WBEZ | hospitals http://www.wbez.org/tags/hospitals Latest from WBEZ Chicago Public Radio en Could Hospital ERs Provide Missing Data On Police Shootings? http://www.wbez.org/news/could-hospital-ers-provide-missing-data-police-shootings-114759 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/istockER.jpg" alt="" /><p><p>For the past two years, Joseph Richardson has been trying to figure out how to keep young black men with knife and gunshot wounds from turning up again with similar injuries at Prince George&#39;s Hospital Trauma Center outside Washington, D.C.</p><p>Richardson is director of the Violence Intervention Research Project at the trauma center. When these men are admitted, he shows up at their rooms to ask them to take part in his ongoing study on risk factors for repeat violent injuries. Sometimes he finds them handcuffed to a hospital bed, guarded by a police officer or two. Richardson has to walk away. The patients are under arrest and off-limits to him.</p><p><a href="http://aasd.umd.edu/facultyprofile/Richardson,%20Jr./Joseph">Richardson</a>&nbsp;is also a criminologist and associate professor at the University of Maryland. And recently, in the context of a national discussion about police violence, he got to thinking about the lack of access that kept him from asking these men what happened. How many of those handcuffed shooting victims had taken a bullet from a cop, he wondered?</p><p>With&nbsp;<a href="https://www.washingtonpost.com/news/post-nation/wp/2014/09/08/how-many-police-shootings-a-year-no-one-knows/">scant data</a>&nbsp;on how many people are shot by police across the country every year, Richardson sees potential in hospital emergency departments. As a researcher he might not have direct access to patients under arrest, but the doctors and nurses certainly do. He&#39;s proposing that emergency departments step in and capitalize on that unique access to compile an alternative data source.</p><p><strong>Doctors And Nurses Could Ask: &#39;Who Shot You?&#39;</strong></p><p>Richardson views police violence as a public health issue and believes health care providers have a role to play in addressing it. The concept seems simple: At some point during a patient&#39;s visit, emergency department staffers ask patients who shot them, record their answers and report the information to state health departments and the Centers for Disease Control and Prevention.</p><p>He&#39;s not suggesting doctors and nurses investigate their patients&#39; claims, or that this self-reported data would even be completely accurate. After all, in quite a few cases it could be impossible to know who shot you.</p><p>Even so, Richardson says that some data are better than none. Hospital-reported numbers along with those recorded by police and media outlets could help define the true scope of police shootings.</p><p>In December, around the time Richardson floated his idea in the<em>&nbsp;Journal of Urban Health</em>,&nbsp;<a href="https://www.washingtonpost.com/national/fbi-to-sharply-expand-system-for-tracking-fatal-police-shootings/2015/12/08/a60fbc16-9dd4-11e5-bce4-708fe33e3288_story.html">the FBI announced plans</a>&nbsp;to expand its database on violent police encounters. For the first time, the agency will collect information on serious injuries, not just fatalities. But it will continue to lean on voluntary reports by local police departments.</p><p>Richardson is skeptical that the federal government can solve the data problem. &quot;There has to be a more pioneering, innovative approach to doing it,&quot; he says. That&#39;s what he&#39;s trying to figure out. He notes that information about people who survive police shootings is especially elusive. &quot;The only way we would know that is either the police would have to report that or the hospitals would have to,&quot; he says. &quot;Up to this point, neither entity has done it.&quot;</p><p>Richardson points to a&nbsp;<a href="http://www.ncbi.nlm.nih.gov/pubmed/19104090">2009 survey of academic emergency physicians</a>&nbsp;that found that almost all of them believed they&#39;d seen cases of excessive use of force by police but had largely failed to report them.</p><p>In interviews with the emergency department staff at Prince George&#39;s, he found that the overwhelming majority said the hospital has an ethical responsibility to record and report police-involved shootings. But doctors and nurses raised concerns about the logistics and consequences.</p><p>Some said it would be difficult to put into practice a standardized approach to collecting the information. Others felt patients weren&#39;t likely to open up to trauma staff &mdash; especially given the presence of police anytime a victim is under arrest. Still others worried they&#39;d be dragged into court to testify if they implicated the police.