Archive for April, 2011

The Overburdened, Understaffed Emergency Room – Part 2

April 25, 2011

The Medical Center Emergency and Trauma Center's ambulance entrance

  I asked the nurse assigned to me, “How many doctors are on duty tonight?”  She replied , “Two.”  That confirmed my suspicion that The Medical Center’s Emergency and Trauma Center was understaffed that night, Sunday, April 3, 2011. That suspicion had been formed when another nurse, the one assigned to triage, told me that wait times would probably be up to seven  hours for some of the many people sitting in the ETC waiting room, and the average wait would be about five hours.  Because I had a head wound and was on a blood thinner which could have increased the chances of internal bleeding, I didn’t have to wait that long.  I got to see a doctor in about two hours from the time I signed in. 

So,  my impression was the ETC was like emergency rooms all over the country, overburdened and understaffed, but was it? In my opinion, that  night, Sunday, April 3, 2011, it was.  However, it was not a normal night. I learned just how abnormal it was when I posed a few questions to Marion Scott, who is Director of Communications for the Columbus Regional Medical System.  I decided to let her speak for herself unedited. This is what she wrote to me.

On the night you were treated, staffing in the ETC was at the “best practice” standard as set by the national Emergency Nurses Association. Staffing ratio is one nurse to four patients.
 
There were two emergency physicians in the ETC that evening; again, an appropriate staffing level under routine conditions. Residents from our teaching program do not routinely work in ETC. They do report to the ETC for duty when we call “trauma,” a designation indicating extraordinary and severe patient volume that increases staffing across clinical and non-clinical support areas. We typically have one to three trauma cases in a 24-hour period. In the 24-hour period during which you were treated, we had 20 trauma cases – seven to ten times the normal trauma volume.
 
You also asked about the number of patients treated in the Emergency and Trauma Center who cannot pay for care. For our last full fiscal year, which ended June 30, 2010, 86 percent of the total patient encounters through the ETC were uninsured and 33 percent resulted in uncompensated care. The Medical Center’s total uncompensated care for last fiscal year was just over $32 million.
 
As you and I have discussed, the greater issue related to emergency care is the number of people who use an emergency room for minor illnesses and injuries and for primary care. Approximately 40 percent of the patients treated in The Medical Center’s ETC could have been treated in a more appropriate setting, such as their physician’s office or an urgent care center. The result of inappropriate use of an emergency room is overcrowded emergency rooms with long waits, inefficient use of hospital resources and higher costs for patients and insurers.
 
Also, many people treated in an emergency room for minor illnesses and injuries do not have a physician, or “medical home.” It is so important to have a physician with whom you can establish an ongoing relationship and who will understand your health and medical needs and provide continuity of care.
 
There are no easy answers or quick fixes to these serious problems. We can address the issues through education, communication, and services to assist the uninsured in finding programs that might help them and to assist people without a physician in finding a medical home. 
 

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The Overburdened, Understaffed Emergency Room – Part 1…Again

April 22, 2011

Since it has taken so long to get the information I wanted to use for part 2 of this series, I figured I would run Part 1 again so it will be fresh on your minds.  I’m shooting for Monday as posting day. I think you’ll find what I have learned interesting. Meanwhile, here’s Part 1 again.  

If you really want to know what an emergency room is like, go as a patient. I did just that when I went to the Columbus Medical Center Emergency Department on  Sunday night, April 3, 2011.  It’s a really nice new facility,  with a professional and friendly staff, which is now a state designated Level Two  trauma center that serves 13 counties in West Georgia and East Alabama. But, there were problems, and they are the same problems emergency rooms face all over the country. 

Since I definitely suffered a trauma when I fell backwards onto a sidewalk, hitting my head, I figured I wouldn’t have to wait long to receive treatment.  After all, there was a really big lump on the back of my head, and I am on a blood thinner for my heart condition atrial fibrillation, which meant I could have been suffering internal bleeding.  I was wrong.

