Another reason to worry about overcrowded emergency rooms

From Reuters:

Patients are more likely to be misdiagnosed or experience treatment delays when emergency rooms are so crowded that they receive care in a hallway, a survey of physicians suggests.

Privacy and confidentiality are vital in emergency care, particularly for patients who may be reluctant to undress or divulge sensitive personal information in front of companions in an exam room or strangers in a hallway, researchers note in the Emergency Medicine Journal.

Convert hospitals into ERs? Proposal would make it easier.

From Crain’s:

A proposed bill that shakes up the way Illinois hospitals get Medicaid dollars contains a plan that would allow any medical center in the state to essentially close and become a free-standing emergency center.

As part of the makeover, state lawmakers plan to create a pool of potentially hundreds of millions of dollars to help hospitals convert. Becoming a free-standing ER is one way to use the extra funds.

Under current state law, free-standing ERs only can operate in a community with 50,000 or fewer residents. They must be within 50 miles of a hospital that owns or controls the ER. The Illinois Health Facilities & Services Review Board, which determines the fate of health care projects in the state to prevent duplicating services, must approve stand-alone ERs.

Currently there are six stand-alone ERs operating in a geographic area that stretches from downstate Streator (about an hour northeast of Peoria) to north suburban Lindenhurst near the Wisconsin border, according to the Illinois Department of Public Health.

As part of the new assessment program, free-standing ERs wouldn’t be limited by population restrictions, and they could bypass the facilities board. Instead, a state committee that oversees the pool of money to help hospitals convert would approve ERs, then the state Healthcare & Family Services Department would sign off.

But first, state lawmakers must pass a bill to overhaul the assessment program, then get federal approval before the existing program expires on July 1.

US News ranks 10 best, worst states for healthcare

From Becker’s:

The publication evaluated all 50 states using 77 metrics across eight categories, including healthcare. To rank states in healthcare, U.S. News examined healthcare access, public health and healthcare quality metrics.

The 10 best states for healthcare are:

1. Hawaii

2. Washington

3. Iowa

4. Connecticut

5. Massachusetts

6. Vermont

7. Minnesota

Southern Illinois hospitals celebrate beating national averages for treating heart attack patients

From the The Southern:

“The national guidelines recommend 120 minutes, but we have kept ourselves within 90 minutes,” Panchamukhi said.

The program boasts impressive door-to-balloon numbers, from referring hospitals as far as 46 miles from Memorial Hospital of Carbondale. Those hospitals include Pinckneyville Community Hospital, Marshall Browning Hospital of Du Quoin, Franklin Hospital in Benton, Ferrell Hospital in Eldorado, Harrisburg Medical Center, VA Medical Center in Marion, Herrin Hospital, St. Joseph Memorial Hospital in Murphysboro and Union County Hospital.

Collide or collaborate? Community health centers and hospitals work through their overlap

From Modern Healthcare (free subscription required):

Despite humble beginnings, federally qualified health centers, known as FQHCs, have become a sleeping giant in the healthcare industry. Amid this transformation, hospitals—particularly in rural or otherwise underserved areas—find themselves stepping carefully in an uneasy dance with primary-care focused health centers.

Emergency Department Frequent Users for Acute Alcohol Intoxication

From eScholarship:

Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described.

Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters.

Results: We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169). Frequent users were older (47 years vs. 39 years), and more commonly male (86% vs. 71%). Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder.

Conclusion: In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

Bystander defibrillator use tied to better cardiac arrest outcomes

From Reuters:

Cardiac arrest patients may be more likely to survive and avoid permanent disabilities when bystanders use a defibrillator to treat them before an ambulance arrives, a new study suggests.

The study focused on 2,500 cardiac arrests that happened in a public place and were considered “shockable,” or possible to treat with an automated external defibrillator (AED). Overall, a bystander used a defibrillator to aid patients in just 19 percent of these cases, the study found.

But when bystanders did intervene, cardiac arrest patients had more than double the survival odds and were also more than twice as likely to leave the hospital able to walk and manage daily tasks with little or no assistance