</p><p><strong>Can Hospitals Balance Care And Reporting On Shootings?</strong></p><p>Logistics aside, what looms over Richardson&#39;s proposal is a philosophical divide over the <a href="http://www.wbez.org/programs/morning-shift/2016-02-02/working-shift-ask-er-doctor-114674">role of the hospital and its staff.</a></p><p>As American College of Emergency Physicians board member James Augustine sees it, muddling a hospital&#39;s mission is bad for patients. &quot;The hospital is not a good place for legal and law enforcement activities to infringe on people&#39;s rights for health care,&quot; says the veteran emergency medicine doctor. &quot;In the emergency setting, this is not a priority.&quot;</p><p>But he doesn&#39;t dismiss the idea outright. The health care system plays a vital role in amassing data, he says. In fact, many trauma centers already collect reams of information and submit it to the National Trauma Data Bank. Stripped of names, it&#39;s used to track everything from auto accidents to clothing-related burns. It might be feasible to add information about violent police encounters to those data collection efforts, Augustine says.</p><p>David Livingston, chief of trauma at University Hospital in Newark, agrees that when it comes to collecting information, hospitals could help. &quot;Emergency departments are the canary in the coal mine of health in our communities,&quot; he says. &quot;They&#39;re a unique public health resource to gather data.&quot;</p><p>But there are serious limitations. Two years ago, Livingston and his colleagues analyzed more than 6,000 gunshot wounds treated at his hospital and found that his own trauma unit&#39;s database didn&#39;t account for nearly 20 percent of them. It turned out the emergency department, not trauma, had handled these relatively minor injuries and Livingston and his co-workers only discovered them when they scoured that department&#39;s billing records.</p><p>As for Richardson&#39;s proposal, Livingston says it could work in theory. &quot;Is it economically and logistically feasible?&quot; he asks. &quot;We&#39;d like to think it is, but I have my doubts.&quot; Getting detailed information would probably require dedicated staff, he says, and that&#39;s expensive. But he&#39;s quick to point out that similar data on cancer, heart disease, smoking, obesity and other conditions has been collected, with the National Institutes of Health or the National Science Foundation footing the bill. &quot;In that respect,&quot; he says, &quot;Dr. Richardson&#39;s contention to put this on trauma centers is shirking the government&#39;s responsibility.&quot;</p><p>Still, Richardson suggests a place to start:&nbsp;<a href="http://nnhvip.org/">hospital-based violence intervention programs</a>. Only about 30 hospitals in the U.S. have these special programs aimed at curbing readmission for violent crimes, but Richardson sees them as prime candidates for pilot projects.</p><p>For University of California, San Francisco trauma surgeon Rochelle Dicker, who heads up the&nbsp;<a href="http://violenceprevention.surgery.ucsf.edu/">violence intervention program</a>&nbsp;at San Francisco General Hospital, keeping tabs on police violence seems like a natural extension of the work her team already does. &quot;Part of our responsibility as physicians is to not just to do the traditional &#39;treat and street,&#39; but to really get to the issues at hand and address violence in a more comprehensive way.&quot; In order to do that, she says, accurate information is key.</p><p>&quot;The work is provocative,&quot; she says of Richardson&#39;s proposal, and it will get people talking. &quot;I applaud the author for taking that first step and opening the door.&quot;</p><p>&mdash; <a href="http://www.npr.org/sections/health-shots/2016/02/04/465568899/could-hospital-ers-provide-missing-data-on-police-shootings?ft=nprml&amp;f=465568899" target="_blank"><em>via NPR</em></a></p></p> Mon, 08 Feb 2016 13:26:00 -0600 http://www.wbez.org/news/could-hospital-ers-provide-missing-data-police-shootings-114759 Ruling Throws Illinois Hospitals' Tax Exemptions into Question http://www.wbez.org/news/ruling-throws-illinois-hospitals-tax-exemptions-question-114414 <p><p>CHICAGO&nbsp;(AP) &mdash; An Illinois appeals court decision has reopened a statewide dispute over whether hospitals should be exempt from paying millions of dollars in income taxes and property taxes to local governments.</p><div><p>The Illinois 4th District Appellate Court ruled Tuesday that part of a 2012 law that allows hospitals to avoid taxes is unconstitutional.