It was on a Sunday night and the emergency room was packed with people waiting to be treated. I knew that all emergency rooms stay very busy because people, who don’t have healthcare insurance and can’t  afford to pay for treatment,  go there to be treated for non-emergency conditions, things like colds and sore throats. But I figured that triage would get me in fairly soon after arrival. After all, a head injury with possible internal bleeding should trump a cold.

I estimate that it took about forty-five minutes from the time I signed in until I saw the triage nurse, a warm, empathetic lady,  who honestly explained the situation.   (Being more concerned about my condition, I didn’t think to advise the staff that served me that I might do a blog on this, so I won’t be using any names.)  She said that some people would be waiting seven hours, and that the average  wait for a night that busy was probably five.  I let her know that with a head injury, on a blood thinner, with possible internal bleeding, I couldn’t wait five hours. She said she knew that and my wait would not be that long since I was a three.  That put me in the middle of the triage line.    There are five triage categories. She explained that five is for people whose condition is the least  urgent.  One, she said,  is for people who need to see a doctor immediately.

Since it was an unusually busy day with a lot of vehicle accidents, including one that involved five motorcycles, there were more number ones than normal.  I would estimate that it took about two hours for me to see a physician, a really nice man, who decided I should have a CT scan.  He said the big bump on the back of my head, an external injury, concerned him a lot less than a possible internal jury.   Fortunately the scan showed my brain had not been injured.  He gave me instructions on caring for a concussion and , after an almost five-hour visit, a friend, who had taken me to the emergency room, drove me home.

Though retired, my reporter’s curiosity , which, after fifty years as a broadcast journalist will probably never go away, inspired me to learn more about  the emergency room situation, not only at the Columbus Medical Center, but nationally.  The common description used by reporters that the facilities are overburdened and understaffed had a true ring to it after my experience.  I’ll tell you what I have learned and discuss some possible solutions in a future post. Stay tuned.

DROP BY AND BUY

April 19, 2011

It looks as  though I will make it to my volunteer job at the Friends of Libraries Bookstore at the Columbus Public Library Thursday.  My hip and leg are pretty sore from the Saturday night fall in the Bill Heard Theater in the River Center; however, the x-rays showed no breaks, so I plan to be there between 2 and 4 p.m., and I hope you’ll drop by and buy a book.  Just don’t ask me to dance.

Join Me at the Library

April 18, 2011

It’s Monday so that means I need to come up with something to post because I’ve promised to try to have a new post on Monday – well, Sunday night sometimes.  I have a few things in my blog oven, but the only one ready to serve is an invitation for you to come to the Friends Book Store at the Columbus Public Library.  I work in the store every Thursday from 2 to 4 p.m., and the time passes quicker when I stay busy ringing up sales so I thought maybe you might like to come by and buy a book.

 I hope to be there this Thursday, but I have to be honest with you. I fell again.  Two weeks ago I fell and hit my head on a sidewalk, but that didn’t interfere with my Thursday volunteer job. However, this time I stumbled on a step in the Bill Heard Theater,fell forward, and rolled on my side when I hit the carpeted floor, causing me to land on my left leg. I don’t think I broke anything, but there is pain so I’ll have to wait to see what the doctor says after the x-rays.

  If I am there Thursday, I will bring an interesting novel I just finished called American Rust by Phillip Meyer. It’s a New York Times Notable Book of the Year, and a Washington Post Top Ten Book of the Year. I paid about $15 for it at Barnes and Nobel. It’ll go for $4 at the book store.  First come, first serve.  Do I recommend it? I do, but I have to warn you that it’s not all sweetness and light.  The goings on in an economically devastated Pennsylvania steel town can get rough. 

  I’m sure it will come as no surprise to you,  but people who work in the bookstore are among its best customers.  I just bought David Baldacci’s The Collectors.  I am a Baldacci fan.  It’s not Hemingway or Steinbeck, but a good action packed and mysterious ride. This one, a hardback,  sold for $26.99 new. I picked it up for $3.

