Older adults can be especially vulnerable to natural disasters, be it a hurricane, tornado, earthquake, or the recent eruptions from Hawaii’s Kilauea volcano. On top of health concerns, they often are socially isolated and lack good transportation options that can slow their response before, during and after a disaster.
A unique emergency department program focused on geriatric transitional care is helping older patients avoid unnecessary hospital admissions by as much as 33 percent, according to results of a study from Northwestern University Hospital in Chicago, Mount Sinai Medical Center in New York, and St. Joseph’s Regional Medical Center in New Jersey. They’re collaborating on The Geriatric Emergency Department Innovations (GEDI WISE) program, an interdisciplinary approach to improving acute geriatric emergency care.
The program keeps older adults out of the hospital while keeping them safe, and has shown to prevent both 72-hour and 30-day readmissions. Continue reading
Emergency medicine physicians contend that Anthem’s policy regarding payment for emergency room visits in some of its markets has been putting patients’ lives at risk.
In six states so far, Anthem has a policy to deny coverage for emergency room visits that it later determines were not emergencies. Continue reading
In recent years, hospital emergency departments (EDs) have drawn millions of poor and underinsured patients coping with dental problems. Yet EDs remain tremendously expensive and ineffective sources of dental care, two new studies remind us.
Between 2008 and 2010, more than 4 million patients turned to hospital EDs for help with dental conditions at a cost of $2.7 billion. Research suggests that the vast majority did not receive dental procedures, but were instead treated with prescription medications. A total of 101 of the patients died in the emergency rooms, according to the study published in the April issue of the Journal of the American Dental Association.
The authors used data gleaned from the Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality (AHRQ), to produce their paper. They found that uninsured patients made slightly more than 40 percent of all dental-condition related ED visits. Continue reading
The recent chemical spill in West Virginia, which contaminated the drinking water of 300,000 people, became another occasion when federal agencies shut the door on reporters seeking answers, fueling public anxiety with their silence.
But after complaints from journalism organizations, including AHCJ, the U.S. Centers for Disease Control and Prevention this week issued a mea culpa and a pledge “to work to reach that critical balance between accuracy and timely release of information the public expects and needs to protect their health.”
The CDC told West Virginia health officials on Jan. 15 that pregnant women should not drink the water until the chemical, called Crude MCHM, was at “nondetectable levels.” Reporters from the Charleston (W.Va.) Gazette had a lot of questions about this order – but could get no answers from the CDC press office. Continue reading
As you probably know, St. John’s Regional Medical Center in Joplin, Mo., sustained serious damage in the May 22 tornado that struck that town. Stories about what happened inside the hospital in that 45 seconds and the ensuing moments have started to emerge.
An emergency room doctor writes about diving for cover and then treating injured patients with limited supplies and only light from a flashlight he held in his mouth as he worked. Photo galleries on Flickr have images showing the damage inside and outside the hospital, as well as the MASH unit that was set up.
Outpatient Surgery Magazine has the tale of an orthopedic surgeon who was in the middle of surgery when the tornado hit. He and his team finished the surgery with a flashlight and while standing in several inches of water. “The doctor who trained me thought it was important to know how to do surgery the way they used to, with manual instruments,” said Dr. Smith. “That should be a part of everybody’s training.” (Hat tip to @JJacksonJr for pointing this piece out.)
Courtney Hutchison, of the ABC News Medical Unit, looks at tornado preparedness for hospitals, especially the failure of the backup generator. As one expert points out, generators need adequate ventilation, which means they are usually near an exterior wall and vulnerable to tornadoes.
A New York Times story describes the frantic race to move patients before the tornado struck and then the aftermath, which included treating patients in the parking lot and using a bus and the beds of pickup trucks to take patients to other hospitals.
St. Johns’ Med Flight manager was briefly sucked out of the hospital:
Suddenly, the glass doors he was holding onto – the ones with the 100-pound magnet to keep them locked – were pulled open. [Rod] Pace was sucked outside briefly and then pushed back in like a rag doll but held on to the handles.
Engineers have started examining the hospital to decide whether it can be salvaged.
In the St. Louis Post-Dispatch, Blythe Bernhard tells the story of a St. Louis doctor, Brian Froelke, who is chief medical officer for the Missouri disaster medical team. That team, of about 40 health care providers, set up a 30-bed tent to serve as a replacement emergency department. Listen to Froelke discuss his experience treating tornado-related injuries. One doctor who was in the hospital when it was hit compared the scene to Haiti after last year’s earthquake.
Thomas Burton of The Wall Street Journal writes about the chaos that the town’s other hospital experienced. It was thrown into darkness and inundated with patients.
Joy Robertson of KOLR-Springfield, Mo., served as a member of the Federal Disaster Mortuary Response Team for several years and responded to the World Trade Center after 9/11. She explains (about halfway through the story) how the morgue operations work in mass fatality disasters and how victims are identified.