</p><p>The issue, which brewed for years before a legislative compromise defined how hospitals could qualify for tax breaks, is likely headed to the Illinois Supreme Court, as well as lawmakers and Gov. Bruce Rauner, according to Laurence Msall of the Civic Federation, a nonpartisan government research group.</p><p>&quot;The Legislature could wait (until the Supreme Court rules), but issues will continue to mount,&quot; Msall said. &quot;The Illinois Department of Revenue needs some direction from both the Legislature and the (Rauner) administration on how to handle pending applications.&quot;</p><p>Five hospitals have applications for tax exemptions before the revenue department: Peoria-based Methodist Services Inc. (two applications), NorthShore University Health System in Lake Forest, Mercy Hospital and Medical Center in&nbsp;Chicago&nbsp;and Swedish Covenant Hospital in&nbsp;Chicago.</p><p>This week&#39;s ruling involves a case against the city of Urbana and other local taxing districts brought by Carle Foundation Hospital, which was seeking relief from taxes in 2004-2011.</p><p>A lower court sided with the hospital, but the appeals court reversed that decision, saying the Illinois Constitution allows lawmakers to exempt only property &quot;used exclusively&quot; for &quot;charitable purposes.&quot;</p><p>&quot;An unconstitutional statute is unenforceable from the moment of its enactment,&quot; the ruling states.</p><p>Urbana Mayor Laurel Prussing anticipates the hospital, which had been the largest taxpayer in the city of 41,000, will try to get the case in front of the Illinois Supreme Court.</p><p>&quot;Part of the inequity in the tax system is we have these very wealthy entities that can afford all kinds of lobbying to wiggle their way out of responsibilities,&quot; Prussing said.</p><p>Since 2012, Prussing said, the city has lost 11 percent of its assessed tax value since Carle was relieved of paying $6.5 million a year in property taxes &mdash; the vast majority of which went to Urbana and its school district.</p><p>Carle spokeswoman Jennifer Hendricks-Kaufmann said the hospital is considering options, including an appeal.</p><p>The Illinois Health and Hospital Association also expressed dismay, with spokesman Danny Chun saying the law &quot;had ended a decade of uncertainty regarding the test for hospital property tax exemption.</p><p>&quot;The law is clear, fair and reasonable,&quot; he added.</p><p>The Illinois Supreme Court weighed in on the issue in 2010, when it suggested nonprofit hospitals that behave like businesses shouldn&#39;t qualify for tax exemptions. Citing that court decision, the state Department of Revenue denied tax exemptions to three hospitals in 2011 and signaled more denials for other hospitals could follow.</p><p>That led to lawmakers&#39; actions in 2012, in which hospitals won a broad definition of charity care and were required to provide free care to some patients. Investor-owned hospitals, too, were included in the tax break in a little-noticed provision that cost the state $10 million a year in lost revenue, according to an AP analysis at the time.</p><p>&quot;This could require, in the end, an amendment to the Constitution in order to affect the needed change,&quot; said Msall of the Civic Federation, which supported the 2012 legislation as &quot;a reasonable compromise&quot; that balanced the interests of hospitals and government.</p></div><p>&nbsp;</p></p> Thu, 07 Jan 2016 15:16:00 -0600 http://www.wbez.org/news/ruling-throws-illinois-hospitals-tax-exemptions-question-114414 Chicago Matters (1999): Doing the Right Thing in Health Care's Brave New World http://www.wbez.org/news/chicago-matters-1999-doing-right-thing-health-cares-brave-new-world-113885 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/3093950d-c565-40f2-9821-67b56e27ae98.jpg" alt="" /><p><blockquote><div><em>&ldquo;What is a life worth living? When is it time to die?</em></div><div>&nbsp;</div><div><em>As modern medicine&#39;s tools grow more powerful, these questions are asked each day, in every hospital in the country. This program will profile the people who answer them: clinical medical ethicists.&rdquo;</em></div></blockquote><div>&nbsp;</div><div>In 1999, Alex Blumberg was a fledgling radio producer who was hired by WBEZ to produce his first half-hour audio documentary.&nbsp;</div><div>&nbsp;</div><div>Blumberg later became a producer at <em>This American Life</em> and co-founder of NPR&rsquo;s <em>Planet Money</em> podcast. In recent years he co-founded<a href="https://gimletmedia.com/" target="_blank"> Gimlet Media</a>, a for-profit podcast company that&rsquo;s innovating around the creation of narrative storytelling podcasts.</div><div>&nbsp;</div><div>But back in 1999 when he was hired to produce the half-hour documentary, &ldquo;Doing the Right Thing in Health Care&#39;s Brave New World,&rdquo; he had very little experience.