remain on the frontlines providing care when and where it is needed most,” said James Johnson, MD, Chief Clinical Officer of Anesthesiology at Envision Healthcare. “While we’ve made progress in vaccinating more people and helping our communities fight this virus, the physical and emotional impact of this pandemic cannot be ignored. Even as clinicians continue addressing the immediate crisis of caring for critically ill patients, they will have to navigate the post-traumatic stress of the pandemic in the months and years to come.”
Envision’s wellness programs include resources tailored to its 25,000 clinicians and the unique stressors of the COVID-19 pandemic, including:
- Coaching and stress management support to help navigate the challenges of COVID-19
- Peer-to-peer support and outreach programs to provide individualized support for clinicians
- Unlimited private and confidential messaging (text, voice, video) and video appointment services with a private therapist through TalkSpace, a global leader in telebehavioral health
- Video conference calls led by trained experts for clinicians and their families that focus on community support
- Targeted counseling and follow-up sessions for clinicians who have elected to travel to COVID-19 hot spots to help them debrief and prepare for reintegration back home
“As a national medical group with 25,000 clinicians caring for more than 32 million patients annually, we recognize the importance of caring for those who care for us and our loved ones,” said Stefanie Simmons, MD, FACEP, Vice President of Clinician Engagement at Envision Healthcare. “It’s imperative that we support the well-being of our nation’s clinicians and eliminate barriers to seeking mental healthcare.”
In addition to offering expanded wellness resources, Envision advocates for public policy changes to reduce stigmas around mental health and promote the study of professional well-being. The medical group recently welcomed the enactment of provisions in the American Rescue Plan to support America’s healthcare professionals. Modeled after the Dr. Lorna Breen Health Care Provider Protection Act – named in honor of emergency physician Dr. Lorna Breen who died by suicide in 2020 – the provisions aim to reduce and prevent burnout, behavioral disorders and suicide among healthcare professionals.
To learn more about Envision’s commitment to clinician mental health and well-being, click here.
About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a leader in ambulatory surgical care, the medical group owns and operates 257 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.
National Glaucoma Awareness Month: Halt the Sneak Thief of Sight with Early Detection
January is National Glaucoma Awareness Month, and AMSURG wants to spread the word about this sight-stealing disease.
Glaucoma is a leading cause of vision loss in the United States. More than 3 million people in the United States, and over 60 million people worldwide, have glaucoma. The National Eye Institute projects this number will reach 4.2 million in the United States by 2030, a 40 percent increase.
Sometimes known as the “The Sneak Thief of Sight,” glaucoma is a blanket term for a group of eye diseases that damage the optic nerve. Glaucoma has no cure and is the leading cause of irreversible blindness. Once the damage is done to the optic nerve, a large amount of vision can be permanently lost without someone noticing.
“Glaucoma is labeled a ‘sneak thief’ because it does just that – it sneaks up on you and does damage without you noticing,” Dr. Jeff Taylor, an ophthalmologist with The Eye Surgery Center of Paducah, Kentucky, said. “That loss of vision doesn’t happen overnight; it’s a gradual process that will eventually result in permanent loss of vision if it is not adequately treated, all happening without you knowing.”
What are some common risk factors for glaucoma?
- Age 45 or older
- Family history of glaucoma
- History of injury to the eye
- African American heritage
- History of steroid use, either in the eye (drops) or systemically (orally or injected)
- Diabetes
- Nearsighted (myopic)
- Farsighted (hyperopic)
- History of elevated intraocular pressure
Early detection is critical to preventing glaucoma from damaging your vision, and the best way to protect your sight is to get a comprehensive eye examination. If glaucoma is detected in a comprehensive eye exam, your eye doctor will design a treatment plan for you. Your doctor will go over the treatment options available and make recommendations for which treatment or combinations of treatments are best for your specific condition.
“If we can document that something is changing with your optic nerve or peripheral vision early, then we can start treatment,” Dr. Taylor said. “Promising new research on glaucoma is conducted every day trying to find a cure, but until that is found, we will continue to use tools like early detection to preserve sight.”
In 2020, AMSURG centers provided thousands of glaucoma procedures. AMSURG is proud to partner with more than 60 ophthalmology and multispecialty centers, and five ophthalmology practice locations, to provide high-quality patient care and consistently work on prevention, awareness, improved treatment methods and new procedure technologies for patients with glaucoma.
