How Hospitals Should Prepare For A Potential Ebola Patient

The Huffington Post reported “Back in August, it only took Mount Sinai Hospital workers in New York seven minutes to isolate and start treating a man who they suspected of having Ebola. Other U.S. hospitals have also speedily screened and tested suspected Ebola patients, all without incident.

The contrast between those other hospitals’ responses and the actions of workers at Texas Health Presbyterian Hospital Dallas, who recently mistook a Liberian man’s symptoms for a common illness and didn’t properly communicate his travel history to other colleagues, can be explained with training and drills, explained Dr. Brian Koll, the executive director of infection prevention for Mount Sinai Health System.

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“I’m Here, Doc, to Make Sure I Don’t Have Anything Serious. I’m Not Sure My Regular Doctor Was Listening to Everything I Was Trying to Tell Him.”

The New York Times article included the following vignette:

“According to the nurse’s note, the patient had received a clean bill of health from his regular doctor only a few days before, so I was surprised to see his request for a second opinion. He stared intently at my name badge as I walked into the room, then nodded his head at each syllable of my name as I introduced myself.

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“…Many Decisions about Discussing Errors with Patients … Involve Situations in Which Other Clinicians Were Primarily Responsible for the Error.”

Have you ever wondered what your physician should say to you if a medical error by another physician is identified?

A New England Journal of Medicine article focused on this question.

“Although a consensus has been reached regarding the ethical duty to communicate openly with patients who have been harmed by medical errors physicians struggle to fulfill this responsibility …”

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“…Variation … is What Plagues Healthcare”

An article in Beckers Hospital Review focused on clinical care variation -

“Back when he was a resident, (he) saw two physicians perform separate colonoscopies, in which they discovered polyps in their respective patients. Each, however, went about removing the polyp in a different way — one via endoscopic surgery, another through open surgery. Despite having the resources and expertise to perform the procedure endoscopically, the physician who decided on surgery said his reason was a simple one: “That’s how I like to do it.”"

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“The Sudden Termination of a Close Doctor-Patient Relationship Is a Wrenching Scenario …”

A major source of emotional and spiritual suffering among patients who are nearing the end of life is the abandonment they feel when they stop being cared for by a physician to whom they have become attached.

The New York Times article noted “’I can tell you, it happens all the time and it breaks the heart of patients and families and oncologists,’ said Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai’s Icahn School of Medicine in New York City.”

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“How Healthcare Is Changing—for the Better”

There are many innovative practices being used to make sure patients are not unnecessarily readmitted to the hospital.

A U.S News article describes a discharge regimen used by the Cleveland Clinic.

“When Richard Jones of Niles, Ohio, 70, was discharged in May, he was sent home with a digital scale to flag any weight fluctuations (a possible sign of fluid buildup), a blood pressure cuff, and other monitoring equipment tied into the hospital system. He was also assigned a telemonitoring support team of nurses, social workers, nutritionists, therapists, and doctors who would check his vital signs daily, remotely or in person, for up to 40 days. In phone and house calls, the team coordinated follow-up doctor visits and counseled the lifelong cheeseburger-and-fries fan on worrisome symptoms to watch for and how to make lifestyle changes stick.”

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“… Comparing the Quality and Outcomes of Care at Competing Cancer Centers”

“Cancer!” Should you rush to a “major” cancer center?

The Modern Healthcare article noted “When it comes to cancer care, there is a huge disconnect between the possibilities of modern medicine and its day-to-day practice. As last fall’s troubling report from the Institute of Medicine noted, variation in oncology practice is wide; collection of quality and outcomes data is poor; and progress in learning what works best for any particular cancer remains slow and halting.”

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Better Hygiene Through Humiliation

Recently The Atlantic reported: “As doctors and nurses move through hospitals, they aren’t the only ones making rounds—hitching a ride on their hands are dangerous bacteria that can lead to infections ranging from antibiotic-resistant staph to norovirus.”

“In recent years, a number of companies have designed systems that aim to nudge doctors and nurses into washing their hands regularly. One of these devices, a badge made by Biovigil, aims to exploit a very powerful emotion: shame. When a doctor enters an exam room, the badge chirps and a light on it turns yellow—a reminder to the doctor as well as an alert to the patient that he is about to be touched by someone with unclean hands. If the doctor doesn’t wash her hands, the light flashes red and the badge makes a disapproving noise. After the doctor waves a freshly sanitized hand in front of the badge, alcohol vapors trigger a sensor that changes the light from red to green.”

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