&nbsp;</div><div>&nbsp;</div><div>&ldquo;This was my third career,&rdquo; Blumberg says. &ldquo;I was 31 or 32-years-old but I was just a beginner. I worked at <em>This American Life </em>as the intern/administrative assistant for six months, and then I quit to freelance.&rdquo;</div><div>&nbsp;</div><div>He was hired for the project by Johanna Zorn, then-Executive Producer of <em>Chicago Matters</em>, a WBEZ collaboration with WTTW Channel 11, the Chicago Public Library and <em>The Chicago Reporter</em>, funded by the Chicago Community Trust. Zorn went on to co-found the <a href="http://thirdcoastfestival.org/" target="_blank">Third Coast Audio Festival</a>.</div><div>&nbsp;</div><div>She says digital editing was just coming into vogue and Blumberg had cut down some interviews for the Poetry Foundation that she liked. &ldquo;He seemed like such a natural,&rdquo; she says.</div><div>&nbsp;</div><div>Each year the <em>Chicago Matters</em> series focused on a different topic. In 1999, the series was called Examining Health.</div><div>&nbsp;</div><div>Blumberg had heard from some medical residents that end-of-life decisions were becoming so common that hospitals were having to employ medical ethicists.&nbsp;</div><div>&nbsp;</div><div>Blumberg says, &ldquo;I had this vision of families and doctors being like: &lsquo;We don&rsquo;t know what to do. Call the ethicists!&rsquo; But it wasn&rsquo;t like that. There wasn&rsquo;t the ethicists lounge with a big red light going, &lsquo;Somebody needs an ethical decision made!&rsquo;&rdquo;</div><div>&nbsp;</div><div>&ldquo;What intrigued me about it was that here was this modern field of medicine calling on this ancient field of philosophy to solve this problem that modern medicine had created. And then it&rsquo;s happening at one of the most intense moments you can imagine.&rdquo;</div><div>&nbsp;</div><div>Blumberg says he got good tape but his original draft was a mess. His editor - Julia McEvoy - made him go back in the writing and identify key turning points in the story. &ldquo;&lsquo;Help us pay attention to this point.&rsquo; I remember her suggesting that. It was a narrative you could follow then.&rdquo;</div><div>&nbsp;</div><div>Zorn, the editor who hired Blumberg, says she&rsquo;s in awe of everything he has gone on to do. &ldquo;He&rsquo;s been such an innovator. It&rsquo;s more than enough to be a fabulous storyteller, but to reinvent radio with a for-profit model is just incredible.&rdquo;</div><div>&nbsp;</div><div>Blumberg says the documentary was an important learning experience for him. &ldquo;I haven&rsquo;t heard it in forever. I would be curious to hear what it sounds like. I was very proud of it at the time.&rdquo;</div><div>&nbsp;</div><div>Tell us what you think in the comments.</div></p> Mon, 23 Nov 2015 09:23:00 -0600 http://www.wbez.org/news/chicago-matters-1999-doing-right-thing-health-cares-brave-new-world-113885 Some Chicago hospitals can actually make patients sicker http://www.wbez.org/programs/morning-shift/2015-07-29/some-chicago-hospitals-can-actually-make-patients-sicker-112506 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/hospital bed Sugree Phatanapherom.jpg" alt="" /><p><p>Some of Chicago&rsquo;s biggest hospitals get a low rating when it comes to protecting patients from infections. A report out this morning from Consumer Reports ranks large hospitals &mdash; those are ones with 300 or more beds &mdash; on how well they do to prevent patients from acquiring infections while in their care. The report says that Northwestern Memorial, Presence Resurrection and University of Chicago Medical Center all did worse than the national baseline when it came to infections acquired in the hospitals. But Doris Peter, Director of Consumer Reports Health Ratings Center, says nationally performance is not that good, with only 6 percent of hospitals getting a higher rating. So what do these ratings mean for you, the patient? It&rsquo;s about being more informed when you&rsquo;re in the hospital&rsquo;s care and asking questions about what your treatment entails.&nbsp;</p></p> Wed, 29 Jul 2015 13:30:00 -0500 http://www.wbez.org/programs/morning-shift/2015-07-29/some-chicago-hospitals-can-actually-make-patients-sicker-112506 Morning Shift: Grading Rahm on education http://www.wbez.org/programs/morning-shift/2015-01-27/morning-shift-grading-rahm-education-111459 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/AFagen.jpg" alt="" /><p><p>We continue our &quot;Grading Rahm&quot; series with a look at how the Mayor has impacted parents, teachers and students dependent on his policies. Former railway administrator Joe Szabo returns to Chicago to work on a roadmap for regional transportation at the Chicago Metropolitan Agency for Planning.