Want to know if you’re at risk? Click here to take a glaucoma risk assessment and find out. Or click here to request an appointment for a comprehensive eye exam at an AMSURG Center.
AMSURG is Proud to Exceed National Benchmarks for Patient Experience Scores
Press Ganey, a survey research firm focusing on patient experience in healthcare, disseminates over 95 million mail, phone and electronic surveys each year. So, when AMSURG’s partnering ambulatory surgery centers (ASCs) exceed the national benchmarks in their results—that’s something to share. Ensuring that patients are safe and satisfied with the care they receive is always a priority but even more so during these challenging times.
More than 95 percent of AMSURG’s partnering ASCs are participating in the Press Ganey’s Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS). Over the last year, the centers have consistently exceeded the national benchmarks for “overall patient experience” and “likelihood to recommend.” Additionally, many of these centers chose to share the results on their websites and to be transparent with their patients’ feedback.
When comparing AMSURG partner ASCs with hospital outpatient departments (HOPDs), AMSURG ASCs have consistently ranked in the 80th percentile in 2020—outperforming the majority of HOPDs. In the second quarter of 2020 and in the midst of crisis, AMSURG centers were in the 87th percentile for overall patient experience ratings.
As AMSURG’s partners are some of the only centers to publicly display these comments and overall rankings, results and experiences have continued to deliver well-earned recognition. One patient at Eastern Connecticut Endoscopy Center, who scored 89 percent for overall patient experience and 88 percent for likelihood to recommend, wrote, “I felt very comfortable and safe with all of the staff and facilities during my recent visit to have a colonoscopy performed. Every effort was made to ensure my safety as a senior citizen, and the procedure was completed in a little more than an hour.”
Westbank Surgery Center, who scored 94 percent for overall patient experience and 93 percent for likelihood to recommend, has also been given amazing feedback, including one pleased patient who applauded the facility and appreciated their team for easing apprehensions. “Very good experience. Staff is very organized, and everything ran smoothly like clockwork as it should. Have had lots of hospital visits. This was an A+ one. I will be returning in 2 weeks for a second procedure and am very at ease about it,” the patient commented.
“AMSURG is a strong proponent of sharing our patient experience scores and we are impressed by the positive feedback from our patients,” said Nina Goins, Vice President of Quality and Clinical Services for AMSURG. “As the centers face new challenges, patient safety and quality remain the primary focus. The great efforts of their care and the constant demonstration of their compassion for patients have absolutely not gone unnoticed, and I think it’s important we commend this valuable work.”
AMSURG will continue to support partnering centers and drive best practices in order to continue providing our patients with high-quality experiences.
For more information about AMSURG’s commitment to our centers amid COVID-19, visit amsurg.com/covid-19.
Introducing The SURG Videocast: Watch the First Episode Today
AMSURG is excited to announce the launch of a new videocast, The Surg. Each month, we will host an ambulatory surgery center (ASC) physician partner to discuss clinical hot topics. Are there pros and cons to pre-procedure testing? What are safe turnaround times in an era of COVID-19? How should you prepare for flu season amidst COVID-19? We’ll answer those questions, and more, as we seek to be a resource for research and best practices, and a voice for our ambulatory surgery centers.
Episode 1
Envision Healthcare Chief Medical Officer and AMSURG Interim President Chan Chuang, M.D., hosts the first episode of The Surg, which you can watch here.
In the episode, Dr. Chuang and Erick Pecha, M.D., a gastroenterologist and founding physician partner with Folsom Sierra Endoscopy Center in California and president of the Gastroenterology Medical Clinic in Folsom, together tackle questions about COVID testing times, surgery center workflow, getting through state inspections, and best practices for increasing capacity while enhancing safety.
One bright spot Dr. Pecha identifies: though patients are somewhat anxious about safety, no-show rates are down from the pre-COVID era. One reason for that is the pre-procedure planning process. “Once you set up the program … and you explain to your patients that our goal is to create a sphere of safety for them that is better than their local grocery store, there has been quite easy adoption by the patients in terms of their compliance.”
Share Your Feedback
As with all of our communications, we welcome your feedback. After viewing The Surg, please take a moment to complete this survey.