Maybe I’ll see you Thursday, if my injuries allow it, and if you come. If I’m not there, they’ll sell you a book, anyway.  I hope I will be there. I enjoy meeting the interesting folks that come in to buy books, and I like the idea of helping raise money for the library. I think public libraries are extremely important in a democratic republic. It’s a lot harder to fool people who do a lot of reading and fooling people is what a lot of politicians really care about. Unfortunately, they often succeed.  But, an informed public makes it harder to do.   

Health Science Professor Named CSU Educator of the Year

April 16, 2011

Columbus State University News Release

April 15, 2011

COLUMBUS, Ga. — An emergency room doctor-turned-professor is Columbus State University’s 2011 Educator of the Year.

Dr. Paula Walker

Dr. Paula Walker, an associate professor of health science, accepted the award during Friday afternoon’s 2011 Scholastic Honors Convocation on Columbus State’s main campus. Other top faculty honorees are business professors Mike Daniels for faculty service and Ed O’Donnell for research and scholarship. The Faculty Cup, recognizing CSU’s top student for 2010-2011, went to biology major Roma Patel.

Walker joined the CSU faculty in 2005 after transitioning to full-time teaching from practicing emergency medicine at Detroit’s St. John Hospital and Medical Center. With advanced cardiac life support among her specialties, she teaches graduate and undergraduate students in courses such as Death and Dying, Consumer Health and Community Health Problems for CSU’s Health Science Program in the College of Education and Health Professions.

Before completing a residency at St. John in 1998, Walker earned a medical degree from Wayne State University in Michigan after finishing undergraduate studies in microbiology at Howard University. Her career shift to education included a stint at Chattahoochee Valley Community College.

She has developed an online course supporting CSU’s distance education initiative and serves as the pre-med advisor to health science students, on the Graduate Council and Preprofessional committees, and she chairs the CSU committee for Who’s Who Among Students in American Colleges and Universities.

O’Donnell, a former aircraft and hydraulic industry project manager, has flourished as a scholar, with recent research published in the Journal of Management Studies, Marketing Management Journal, Frontiers of Entrepreneurial Research and others. An assistant professor of marketing for the Turner College of Business and Computer Science, his current research interests include international product strategy, sales management and inter-organizational business relationships.

Daniels, while teaching at CSU for 31 years, has served 120-plus institutional committee appointments. A professor of economics, he has produced more than 40 economic studies supporting educational, business, infrastructure and quality of life improvements in the surrounding community.

Patel was unable to attend the convocation, as she was in Huntsville to present her recent research into orthodontic rubber band toxicity as part of a regional conference of the Tri-Beta national biological honor society. A CSU Dean’s List regular pursuing a career in dentistry, she also has been active in supporting medical services to impoverished Costa Rican communities as local chapter president for the American Medical Student Association.

Other top student honors, the Academic Recognition and Phi Kappa Phi Senior awards, went to music majors Emily Vold and Amanda Beard respectively.

New faculty emeritus designees are retired or retiring professors Bill Birkhead (biology), Terry Norris (criminal justice) and library faculty Erma Banks, Callie McGinnis and Sandra Stratford. The award to the late Bill Chappell (political science), also part of this class, was presented to his widow, Delane, during a March 4 memorial service on campus.

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Aflac’s Dan Amos Tells Columbus Rotarians…

April 13, 2011

The Japanese earthquake will not have an impact on this year’s earnings growth. Also, he said the people of Japan are not in panic. He said 75 percent of Aflac’s earnings come from Japan.

He said impact of the nuclear power plant crisis is something no one knows.

He is still speaking as I post this via iPhone.

-0-

He’s finished and I’m back home at my computer.

My 2011 Aflac stuffed duck, which was in the seat of my table chair at the Rotary Club of Columbus meeting.

 

What is clear to me after hearing his talk is that he and his marketing folks really know how to make the most of situations that could be bad.  He and Aflac got a tremendous amount of positive national exposure from two crises, the Japanese earthquake and tsunami and the dismissal of Gilbert Gottfried as the voice of  the  Aflac duck because of insensitive jokes he tweeted about the Japanese earthquake.

