Grassroots group’s goal to support rural hospitals

From the Record-Delta:

St. Joseph’s Hospital is exploring the formation of a grassroots advocacy team of local citizens that can push for issues to help rural hospitals.

Skip Gjolberg, administrator at St. Joseph’s Hospital, saw the grassroots advocacy work in Chippewa Falls, Wisconsin.

“It was pretty successful,” he said.

Grassroots advocacy is political activity with the goal of creating change and can be successful at federal, state and local level, according to Gjolberg.

Minnesota Doctors Face Opioid Prescribing Limits

From US News:

A Minnesota task force has set new limits on opioid prescriptions by doctors who participate in the state’s Medicaid program.

The rule was adopted by the state’s Opioid Prescribing Work Group on Thursday but won’t take effect until they’re approved by the state human services commissioner, the Star Tribune reported .

Nonsurgical physicians and dentists can have no more than half of their opioid prescriptions exceed 100 morphine milligram equivalents, which is equivalent to about 20 Vicodin or Percocet pills at the typical 5 milligram strength. Surgeons will have a limit of 200 morphine milligram equivalents per outpatient prescription.

Inappropriate Dosing in Elderly Emergency Department Patients

From the Pharmacy Times:

ED providers often prescribe high-risk medications at supertherapeutic doses to older patients. Indeed, these medications are inherent to the treatment of common reasons for an ED visit, but dose sensitivity increases with advanced age. The addition of a pharmacist into the ED or the incorporation of high-priority ED medicine verification may avoid the administration of inappropriately high doses. Future prescriber education, such as pharmacist-led in-services, should focus on the importance of dose moderation in younger elderly patients.

A new role for first responders: providing in-home health care

From STAT:

…hospitals and insurers have begun trying to change that story by changing how emergency medicine is delivered. The idea is, instead of transporting patients to the hospital, emergency medical technicians respond to their needs in their own home. Many patient needs — for instance, slightly elevated blood pressure, a dip in blood sugar — are simple enough to not need a trip to the hospital. Avoiding hospitals saves insurers money, is easier on patients, and reduces the risk of hospital-acquired infections.

It’s called mobile integrated health; currently, more than 100 such programs exist nationwide. In Massachusetts, a number of pilot programs in mobile integrated health have sprouted up in recent years. The Department of Public Health has waived certain rules governing EMS providers for two Boston-area pilot programs.

Federal Government Declares Emergency Physicians Incapable of Performing Medical Screening Exam for Psychiatric Patients in AnMed Lawsuit

From ACEP Now:

There is no EMTALA issue in emergency medicine more difficult, more confusing, or more risk-prone than managing psychiatric patients in the emergency department. The AnMed Health case is the quintessential example and should greatly concern emergency physicians.

AnMed Health, a hospital system based in Anderson, South Carolina, recently settled with the Office of Inspector General (OIG) for $1.295 million for allegedly failing to appropriately screen and stabilize psychiatric patients presenting to the hospital’s emergency department.

4 New Hampshire hospital workers fall ill after exposure to unidentified white powder in ER

From Becker’s:

“The officer struggled with Macenas as he attempted to swallow the unknown powdery substance,” police said in a statement, according to the Union Leader. “The struggle caused a tear in the plastic bag, which caused the powdery substance to contaminate the floor of the bathroom and the adjacent hallway. A second officer assigned to the hospital detail helped the officer subdue the combative man.”

After the incident, two police officers, a nurse, a physician, a hospital security guard and a nursing student complained of nausea, headaches, rapid heartbeat and other symptoms.

Firefighters in hazardous material suits decontaminated the bathroom where the incident occurred and an adjacent hallway, treating the powdery substance as if it were heroin or fentanyl. A lab is testing the substance to determine its content.

AMA votes to keep ICE officials out of hospitals

From Becker’s:

The American Medical Association House of Delegates voted against allowing federal immigration officials in hospitals at its interim meeting in Honolulu.

U.S. Immigration and Customs Enforcement policy normally prohibits agents from enforcing immigration policies through interviews, searches or arrests in “sensitive locations” such as hospitals. However, instances do occasionally occur. For example, the AMA cites a case in which a 10-year-old patient with cerebral palsy was taken into custody by ICE agents shortly after discharge from a surgery.

“Our patients should not fear that entering a hospital will result in arrests or deportation. In medical facilities, patients and families should be focused on recovery and their health, not the ramifications of their immigration status,” Andrew Gurman, MD, immediate past president of the AMA, said in a press release.