Envision Healthcare Appoints Key Leaders
Envision Healthcare, one of the nation’s leading medical groups, today announced new additions to its leadership team, with Jay Martus returning to the organization in the new role of Chief Revenue Officer and Jeff Snodgrass joining as President of AMSURG.
“As a national medical group, our leaders all share the same mission – supporting clinicians so they can care for patients,” said Envision Chief Executive Officer Jim Rechtin. “Jay and Jeff have extensive experience in healthcare administration, and they will be part of the leadership team that is charting the course so Envision can continue to set standards for patient care. I am very pleased to welcome Jay back to our organization and look forward to having both him and Jeff on board.”
As Chief Revenue Officer, Martus will focus on managed care, malpractice risk and hospital contracting. Martus spent 20 years at Sheridan Healthcare, which later became Envision Physician Services following the 2016 merger between Envision and AMSURG. Until 2014, he served as Executive Vice President and Chief Legal Officer. He also previously served as President of Advantia Health, a board member of Ob Hospitalist Group and a healthcare consultant.
As President of AMSURG, Snodgrass will lead one of the country’s largest ambulatory surgery management operations. Prior to joining Envision, Snodgrass served as President and Chief Executive Officer of Azura Vascular Care and National Cardiology Partners, leading the company’s vascular and cardiology outpatient, interventional and surgical business units at Fresenius Medical Care. Before joining Fresenius, Jeff was the Chief Financial Officer at inVentiv Health, supporting the integration and creation of a global Contract Research Organization. Snodgrass spent 17 years at Merck & Co., most recently serving as Vice President of Finance for Merck’s research and development organization.
With a new AMSURG President in place, Interim President Dr. Chan Chuang will return to his previously announced, full-time role as Envision’s Chief Medical Officer. Both Martus and Snodgrass will be in their new roles by early September.
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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a market leader in ambulatory surgical care, the medical group owns and operates 257 surgery centers and one surgical hospital in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.
AMSURG Centers Excel in Patient Experience
Eight Centers Receive the Coveted Press Ganey Guardian of Excellence Award
Surgery centers across the AMSURG network work diligently to deliver an ideal experience and safe, high-quality care to our patients every day. Eight of our centers have consistently exceeded patient experience goals and were awarded the 2020 Press Ganey Guardian of Excellence Award. These surgery centers maintained exemplary patient experience ratings for the past year, ranking within the top fifth percentile of Press Ganey’s eligible clientele. Only 18 of 2,700 surgery centers received the award and AMSURG is honored to represent nearly half of the award recipients.
Guardian of Excellence Award Winners
Gastroenterology
- Endoscopy Center of Southeast, Beaumont, Texas
- Woodlands Endoscopy Center, Texas
- The Endoscopy Center, Knoxville, Tennessee
- Sun City Endoscopy Center, Arizona
Ophthalmology
- The Eye Surgery Center of Paducah, Kentucky
- EyeCare Consultants Surgery Center, Evansville, Indiana
Orthopaedic
- Surgery Center of Volusia, Port Orange, Florida
- Orthopaedic Surgery Center of Ocala, Florida
*This is the second consecutive year for Sun City Endoscopy Center to receive the prestigious award.
“Our surgery centers are an integral part of the healthcare systems in the communities they serve. We commend each of the surgery centers for their commitment to providing exceptional care and experiences for every patient,” said Chan Chuang, M.D., FCCP, FACP, AMSURG President and Envision Healthcare Chief Medical Officer. “These eight centers are shining examples of what it means to provide patient-centered care.”
The Guardian of Excellence Award recognizes healthcare organizations that score in the 95th percentile for patient experience, employee/physician engagement or clinical quality performance. Press Ganey, a leader in development and distribution of patient satisfaction surveys, partners with more than 26,000 organizations to administer the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS). The survey measures the care experiences of patients who receive procedures at Medicare-certified surgery centers.
“AMSURG is very proud of the work these centers perform in service to patients every day. This year has been especially unique, presenting new challenges and working environments,” said Nina Goins, Vice President of Quality and Clinical Services, AMSURG, “The centers have not let these challenges impact the focus on keeping our patients our first priority. They are truly setting the standard.”
AMSURG is proud to recognize these centers and their employees for their ability to uphold and consistently deliver high-quality patient care.