The New York Times reported: “Hospitals nationwide are hustling to prepare for the first traveler from West Africa who arrives in the emergency room with symptoms of infection with the Ebola virus.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, has said such a case is inevitable in the United States, and the agency this month issued the first extensive guidelines for hospitals on how recognize and treat Ebola patients.
The recommendations touch on everything from the safe handling of lab specimens to effective isolation of suspected Ebola patients …
ABC News reported: “American hospitals and state labs have handled at least 68 Ebola scares over the last three weeks, according to the U.S. Centers for Disease Control and Prevention.
Hospitals in 27 states alerted the CDC of the possible Ebola cases out of an abundance of caution amid the growing outbreak in Guinea, Liberia and Sierra Leone. Fifty-eight cases were deemed false alarms after CDC officials spoke with medical professions about patient exposures and symptoms, but blood samples for the remaining 10 were sent to the CDC for testing, the agency told ABC News today.
The Mount Sinai Hospital has been ranked No. 16 out of nearly 5,000 hospitals nationwide in the U.S. News & World Report 2014–15 “Best Hospitals” guidebook. Additionally, New York Eye and Ear Infirmary of Mount Sinai achieved a No. 10 national ranking for Ophthalmology, while Mount Sinai Beth Israel and Mount Sinai St. Luke’s/Mount Sinai Roosevelt attained “high-performing” designations in a total of 11 specialties.
Further, according to U.S. News & World Report, The Mount Sinai Hospital is one of only 17 hospitals to receive “very high scores” in at least six clinical specialties, earning it Honor Roll status.
We all go to the doctor, the ER or are admitted to the hospital without asking what it will cost.
A New York Times article started with this vignette:
“Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.
In the recent past a hospitalized patient expected to see one’s primary care practitioner making rounds, examining patients and writing “orders.”
An article in Newsday addressed the question: “Do you know if your primary care physician will manage your care if you are admitted to the hospital?”
“Reflecting today’s changing medical practices, some primary care doctors don’t set foot inside their patients’ hospital rooms at all — leaving their care to physicians called hospitalists.
An article in Becker’s Hospital Review reported that hospital interns generally failed to use “five key communications strategies, including introducing themselves, explaining their role in the patient’s care, touching the patient, asking open-ended questions such as ‘How are you feeling today?’ and sitting down with the patient. The five actions are components of what is termed ‘etiquette-based medicine,’ as described in a 2008 New England Journal of Medicine article by Michael W. Kahn, MD.”
“With internal medicine in particular, especially these days, it’s about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term … You can’t do that if you’re not connecting with the patient very well.”
The New York Post reported “An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington state’s insurance exchange. MD Anderson Cancer Center says it’s in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more”
“Doctors and administrators say they’re concerned. So are some state insurance regulators. In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP’s survey said patients have access through all the insurance companies in their state exchange”.
An article in the Wall Street Journal noted “Quality” has been the buzzword in health care for a decade, but the worthy goal is driving health-care providers to distraction. All stakeholders—insurers, patients, hospital administrators and government watchdogs—are demanding metrics to ensure that money is spent wisely.
A recent Modern Health Care article noted “The key is getting that travel history right up front when you’re interviewing the patient and then as soon as you suspect MERS—even before you do the testing—you should make sure you have that patient on isolation precautions so they don’t spread to any other patients or healthcare workers.”
The major lesson from this first MERs experience in the U.S. for other healthcare providers is “to think about MERS you really need to get a good travel history…”
“Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes.”
A Kaiser Health News article noted “Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements.”
“Doctors have one eye on the patient and one eye on the clock…”