Physicians feel pressured to provide unnecessary care for VIP patients

From Becker’s:

The study, published in the Journal of Hospital Medicine, surveyed hospitalists across eight hospitals about services provided to patients who are considered “VIPs.” In some hospitals, “VIP services” are provided to patients with close relationships to the hospital and may include extra space, enhanced facilities and extraneous comforts and supports. Of the respondents who reported that the presence of VIP services at their hospital, a majority said they felt pressure from VIP patients or their family members to perform additional treatments or tests and roughly one-third felt this pressure from hospital staff, according to the report.

Vomiting dummy hurls reality at Royal Flying Doctor Service emergency training

From ABC:

The brainchild of RFDS doctor Andy Caldin, the dummy’s purpose is to expose paramedics and nurses to the harsh realities of artificial respiration in the outback.

“This is our vomiting mannequin,” Dr Caldin said as he courteously introduced the dummy.

Hospital recommends Beyonce and ABBA for CPR training

From CNN:

In an effort to help train first responders in hands-only CPR, the hospital dropped a 40-song playlist jam-packed with artists from Beyonce to Lynyrd Skynyrd.
The hospital site lists out all the CPR steps, but the key number to remember is 100 compressions per minute. That’s where the playlist comes in.
With every song bumping at the 100 beats-per-minute benchmark, each works as a guide for timing compressions.
Headlining the playlist is the most applicable song: “Stayin’ Alive” by the Bee Gees. However, if you want a song that’s less dead-on, the hospital also recommends “Hips Don’t Lie” by Shakira and “One Week” by Barenaked Ladies.


Early Intervention Could Help Physician Patients Steer Clear of the ED

From NJ Spotlight:

New Jersey lawmakers are seeking to significantly expand initial screening programs for mental illness in an effort to divert patients in crisis from hospital emergency rooms into more appropriate community-based treatment.

In recent years, hospital officials have seen a growing number of patients with psychiatric problems flocking to their emergency departments when they are unable to find affordable care elsewhere. This results in less effective patient care and higher healthcare costs overall, experts note.

On Monday, an Assembly panel was the first legislative body to approve measures to beef up early intervention services (EIS) for individuals with mental illness and ensure each of New Jersey’s 21 counties have locally based programs — effectively doubling the number of sites currently operating. The proposals, introduced in January and crafted with significant input from hospital officials and mental health providers, are designed to better identify patients that need help and connect them with local mental health programs before they end up in the emergency room.

Cafes, ATMs might be good places for emergency defibrillators

From Reuters:

Storing defibrillators at coffee shops and banks with automated teller (ATM) machines might help bystanders provide faster emergency aid to patients having a cardiac arrest, a Canadian study suggests.

That’s because these places are often located near where patients typically experience cardiac arrest, and they may be open around the clock, researchers conclude in the journal Circulation.

Plus, bystanders who have no idea where to look for what’s known as an automated external defibrillator (AED) can probably easily find the nearest bank or chain coffee shop like Tim Hortons or Starbucks.

In Georgia, Rural Hospitals Struggle To Survive

From WABE:

Irwin County is about a three-hour drive from Atlanta down I-75 and has a population of about 9,000 people. But the hospital delivers babies from around the area, about 400 a year.

“If we’re not here, people die, and that’s something that we live with every day,” said Clay Jones, regional director of operations for E.R. Hospitals, which manages Irwin County Hospital and three other rural hospitals in Georgia.

Last year, Irwin County Hospital was about $2.5 million in the red, hospital officials said. Irwin County Hospital recently topped a state list of rural hospitals in need of financial help and is one of dozens in Georgia trying to stay afloat. According to the NC Rural Health Research Program, six rural hospitals in Georgia have closed since 2010.

Jones said one reason for the shortfall at Irwin County is that people who come in often don’t have insurance – and even if they do, they can’t meet the high deductible.

“Our emergency room doesn’t make money because a lot of people that come to our emergency room just aren’t able to pay in rural markets,” Jones said.


Characteristics of Emergency Department Visits for Super-Utilizers by Payer, 2014

From HCUP:

    • Emergency department (ED) super-utilizers were defined as those patients with the highest number of ED visits in 2014, by payer: four or more visits for privately insured patients aged 1-64 years or Medicare patients aged 65 years and older; six or more visits for Medicaid or Medicare patients aged 1-64 years.
    • In 2014, although super-utilizers constituted a relatively small proportion of all patients seen in the ED (2.6 to 6.1 percent, depending on the payer-age group), they accounted for a large share of all ED visits (10.5 to 26.2 percent).
    • Among Medicare patients aged 65 years and older, those with three or more chronic conditions constituted 33.3 percent of all ED visits among super-utilizers compared with 26.7 percent of ED visits among other patients.
    • ED super-utilizers accounted for 15 to 34 percent of all ED visits for abdominal pain and 13 to 29 percent of all ED visits for back pain.
    • ED super-utilizers aged 65 years and older accounted for 19 percent of all ED visits for urinary tract infections, 16 percent of ED visits for nonspecific chest pain, and 14 percent of ED visits for superficial injury.
  • Super-utilizers under age 65 years accounted for 19 to 40 percent of all ED visits for headaches.

This HCUP Statistical Brief extends AHRQ’s earlier work on super-utilizers by shifting focus from hospital inpatient stays to emergency department (ED) visits. In this Statistical Brief, we limited our analysis to ED visits among patients who were treated in the ED and then released from the ED, transferred to another type of nonhospital health facility, or died in the ED. Patients who were treated in the ED and then admitted to the same or a different hospital for inpatient services were not included, because they represent a different type of patient (e.g., in terms of condition severity or treatment needs). The earlier HCUP Statistical Briefs that focused on inpatient stays included admitted patients who were initially treated in the ED.

For this report, ED super-utilizers were defined on the basis of a consistent cut-off rule of approximately 2 standard deviations above the mean number of ED visits during 2014, applied to the statistical distribution specific to each payer and age group:

  • Medicare aged 65+ years: four or more ED visits per year
  • Medicare aged 1-64 years: six or more ED visits per year
  • Private insurance aged 1-64 years: four or more ED visits per year
  • Medicaid aged 1-64 years: six or more ED visits per year

This Statistical Brief presents pooled 2014 ED data across 13 geographically dispersed States, representing approximately 28 percent of the U.S. population. Patient demographics, resource use, and outcomes of ED visits for super-utilizers are compared with visits for other patients by primary expected payer (Medicare, private insurance, and Medicaid). The five most common first-listed diagnoses for ED visits are also identified for these super-utilizers. Differences greater than 20 percent between estimates are noted in the text.