 

The networks and news channels interviewed Amos right after the quake and tsunami because they knew of Aflac’s commercial ties with Japan.  And the firing of Gottfried generated over 8 thousand news stories, and lots of play by late night TV comedians.  The search for a new voice has drawn eleven thousands entries and gotten a lot of news coverage.

In referring to the CBS news story that called the Aflac duck the most famous in the world,  Amos said, “Eat your heart out Donald Duck.”

Every time he speaks to the Rotary club Aflac puts stuffed ducks at every plate.  I have gotten a number of them over the years and, of course, gave them all to children I know. I’m not sure who I’ll give this one to  because  I’ve run out of little children.  Anybody want a quacking Aflac duck?

The Overburdened, Understaffed Emergency Room – Part 1

April 11, 2011

If you really want to know what an emergency room is like, go as a patient. I did just that when I went to the Columbus Medical Center Emergency Department on  Sunday night, April 3, 2011.  It’s a really nice new facility,  with a professional and friendly staff, which is now a state designated Level Two  trauma center that serves 13 counties in West Georgia and East Alabama. But, there were problems, and they are the same problems emergency rooms face all over the country. 

Since I definitely suffered a trauma when I fell backwards onto a sidewalk, hitting my head, I figured I wouldn’t have to wait long to receive treatment.  After all, there was a really big lump on the back of my head, and I am on a blood thinner for my heart condition atrial fibrillation, which meant I could have been suffering internal bleeding.  I was wrong.

It was on a Sunday night and the emergency room was packed with people waiting to be treated. I knew that all emergency rooms stay very busy because people, who don’t have healthcare insurance and can’t  afford to pay for treatment,  go there to be treated for non-emergency conditions, things like colds and sore throats. But I figured that triage would get me in fairly soon after arrival. After all, a head injury with possible internal bleeding should trump a cold.

I estimate that it took about forty-five minutes from the time I signed in until I saw the triage nurse, a warm, empathetic lady,  who honestly explained the situation.   (Being more concerned about my condition, I didn’t think to advise the staff that served me that I might do a blog on this, so I won’t be using any names.)  She said that some people would be waiting seven hours, and that the average  wait for a night that busy was probably five.  I let her know that with a head injury, on a blood thinner, with possible internal bleeding, I couldn’t wait five hours. She said she knew that and my wait would not be that long since I was a three.  That put me in the middle of the triage line.    There are five triage categories. She explained that five is for people whose condition is the least  urgent.  One, she said,  is for people who need to see a doctor immediately.

Since it was an unusually busy day with a lot of vehicle accidents, including one that involved five motorcycles, there were more number ones than normal.  I would estimate that it took about two hours for me to see a physician, a really nice man, who decided I should have a CT scan.  He said the big bump on the back of my head, an external injury, concerned him a lot less than a possible internal jury.   Fortunately the scan showed my brain had not been injured.  He gave me instructions on caring for a concussion and , after an almost five-hour visit, a friend, who had taken me to the emergency room, drove me home.

Though retired, my reporter’s curiosity , which, after fifty years as a broadcast journalist will probably never go away, inspired me to learn more about  the emergency room situation, not only at the Columbus Medical Center, but nationally.  The common description used by reporters that the facilities are overburdened and understaffed had a true ring to it after my experience.  I’ll tell you what I have learned and discuss some possible solutions in a future post. Stay tuned.

After the Fall

April 4, 2011

It’s Monday, so I have to live up to my promise to try to post something new.  It can’t be long and involved though because I’m suppose to be taking it easy for a few days.  You see, I fell Sunday evening and hit my head on the sidewalk which  led to an interesting experience at the Columbus Medical Center emergency room.  The CAT scan didn’t turn up anything bad, so I am back at home with a big bump on the  back of my head and instructions on what to do following a concussion.  The main instruction is that I should rest.  I suppose number two is that I shouldn’t drive for 3 days. Anyway, it was an interesting and informative Sunday night in the emergency room of today. I’ll tell you why  in a few days. Stay tuned.