EPs Don’t Beat a Path to Tiny Hospitals — Their Loss

From Emergency Medicine News:

…this ABEM–certified physician can testify that work at TMH is incredible. You never really know whether you’ll see an MI, a pulmonary embolus, the occupants of an Amish buggy hit and disintegrated by a Ford F-250, a raging case of altitude sickness, or a hypothermic old lady with dementia wandering barefoot in the cold night. It really calls on all of your personal resources and training and your sense of adventure. Fortunately, help is often only a helicopter or fixed-wing flight away. (If the weather is good, that is.) But don’t worry! The county usually has two ambulances.

OSHA Launches Program To Protect Nursing Employees

From NPR:

The federal Occupational Safety and Health Administration (OSHA) will announce Thursday that it’s going to crack down on hospitals, for the first time ever, to prevent an epidemic of back and arm injuries among nursing employees.

Nurses and nursing assistants suffer more of those debilitating injuries than any other occupation, and those injuries are caused mainly by moving and lifting patients.

ACEP Issues Statement Following Supreme Court Verdict

Press Release:

The decision today by the Supreme Court will prevent millions of people from losing their health insurance, but does not stem the rising tide of visits to the nation’s emergency departments or solve other problems emerging in the post-Affordable Care Act health care system, according to a statement from Dr. Michael Gerardi, president of the American College of Emergency Physicians (ACEP).

“Emergency physicians support universal health coverage, although the challenges that Medicaid patients have faced in getting timely appointments with doctors demonstrate that health insurance does not guarantee a person’s access to medical care.  Furthermore, certain practices that have emerged within the insurance industry, in which the true cost of medical care is shifted from the insurance industry to the patients and providers, are troubling.

High-deductible plans with high co-pays for emergency department visits may dangerously discourage patients from seeking urgently needed care.  In addition, recent drastic and precipitous reductions in reimbursement for out-of-network emergency care end up shifting costs to underinsured patients and the physicians who treat them at unreasonably discounted rates. This cost-shifting has allowed insurance companies to reap large profits at the expense of patient care.

The reliance on emergency care remains stronger than ever.  As emergency physicians, we are dedicated to caring for all our patients, regardless of whether they have health insurance coverage.  This is the law and also our moral responsibility.

Emergency departments provide incredible value to America.  We care for 136 million patients each year with only 4 percent of the nation’s health care dollar, according to the CDC.  Even primary care physicians depend on emergency departments to perform complex diagnostic workshops and facilitate admissions of acutely ill patients, or simply to handle the overflow resulting from workforce shortages throughout the health care system.

And emergency visits will continue to increase for many reasons,  including our aging population and primary care physician shortages.   Emergency departments are facing soaring demands, and we must have adequate resources.  The nation’s focus must be on supporting this critical service that everyone needs.”

Visits to emergency departments increased by nearly 50-percent from 1993-2013, while there was an 11-percent decrease in the number of emergency departments in America during that same time period, according to the American Hospital Association Trendbook.  There were 4,440  emergency departments in the United States in 2013.

According to “The Evolving Role of Emergency Departments in the United State,” published by RAND in 2013, the

4 percent of America’s doctors who staff  hospital emergency departments manage:

  • 11 percent of all outpatient care in the United States
  • 28 percent of all acute care visits
  • Half of the acute care visits by Medicaid and CHIP beneficiaries
  • Two-thirds of all acute care for the uninsured

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

ACUTE CARE Partner Avera Holy Family Named One of the “100 Great Community Hospitals”

From Becker’s:

For the purposes of this list, Becker’s defines community hospital as a hospital with fewer than 550 beds and that have minimal teaching programs. Some are located in suburban areas near major cities, while others are found in rural towns that serve as the only hospitals in their communities. Whether independent or part of a larger health system, the hospitals on this list have continually worked to provide high-quality care.

The Becker’s editorial team selected community hospitals based on rankings and awards from such organizations as iVantage Health Analytics, Truven Health Analytics, Healthgrades and CareChex.

Avera Holy Family Hospital (Estherville, Iowa). Located in the Des Moines River valley in Northwest Iowa, Avera Holy Family Hospital was established in 1944. [READ MORE]

New option for rural emergency acute care

From Becker’s:

Senator Charles Grassley (R-Iowa) has introduced the Rural Emergency Acute Care Hospital Act, which would allow Critical Access Hospitals and prospective payment system hospitals with 50 or fewer beds to convert to Rural Emergency Hospitals.

These hospitals would only offer emergency care and would receive enhanced reimbursement rates of 110 percent of reasonable costs to move patients to acute-care hospitals in nearby communities.

Sen. Grassley introduces additional rural hospital model bill

From Rural Health Voices:

The Rural Emergency Acute Care Hospital Act of 2015 (S.1648) was introduced today by Sen. Chuck Grassley (R-IA), to establish a new Medicare payment designation, the Rural Emergency Hospital to sustain emergency services in rural communities.

Rural hospitals are critical to the 62 million rural Americans that rely on them to receive necessary local care. Rural hospitals provide care to vulnerable rural Americans as well as serve as an important economic and social anchor for their communities. However, far too many of these hospitals are in trouble.

Since 2010, 55 rural hospitals have closed, 283 more are on the brink of closure. And the pace of closures is increasing, since January 2013, more rural hospitals have closed than in the previous 10 years combined. Continued cuts in hospital payments have taken their toll, forcing closures and leaving many of our nation’s most vulnerable populations without timely access to care. If Congress doesn’t act to stop the bleeding and prevent further closures of rural hospitals, 700,000 patients would lose direct access to care; patients and local economies will suffer.

Our health care system is undergoing dramatic changes.

As stated in NRHA’s policy paper, providers have become increasingly aware that the current rural safety net programs are not structured for success in this new environment.

While it is critically important to sustain the rural safety net providers such as Rural Health Clinic, Federally Qualified Health Center, Critical Access Hospital, Medicare Dependent Hospital, Sole Community Hospital, physicians and other rural programs and providers during this time of change and uncertainty, it is equally important to outline a meaningful phased and non-destructive transition strategy that successfully links today’s payment and patient care delivery structures to the health care systems of the future.

NRHA applauds the forward thinking of Sen. Grassley by introducing a new model of rural health care to provide rural hospitals and communities a path forward to provide local care.  NRHA remains committed to advancing legislation that will also stabilize the rural health care safety net by stopping the numerous Medicare cuts that are significantly harming the financial viability of many rural hospitals.

CPR delivered: ‘I left a pizza boy and came back a pizza man’

From the Post-Independent:

“When I pulled up there, I knew something was wrong, and I had to act. They asked me right away if I knew CPR,” Lemmer said. “I jumped in right away to do those chest compressions.”

Trained in CPR a year ago, Lemmer didn’t think twice about acting. He said it was like a fight-or-flight choice, and he had to fight. A situation like that is tense with a lot of variables, he said.

“I called my parents and said this has been the craziest pizza delivery ever. I left a pizza boy and came back a pizza man,” Lemmer said. “They were proud of me. Totally unexpected thing.”