Rural hospital execs in Georgia must finish finance classes by end of 2020

From Becker’s:

Georgia is requiring executives and board members at 59 rural hospitals to take financial management classes and receive other training to improve rural healthcare, the Georgia Hospital Association confirmed.

The requirement passed by Georgia lawmakers in 2018 comes amid a slew of rural hospital closures in the state.

Overzealous in preventing falls, hospitals are producing an ‘epidemic of immobility’ in elderly patients

From the Washington Post:

Falls remain the leading cause of fatal and nonfatal injuries for older Americans. Hospitals face financial penalties when they occur. Nurses and aides get blamed or reprimanded if a patient under their supervision hits the ground.

But hospitals have become so overzealous in fall prevention that they are producing an “epidemic of immobility,” experts say. To ensure that patients will never fall, hospitalized patients who could benefit from activity are told not to get up on their own — their bedbound state reinforced by bed alarms and a lack of staff to help them move.

That’s especially dangerous for older patients, often weak to begin with. After just a few days of bed rest, their muscles can deteriorate enough to bring severe long-term consequences.

“Older patients face staggering rates of disability after hospitalizations,” said Kenneth Covinsky, a geriatrician and researcher at the University of California at San Francisco. His research found that one-third of patients 70 and older leave the hospital more disabled than when they arrived.

These telemedicine doctors are getting licenses in all 50 states to treat patients in most remote areas

From CNBC:

Blake McKinney is a doctor with medical licenses in 49 states and a 50th likely on the way. That would put him into a small but growing group of physicians who see a big future online.

Telemedicine, which involves medical consults via the web and smartphone apps, requires that doctors have licenses to treat patients wherever they are, not just in a single location. With licenses across the country, McKinney can be at home in Denver, but treat a patient in Rhode Island or Delaware or anywhere else in the U.S.

 

“See Me Now” program connects emergency room providers with former patients

From Fox43:

On Tuesday night, Penn State Hershey Medical Center hosted an opportunity for emergency room staff to reconnect with some of their former patients.

It’s part of an effort called “See Me Now,” which are events allowing families to express gratitude and find closure while giving healthcare providers the chance to see the meaning of their work in a positive setting.

AHA: How to boost rural healthcare access

From the AHA via Becker’s:

As HRSA and the Department of Health and Human Services’ (HHS) Rural Health
Task Force continue their efforts to support health care in rural America, we urge
the agencies to consider the following:

  • Reassessing the services considered to be “core” or essential over time is
    important in order to account for shifts in care delivery, advances in
    knowledge and practice, and other developments in the health care field;
  •  Community characteristics, needs and preferences should always be
    considered when recommending services to be made available;
  •  Any policy approaches to improve access to care in rural areas must allow
    for flexibility and promote community-driven solutions; and
  •  Federal agencies should use a “rural lens” when developing regulatory
    actions – not only when reviewing them after they have already been
    formed.

COPD patients with high insurance deductibles more likely to skip care

From Modern Healthcare:

Patients with chronic obstructive pulmonary disease who were enrolled in private high-deductible health plans more frequently reported putting off or skipping care and ending up in the hospital or emergency department than patients without high deductibles, according to a new study.

Those with high deductibles were also more likely to report struggling to pay monthly bills and report family out-of-pocket healthcare costs that exceeded $5,000 in a year, Harvard Medical School researchers wrote in the study published Thursday in the Annals of the American Thoracic Society.

“Our study shows that patients with COPD who are privately insured, especially those with high deductibles, aren’t getting the care they need, with dangerous consequences for their health,” lead author Dr. Adam Gaffney, an instructor in medicine at Harvard Medical School, said in a statement.

Recognition, Prevention, and Treatment of Delirium in Emergency Department: An Evidence-Based Narrative Review

From the American Journal of Emergency Medicine:

Background

Delirium is an acute disorder of attention and cognition that is common, serious, costly, under-recognized, and potentially fatal. Delirium is particularly problematic in the emergency department (ED) care of medically complex older adults, who are being seen in greater numbers.

Objective

This evidence-based narrative review focuses on the key components of delirium screening, prevention, and treatment.

Discussion

The recognition of delirium requires a systematic approach rather than a clinical gestalt alone. Several delirium assessment tools with high sensitivity and specificity, such as delirium triage screen and brief Confusion Assessment Method, can be used in the ED. The prevention of delirium requires environmental modification and unique geriatric care strategies tailored to the ED. The key approaches to treatment include the removal of the precipitating etiology, re-orientation, hydration, and early mobilization. Treatment of delirium requires a multifaceted and comprehensive care plan, as there is limited evidence for significant benefit with pharmacological agents.

Conclusion

Older ED patients are at high risk for current or subsequent development of delirium, and a focused screening, prevention, and intervention for those who are at risk for delirium and its associated complications are the important next steps.