Thank you to all who contributed their time and efforts in support of HB21-1184, Physician Assistant Collaboration and Reimbursement. The bill did not pass out of the Colorado House Health & Insurance Committee (5 in favor, 8 oppose) and will not move any further in the legislative process (Click here to listen to the hearing). While this is not the outcome we desired, CAPA recognizes the progress made in engagement and awareness around the need to modernize PA practice in Colorado. We are in it for the long game.
CAPA remains committed to our mission to advocate for state regulation change that supports PA practice and access to high quality health care in Colorado. PAs are well-trained, quality medical providers who take care of patients as part of the medical team, and we will continue educate, advocate and increase understanding of the important role that PAs play. As an organization, we wholeheartedly believe that removing arbitrary administrative barriers will allow PAs to better serve the patients of Colorado.
What can you do to help these efforts? A great place to start is continuing your CAPA membership and encouraging your colleagues to join. CAPA now has an auto-renewal feature that takes one thing off your to-do list and ensures your support of Colorado PA advocacy remains consistent. Next, look for opportunities to get involved! Stay tuned for opportunities for further input and engagement around legislative priorities!
For more information about this bill and CAPA legislative priorities, please visit ColoradoPAs.org/legislative-priorities.
Alyn Whelchel, PA-C
President, CAPA 2020-2021
Table of Contents:
Colorado Academy of PAs
PO Box 100356
Denver, CO 80250
Looking to get involved?
Don't miss CAPA's Annual Spring CME Conference on April 17th from 8:00 a.m. to 5:30 p.m. MST! (Click here to see the agenda). We are excited to spend the day with our PA community, including an exclusive social happy hour to network! You will be glad you signed up!
Note, registration closes on Wednesday, April 14th at noon.
Has your membership lapsed? Be sure to keep your membership active and keep receiving CAPA correspondence, supporting PA advocacy in the state and have access to CAPA events and CME opportunities!
Visit the Membership Page to renew or log-in to your CAPA account.
CAPA, AAPA, the PA Foundation, other state chapters, and many national medical organizations and centers across the country are partnering with the National Institutes of Health's (NIH) All of Us Research Program to raise awareness about the importance of participation in research. All of Us is seeking one million or more individuals from across the U.S. who have been excluded from past biomedical research to participate in creating a robust and diverse data resource. Scientists and medical researchers with access to the data can use it to understand more about why people get sick or stay healthy.
The mission of the program is to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all of us.
Please consider participating in and sharing this fascinating and important program with your patients, colleagues, and friends. For more information, you can visit the Join All of Us website to learn all about the program expectations, browse frequently asked questions, explore the process, and much more.
Click on these
Additional Resource Links:
Call for CAPA Board Nominations
CAPA Members, please nominate your fellow PAs or yourself for the leadership positions in CAPA. We are proud of what CAPA provides to all PAs in Colorado and are calling to all who want to get involved. The positions below are available for the 2021/2022 CAPA Board of Directors (BOD) and House of Delegates (HOD). Interested? Please visit the CAPA Elections webpage for more information about the following positions and to fill out an Election Application or Nomination Form.
Please contact us if you would like further information on the duties and responsibilities or have any other questions regarding the positions or the elections. The first BOD meeting after the elections will take place on Saturday, July 17th, 2021 - plan to be there if elected!
Colorado's COVID Vaccine Plan
Make sure you are staying up to date. Click here to see the latest information.
by Michael Victoroff, MD, COPIC Patient Safety and Risk Management
DEALING WITH POTENTIALLY DANGEROUS PATIENTS
Health care providers regularly deal with patients under stress and are exposed to the risk or threat of violence in the workplace at higher rates than most other professions. Unfortunately, at times, the nature of the profession makes it necessary for providers to care for, manage, or defend themselves from a person who is acting out violently.
RISK FACTORS FOR VIOLENCE IN PATIENTS
The strongest risk factor for violence is a history of violence. Other risk factors include:
· Delirium and delusional states
· Suicidal intent
· Fear, anger, and revenge
· Explosive or antisocial personality traits
· Communication barriers, like language, sensory or intellectual impediments
AWARENESS OF SIGNS IN PATIENT BEHAVIOR
Violence can be impulsive and unpredictable. But, there are signals that give a sense of when an assault may be impending. Many of these are intuitively apparent, including head shaking, jaw tightening, eyes diverted, and impingement on interpersonal space. Verbal signals like shouting and threatening are familiar. The important goal is neither to disregard these behaviors, nor to escalate them by overreacting. It is hard to be non-judgmental in the face of an assault, but training and experience can help people remain composed and professional in situations that can be deflected or de-escalated.
OSHA requires employers to provide their workers with “a workplace free from recognized hazards.” Facilities should implement comprehensive plans addressing violence prevention, warning signal recognition, threat assessment, verbal and physical de-escalation, and other topics. These and other valuable tips are outlined in “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers,” which can be downloaded at https://www.osha.gov/Publications/osha3148.pdf
CONSIDERATIONS FOR ADDRESSING TENSE SITUATIONS
A delicate judgment needs to be made sometimes between confronting a belligerent person with threats (e.g., “You’re making me very uncomfortable. If you continue to act like this, I’m going to call security.”) versus attempting to bond with them by being accommodating (e.g., “I definitely get why that’s bothering you. Let me see if I can do something to help.”). Unfortunately, there is no fixed rule for when to apply one tactic or the other.
