Christina's Considerations

Re-energize in the National Parks

I just scratched off one of the items on my to-do list and feel really great about the accomplishment.  I had a recent trip to Utah and visited Zion and Bryce Canyon National Parks, two magnificent examples of the power of nature.

I've always been fascinated with nature, but in 1981 or 82 I took a geology class at LSU taught by an exceptional geologist and teacher and learned to appreciate and read rocks and earth formations.  These two parks have been at the top of my "must see" list for a number of years and were just as impressive as I expected.

Years of environmental forces have shaped these rocks, much like we are shaped by the environmental forces in our life.  Up close they may not seem very impressive, but step back a moment and look at the whole picture to appreciate their journey!

How to Prevent Picking Up Infections at Hospitals

I'm sometimes asked if I'll run guest posts and include my first one below.  The posts need to relate to the topics of this blog and be an appropriate length.  I hope you enjoy this one by Kat Sanders, who regularly writes on the topic of ekg tech.

How to Prevent Picking Up Infections at Hospitals

It’s ironic that the very place we go to get well can make us really sick – did you know that most infections are picked up at hospitals? More than 2 million people suffer from hospital acquired infections every year. And it’s not really a big surprise when you consider the fact that it is a building filled with sick people and so full of floating germs that are looking for healthy people to infect. So the next time you’re scheduled to visit a hospital, either for your own health or just as a companion, ensure that you don’t pick up an infection with these tips:

· Ensure that your doctor practices good hygiene: Your doctor and nurse are supposed to wash their hands before they examine and treat you and must wear gloves to ensure that you do not pick up new infections. If they fail to practice the necessary hygiene measures, you must speak up and let them know that you would like them to wash their hands first before examining you.

· Ensure that you are treated with single-use devices: When you’re visiting a laboratory to provide blood and other bodily fluids for tests, ensure that new syringes and needles are used. Also ensure that any medication is injected into you with fresh devices that are opened in front of you. Insist on your nurse using disposable gloves when he or she is attending to you.

· Tell your doctor about any medication you’re on: If you are on any medication, especially antibiotics, they may cause you to pick up an additional infection if combined with the new drugs your doctor gives you. So ensure that you tell your doctor of the medication you have taken recently or are still taking now.

· Limit your visitors: If you have to stay in the hospital for a few days, limit your visitors, especially if you’ve just undergone a surgical procedure that has left you prone to infections. The more people that come to see you, the higher your chances of being infected because your body and immune system are weak after the surgery and have not recovered sufficiently to fight disease and the germs that cause them.

Most hospitals are now effecting policies that require their medical personnel to devote extra attention and importance to hygiene; because this is the only way that hospital acquired infections can be kept to the bare minimum.

By-line:

This guest article was written by Kat Sanders, who regularly writes on the topic of ekg tech . Kat welcomes your comments and questions at her email address: katsanders25@gmail.com.

 

Impact of Pediatric Obesity on Hospital Costs

It really makes me sad when I see a child who is obese.  Not one who is just a little overweight, but really obese.  I'm sad because of the health problems that the child will face over their lifetime, unless they lose the weight.

So Health Affairs' paper on the  Effects of Childhood Obesity on Hospital Care and Costs caught my attention and I read it.  Some of the key and alarming findings include:

• a near-doubling in hospitalizations with a diagnosis of obesity between 1999 and 2005

• an increase in costs from $125.9 million to 237.6 million (in 2005 dollars) between 2001 and 2005

• Medicaid appears to bear a large burden of hospitalizations for conditions that occur along with obesity (attention taxpayers!)

• Charges for hospitalizations with a primary diagnosis of obesity increased by 66.3 percent annually

• Among hospitalizations for which obesity was listed as a secondary diagnosis, affective disorders were the most frequent primary diagnoses, followed by pregnancy-associated conditions, asthma, and diabetes.

• Depressive disorder was the most common diagnosis in the "other mental disorders" category. Surprised?

• The leading diagnosis in the "other bone disorders" hospitalization group was slipped capital femoral epiphysis a well-known comorbidity of childhood obesity. 

Teach children about good nutrition and exercise, set a good example and get help early, if needed.  Don't stand by and allow a child to become significantly overweight or obese and burdened by health problems for the rest of their life.

Prevention is the real key to reducing costs as Dr. Erika Schwartz describes in her article true prevention.  Until this happens, we are stuck with the costs of just keeping up with the numbers and severity of the chronically ill.

Why should anyone be led by you?

A Harvard Business Review article shares its authors' findings of four qualities of great leaders that the authors found unexpected.   However, I've always found that great leaders:

1) selectively reveal their weaknesses;

2) rely heavily on intuition to gauge the appropriate timing and course of their actions;

3) manage employees with "tough empathy"; and

4) capitalize on their differences.

Santa Paula Hospital: A Success Story!

It is official, three years after its re-opening Santa Paula Hospital has not only met its goals, but exceeded them.  Today's Ventura County Star article provides some of the details that we could see when I left in December.

I'm truly proud to have been part of this story and to have helped make the adjustments that were needed to ensure the success we expected.  The employees, volunteers and physicians are wonderful and I don't hesitate to recommend the quality and safety of care provided.

Congratulations to the community on having your hospital back, but don't ever allow your attention to wane and the hospital to drift off down another unfortunate path!

Paperless health care? One hospital's long journey

My local paper had a great story from Associated Press the other day about Childrens Hospital of Pittsburgh and their journey towards a paperless medical record.  They (correctly) see this transition as a process and not buying software and flipping a switch.  They have realized a drop in medication errors of 45% since 2002, but also have a lesson learned about patients trasferred in from other hospitals to their ICU.  Their lesson from the five months after the switch to paperless was that the death rate doubled during the perilous time of the hand-off because of their well organized routine. 

Those who are about to look at their own implementation should address:

• the need for patients being registered en route to avoid delays in medication orders

• increases in time to click through unfamiliar software (perhaps assign your most familiar staff to these cases)

• having wireless computers at the bedside for these new admits.

One of the mom's was intereviewed and reports how the electronic system has made a difference by her not having to haul x-rays around to doctors and a new ease in making specialist appointments.  However, she is also concerned bcause her doctor's practice (affiliated with the hospital) is only partly digital and next year will buy a new system that doesn't talk to the hospital system........!

OK, I know.  It is a process, a journey and there will be some bumps in the road.  But, in the end we will arrive!  I just know we will!

LEAN Works for the workplace!

The CDC is helping workplaces to learn about obesity and the benefits of a lean workplace with their new site LEAN Works   This effort comes in response to a study in 2000 that found the total cost (direct and indirect) attributable to obesity estimated at $117 billion.  In addition, between 1987 and 2001, they found diseases associated with obesity accounted for 27 percent of the increases in medical costs and  medical expenses for obese employees are estimated to be between 29 percent and 117 percent greater than medical expenses for employees with a healthy weight.

"CDC's LEAN Works! Leading Employees to Activity and Nutrition" is a FREEweb-based resource that offers interactive tools and evidence-based resources to design effective worksite obesity prevention and control programs, including an obesity cost calculator to estimate how much obesity is costing your company and how much savings your company could reap with different workplace interventions.

Improving the Efficacy of an IT System

A year ago I was asked by a group of management students to participate in their Masters project.  Their research on the impact of  an IT implementation was published in the May/June issue of the Journal of Healthcare Management and is titled "Strategic, Political, and Cultural Aspects of IT Implementation:  Improving the Efficacy of an IT System in a Large Hospital."  It will be of value to anyone wanting to learn from the lessons of others.

I'm happy to see these University of Massachusetts, Boston graduates have their work published and to have been invited to participate.