CMO Message: November 2023

November 6, 2023

Welcome to November! This time of the year always flies by for me … from Halloween through several holidays and right into the New Year! It’s a time to appreciate friends and family, but it's also the time we expect the typical fall and winter respiratory disease seasons. I will keep you updated on trends and changes with regard to disease activity using our newsletters (and as needed by email between newsletters) during this timeframe, and we continue planning with key leaders for potential surges.

1) What to watch: Respiratory Illness Season and masking, GMLOS O:E, EDD (Estimated Discharge Date)

a) Respiratory Illness Season: The CDC continues to anticipate this year’s fall and winter respiratory disease season will most likely result in a similar number of hospitalizations as last season. As of late October, respiratory virus activity remained low nationally. COVID-19 activity declined in many areas of the country, but it remained the cause of new respiratory virus hospitalizations and deaths.

Our ministries, in conjunction with the other Providence Swedish Puget Sound hospitals and the Northwest Health Response Network will move to Universal Masking when epidemic thresholds are reached according to the CDC’s syndromic surveillance system (ESSENCE). This system uses data collected from Chief Complaints and Discharge Diagnoses and monitors trends in seasonal viruses including RSV, influenza and COVID-19. Information from WA DOH on trends can be found here: and the CDC’s Resp-Net Interactive Dashboard can be found here:

b) GMLOS O:E: We have done tremendous work to bring GMLOS O:E down, but it remains flat over time. We need your help to get to our goal of 1:4 at St. Peter Hospital and 1.1 at Centralia Hospital. GLMOS O:E is the ratio of the aggregated observed LOS over the aggregated expected LOS. The expected LOS is a CMS provided geometric mean in days for a given inpatient encounter based on the encounter’s MS-DRG, and can further be broken down by patient disposition (i.e. to home, home with home health, SNF, hospice, LTCH, etc.). Most of our patients go home (75%) and most discharges home don’t have the coordination and insurance delays of discharges to other destinations. Our O:E to home should be 1.0 or less (kudos to PCH whose O:E to home was 0.95)!. We will need continued efforts around discharge planning starting at admission and developing a discharge culture, focused on helping patients get ready for discharge throughout their stay. We are working with the other places our patients discharge to in order to decrease the O:E in those areas through initiatives including a Post Acute Collaborative.

c) What’s the EDD (estimated date of discharge)? Help us identify patients that are scheduled to discharge by updating the EDD (estimated discharge date). This can be done by adding the “D/C Planning” column tab to your patient list (Edit List – Properties – Available Columns search “D/C Planning – choose “+ Add Column”). This column contains the expected discharge date, risk for readmission and discharge required documentation status. You can double click once you have this column to update/add patient’s EDD.

2) Upcoming Events:

               Christmas in the Forest – Dec. 1, 2023. An opportunity to gather with friends and support Mission-driven programs of Providence. We hope to see you there! Gala Registration is here:

               North Division Medical Staff Leadership Conference – Jan. 26-27, 2024, Renton, WA. Final details are being worked out and shift to Friday to Saturday conference for less impact on some clinical schedules. Opportunity for anyone with interest/future plans for leadership on our Medical Staff to meet executive leadership and gain educational insight. CME available.

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