John McCain this week rejected calls by his Democratic opponents for universal health coverage. His market-based solution is similar to a proposal put forth by President Bush last year. In a speech at a cancer research center, McCain dismissed proposals for universal healthcare as riddled with "inefficiency, irrationality and uncontrolled costs." He said the 47 million uninsured Americans will get coverage only when they are freed from the shackles of the current employer-dominated system.
Florida legislators have approved $14-million for the Hernando County Health Department for a new public health clinic. The new clinic would unite Health Department offices currently spread among several sites throughout the county, and officials said a new clinic would help the uninsured in the county who end up in emergency rooms for primary care. According to a Health Needs Assessment, about 17 percent of Hernando residents do not have medical insurance.
The governing board of Marrero, LA-based West Jefferson Medical Center threw all discussion about how it runs the public hospital behind closed doors, and vowed to maintain the format. Attorney Peter Butler Jr. said the board adopted the new agenda format to expedite meetings. Louisiana's open meetings law requires government bodies to conduct their business in public, except during nine situations outlined by the Legislature. A separate law passed specifically for hospital service districts provides an exemption for developing "marketing strategies and strategic plans to effectively compete."
The John C. Murphy Health Center in Berkeley, MO, will no longer have pediatricians and obstetricians-gynecologists working there. The doctors will continue to be in two other county-run health centers. The change would not save money or reduce staff, but simply open up space in the crowded John C. Murphy Health Center, said health officials. In a statement, the director of the research and medical services division of the health department said "we recognize that some clients may be concerned about these changes, but I want to assure everyone who comes through our doors that no matter what clinic a county resident visits, they will have their medical needs assessed and addressed."
Attracting insured patients to Texas-based JPS Health Network has long been a priority of Chief Executive Officer David Cecero, but physicians and community activists say JPS' chase of the insured can squeeze out low-income patients and divert resources. Cecero says insured patients can help make up for the money-losing services that JPS provides to low-income and other uninsured residents. The strategy is based on cost-shifting common to hospitals: Profits from some patients are used to make up for losses on others.
Columbia, SC-based Sisters of Charity Providence Hospitals has announced it posted a profit in 2007, the first time it has done so since 2004. Providence finished 2007 with a $5.7 million profit versus a loss of $1.4 million the previous year, and a $2.4 million loss in 2005. The turnaround was accomplished by improving the hospital's financial operation, controlling costs and making staffing adjustments, said officials.
Workers at Chilean public hospitals are striking to demand better working conditions and filling of vacancies. Doctors have not joined the walkout, but Union leader Carlos Castro says about 80 percent of the 65,000 workers joined the strike. Emergency services were not affected, but many nonurgent surgeries had to be rescheduled as a result of the strike.
A unanimous vote by the U.S. Senate sends the Genetic Information Nondiscrimination Act back to the House. The bill would bar health insurance companies from using genetic information to set premiums or determine enrollment eligibility. Employers also could not use genetic information in hiring, firing or promotion decisions.
City supervisors have given their approval to a $5.1 million settlement stemming from a 2005 incident of medical malpractice at San Francisco General Hospital. A spokesman for City Attorney Dennis Herrera said the settlement is "the largest in recent memory involving medical malpractice." The city admitted to mishandling the case of John Weatherspoon III, who visited the hospital in June 2005 complaining of fever and cough symptoms that had persisted for nearly a week.
There are more than 250,000 cases of catheter-related blood stream infections among American hospital patients each year, the CDC says. That's why, when your hospital goes 26 months without one, people notice.
Sutter Roseville Medical Center in Roseville, CA, is another one of the "zero heroes" I was introduced to recently. Under the leadership of Sophie Harnage, RN, BSN, clinical manager of infusion services, nurse-driven specialty teams have taken the facility's CRBSI rate from 11 in 2005 to zero during the last two-plus years.
The secret to SRMC's success is a bundle created by Harnage and documented in the Journal of the Association for Vascular Access in December 2007. Its steps include using peripherally inserted central catheters, ultrasound to select insertion sites, surgical-like coverage of both the patient and caregiver, a two-step cleansing and disinfection process, disinfection of the IV connector septum, and daily monitoring of the catheter line.
SRMC's nurses used to use traditional methods to determine where on the arm to insert a catheter, Harnage says. "But two years ago, we went 100% ultrasound . . . It was a big move to make that rule."
Before nurses are allowed to administer the PICC lines they must take a course on the ultrasound-guided technology and demonstrate they are competent in the procedure. Members of the team must also commit to following the steps included in Harnage's bundle.
The result, Harnage says, is an infection rate that hasn't moved from zero in more than two years and a nurse-driven team that is engaged and involved in keeping patients free from infection. "It empowers the team and excites the team," Harnage says. "They're very proud of their high success rate and the skill that they possess."
To come up with her bundle and the specialty team approach, Harnage says she spent a lot of time talking with her colleagues from hospitals all over the country. "I did my homework by asking various medical centers from around the country to ascertain best practices," she says. She gives credit to the many nurses who gave her an inside look at how their hospitals are working to fight infection.
The success that her team has experienced at SRMC gives Harnage hope that other hospitals can also become "zero heroes." She advocates for hospitals empowering nurses to lead the way in infection control.
"We have to take control of lines through assessment, insertion, and removal," she says. "Only specially-trained nurses offer this kind of consistency."
