Marshfield Clinic in Wisconsin was one of two large physician groups of 10 participants in a federal quality improvement demonstration project that received shared savings during each of the five performance years. The clinic earned a shared savings payment of $15.8 million for the fifth year, which will be used to fund further changes and improvements, said Theodore Praxel, MD, medical director for the clinic's Institute for Quality, Innovation and Patient Safety. Marshfield earned a total of $56 million over the five performance years, according to CMS project documents. University of Michigan Faculty Group Practice was the other physician group that received shared savings in each of the five years, according to CMS. Marshfield Clinic said its ability to consistently drive quality while reducing Medicare costs was the result primarily of investing in a well-developed electronic health record and other tools to enable that improvement, some of it prior to the demonstration project.
Over the past year, the ICU at my hospital has been field-testing a more open approach. We are not the first to do so. Geisinger Medical Center in Danville, PA, went to an open ICU policy nearly a decade ago, found it extremely disruptive and soon reverted to only 30 minutes of visiting six times a day. On a second attempt, however, Geisinger developed an extensive communication program for both families and staff, and open ICU visitation has been successful since 2003. A 1997 study found that open ICU visitation practices had a beneficial effect on 67% of patients and 88% of families. I am surprised by how well the open policy at our hospital has worked over the past six months. I have become comfortable seeing family members stretched on recliners in the ICU during my early-morning visits. They update me on how the night went for the patient. One ICU specialist said, "I don't have to chase down families to update them on what is happening." Some ICUs are also inviting families to participate when a team of a dozen professionals, including doctors, nurses, pharmacists and social workers, decide on the plan for the patient.
South Lincoln Medical Center here reached an important milestone recently for using electronic health record technology under the Medicare EHR Incentive Program. SLMC is the first hospital in Wyoming and one of the first Critical Access Hospitals in the nation to complete a 90-day period of demonstrating EHR "meaningful use" as defined by the Centers for Medicare/Medicaid Services. A CAH is a rural hospital located at least 35 miles from any other hospital with no more than 25 inpatient beds. SLMC, a 16-bed facility, has been serving the area since 1961. Having reached this milestone, SLMC qualifies for a federal incentive payment from Medicare. The Medicare EHR Incentive Program is a CMS effort designed to encourage the adoption and use of electronic health records. The Wyoming Department of Health is developing a Medicaid EHR Incentive Program, which is also likely to provide incentive payments to the Kemmerer hospital later this year. Wyoming Department of Health Director Tom Forslund said, "South Lincoln Medical Center's achievement is a welcome demonstration that electronic health record initiatives can be successful in Wyoming."
Hurricane Irene's sweep up the East Coast spawned a swath of damage from powerful winds and rains, but also a legacy of a happier sort -- a crew of new babies born in the heart of a howling storm. Some hospitals dotting the Eastern seaboard reported sharp upticks in hurricane births over the wild weekend, giving new life to an old rumor about a drop in barometric pressure sending women into labor. At Sentara Obici Hospital in Suffolk, VA, 15 babies were born between Friday night and Sunday morning, topping the usual three or four in a typical day, said Sharon Hoggard, spokeswoman for Sentara Health System. Specific studies of the link between barometric pressure and labor have found small associations, but no clear ties. And some studies have found no relationship at all. Wall-to-wall hurricane coverage might send some women to the hospital earlier than usual, and people might pay attention more when a flurry of babies is born in a storm.
On Friday and Saturday, New York City shifted thousands of patients out of low-lying hospitals and nursing homes in the projected path of the hurricane. The goal was to avoid a situation like the one after Hurricane Katrina, when vulnerable patients suffered or died after institutions in New Orleans lost power and evacuations took days. Prestorm evacuations, however, came with their own risks, and difficulties were apparent over the weekend at hospitals and shelters. Eventually, the Promenade residents were accepted at the armory. "When you looked out, all you could see were ambulances," said Joseph Williams, MD, director of primary care at Kings County Hospital Center, which had sent medical staff members to the armory. "After some heated discussion with the ambulance manager, the decision was made to keep the patients and not put them at risk." Maimonides Medical Center in Brooklyn took in more than 100 evacuees starting on Friday. Some arrived in carefully planned transfers, and others were unexpected arrivals, according to Maimonides administrators. At one point on Saturday, patients were lined up on gurneys from the emergency room to the street, said John Marshall, MD, the center's chairman of emergency medicine. Staff members moved patients into a former intensive-care unit, now empty, to evaluate them. "Virtual beds" were created in the hospital's computer system to allow some patients to be moved into hallways to ease the strain on the emergency room.
While the most aggressive system of Tropical Storm Irene has exited the mid-Hudson Valley, flood waters are impacting many of the region's local hospitals. While Orange Regional Medical Center's campus in the Town of Wallkill was not impacted by flood waters, the approach to the hospital from Route 17 off Crystal Run Road/East Main Street was cut off around Phillipsburg Road, near the Wallkill River. In Warwick, the bridges surrounding St. Anthony Community Hospital have been washed out, leaving the hospital on an island, Bon Secours Charity spokeswoman Deborah Marshall said. However, the hospital is fully staffed and functional. At Bon Secours Community Hospital in Port Jervis, Bon Secours officials are eying the Neversink River, which will crest later this afternoon or evening. A number of hospital parking lots are underwater, Marshall said. Flooding on local roads is making it difficult for medical professionals to get to the hospital. Marshall said police and other emergency personnel are helping those practitioners get to the hospital.