The practitioners who are most talented in this art tend to be those with experience. One important point about verbal confrontation is that high stress levels can generate a state of “auditory exclusion,” in which any party might actually not be able to hear questions, instructions, or commands. Besides offering training, facilities and practices need to assure adequate staffing for safety. They can support their staff with policies that encourage personnel to take unobtrusive, protective steps at an early stage of discomfort. Some of these include involving chaperones or asking a colleague to join a tense discussion, maintaining interpersonal space, not leaning/reaching across the patient’s body, or not allowing a patient to block the way out of a room. In some cases, it might be better to avoid giving a patient the sense of being physically or emotionally “cornered.”
Physical and technological measures are available that can be useful. Some of these are flags in the patient chart about a past history of violence or delirium, a coded flag on the patient’s door or stretcher, color-coded patient gowns or wristbands, “panic buttons” in patient care areas or even wireless alarms carried as ID badges. Appropriate physical barriers (such as reception desks) and clear pathways within the facility are common sense measures. Visible video cameras may have a deterrent effect (and recordings can help defend providers, when their actions are proper.)
Finally, it should be remembered that people who have been subjected to violence may carry a bit of latent PTSD. The very training and policy discussions intended to improve safety can be experienced as stressful by some trainees. Some people don’t have the temperament to intervene in a violent encounter, and it is not reasonable to build this duty into everyone’s job requirement.
The 2021 House of Delegates (HOD) meeting is approaching. A town hall will be held for all Colorado PAs to discuss the submitted resolutions prior to the meeting, but you do not have to wait until then to let the CAPA HOD delegation know your thoughts regarding the title change investigation (TCI). We encourage all PAs to look at or listen to the TCI report, which is available to all AAPA members at AAPA.org/title-change-investigation. We have received unprecedented numbers of responses to the recent survey, but we would like to hear from as many PAs as possible prior to the meeting. Contact CAPA at email@example.com with any questions or concerns regarding the HOD meeting, and keep an eye out for the town hall date, which will be in late April or early May.
Chief Delegate 2020-2021
Annalise Grammerstorf, PA-S, Student Director
Students from the four Colorado PA programs will be hosting a virtual silent auction during the Annual Spring CME Conference this year! Bidding will begin on Friday, April 16th, the day before conference, at 12:00 p.m. and run until 8:00 pm on Saturday, April 17th, the day of conference. The auctions are available now for Colorado PAs, colleagues, friends, and family to browse items.
Please contact Annalise Grammerstorf at firstname.lastname@example.org if you have any questions!
Colorado Mesa University
Raising funds for Roundup River Ranch
Browse items at https://www.32auctions.com/CMU-CAPAauction
Rocky Vista University
Raising funds for Go4Graham
Browse items at https://www.32auctions.com/CAPA_RVU_G4G
Red Rocks PA Program
Raising funds for Against Malaria Foundation
Browse items at https://www.32auctions.com/RRCCPA
University of Colorado CHA/PA Program
Raising funds for Camp Wapiyapi
Browse items at https://www.32auctions.com/cme-chapa-auction
Colorado PA Programs Update
Happy Spring from the Colorado Mesa University PA Program!
Our inaugural cohort is finishing up their final clinical rotations and will be graduating May 21st, 2021. It is a bittersweet moment as we send our first class out into the world!
The Class of 2022 is halfway way through their last semester of didactic! We are fortunate to have had class in person since July. As COVID-19 vaccines have begun to roll out on the Western Slope, many of our students have had the unique opportunity of volunteering to administer the vaccines in partnership with Community Hospital in Grand Junction. On March 5th, students ran a mobile vaccine clinic and were able to bring vaccines to several independent living facilities to vaccinate the residents. It has been an incredible experience to connect with our community! This week, the first three clinical rotations were revealed to the students of our class! We are looking forward to putting our knowledge to the test and interacting with patients in a clinical setting.
In January we welcomed the class of 2023 to CMU. Everyone has a unique set of skills and passions with past experiences as paramedics, EMTs, dietitians, scribes, and medical and surgical assistants. Currently they are learning about the pelvic cavity in anatomy, chest and lung exam in history and physical exam, and mechanisms of action in pharmacology.
Jessica Dowgiert, PA-S, and Alexandra Pollack, PA-S
Happy Spring from Rocky Vista University’s PA program!
The class of ‘21 is finishing up the last couple months of their clinical rotations. They are participating in clinical rotations throughout Colorado and surrounding states. Even when they are busy with rotations, the class of ’21 has been so generous and helpful to the class of ’22 by hosting “Fireside Chat” zoom sessions where they give advice and answer questions about clinical rotations. The class of 2022 is so appreciative for their generosity and mentorship! When they aren’t busy in clinical rotations or giving advice to the class of ’22, the class of ’21 can also be found working hard on their capstone projects.
The class of ‘22 has been busy studying as they are over halfway through the last semester of didactic year! Although they are entirely virtual for lectures, the students have been ecstatic to be able to get onto camps for a couple days this semester to practice ultrasound and physical exam skills. They are also looking forward to May when they will start the Introduction to Supervised Clinical Practice Experiences course before they begin clinical rotations in June. With a virtual learning environment, the class of ’22 has worked hard to be creative in their efforts to stay connected and continue to build a sense of community among their cohort. They have enjoyed scheduling times to play virtual Codenames when they aren’t busy studying. They are also looking forward to welcoming the upcoming class of ’23 by being assigned a “PA-pal” to share advice and tips with on how to survive the didactic year.