</p><div class="storify"><iframe allowtransparency="true" frameborder="no" height="750" src="//storify.com/WBEZ/morning-shift-2019/embed?header=false&amp;border=false" width="100%"></iframe><script src="//storify.com/WBEZ/morning-shift-2019.js?header=false&border=false"></script><noscript>[<a href="//storify.com/WBEZ/morning-shift-2019" target="_blank">View the story "Morning Shift: Grading Rahm on education" on Storify</a>]</noscript></div></p> Tue, 27 Jan 2015 07:49:00 -0600 http://www.wbez.org/programs/morning-shift/2015-01-27/morning-shift-grading-rahm-education-111459 Teaching hospitals hit hardest by medicare fines for patient safety http://www.wbez.org/news/teaching-hospitals-hit-hardest-medicare-fines-patient-safety-111272 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/er.jpg" alt="" /><p><p>Medicare has begun punishing 721 hospitals with high rates of infections and other medical errors, cutting payments to half the nation&#39;s major teaching hospitals and many institutions that are marquee names.</p><p>Intermountain Medical Center in Utah, Ronald Reagan UCLA Medical Center in Los Angeles, the Cleveland Clinic, Geisinger Medical Center in Pennsylvania,&nbsp;Brigham and Women&#39;s Hospital in Boston, NYU Langone Medical Center and Northwestern Memorial Hospital in Chicago are all being docked 1 percent of their Medicare payments through next September,&nbsp;<a href="http://cdn.kaiserhealthnews.org/attachments/HACPenaltyChart.pdf">federal records show</a>.</p><p>In total, hospitals will forfeit $373 million, Medicare estimates.</p><p>The federal health law required Medicare to lower payments for the quarter of hospitals with the highest rates of hospital-acquired conditions, or HACs.</p><p>These&nbsp;<a href="https://www.qualitynet.org/dcs/ContentServer?c=Page&amp;pagename=QnetPublic%2FPage%2FQnetTier3&amp;cid=1228774294977">avoidable complications</a>&nbsp;include infections from central line catheters, blood clots and bed sores.</p><p>The penalties come as hospitals are showing some success in&nbsp;<a href="http://www.ahrq.gov/professionals/quality-patient-safety/pfp/interimhacrate2013.html">reducing harmful errors</a>. A recent federal report found the frequency of mistakes dropped by 17 percent between 2010 and 2013, an improvement Health and Human Services Secretary Sylvia Burwell called &quot;a big deal, but it&#39;s only a start.&quot; Even with the reduction, one in eight hospital admissions in 2013 included a patient injury.</p><p>Dr. Eric Schneider, a Boston health researcher, said studies have shown that medical errors can be reduced through a number of techniques, such as entering physician orders into computers rather than scrawling them on paper, better hand washing and checklists on procedures to follow during surgeries. &quot;Too many clinicians fail to use those techniques consistently,&quot; he said.</p><p>The quality penalties have &quot;put attention to the issue of complications and that attention wasn&#39;t everywhere,&quot; said Dr. John Bulger, chief quality officer at Geisinger Health System, based in Danville, Pa. However, he said hospitals like Geisinger&#39;s now must spend more time reviewing their Medicare billing records as the government uses those to evaluate patient safety. The penalty program, he said, &quot;has the potential to take the time that could be spent on improvement and [spend it instead] making sure the coding is accurate.&quot;</p><p>Hospitals complain there may be almost no difference between hospitals that are penalized and those that narrowly escape fines. &quot;Hospitals may be penalized on things they are getting safer on, and that sends a fairly mixed message,&quot; said Nancy Foster, a quality expert at the American Hospital Association.</p><p>The penalties come on top of other fines Medicare&nbsp;<a href="http://kaiserhealthnews.org/news/medicare-readmissions-penalties-2015/">has been levying</a>. With the HAC penalties now in place, the worst-performing hospitals this year risk losing more than 5 percent of their regular Medicare reimbursements.</p><p>About 1,400 hospitals are exempt from penalties because they provide specialized treatments such as psychiatry and rehabilitation or because they cater to a particular type of patient such as children and veterans. Small &quot;critical access hospitals&quot; that are mostly located in rural areas are also exempt, as are hospitals in Maryland, which have a special payment arrangement with the federal government.</p><p>In evaluating hospitals for the HAC penalties, the government adjusted infection rates by the type of hospital. When judging complications, it took into account the differing levels of sickness of each hospital&#39;s patients, their ages and other factors that might make the patients more fragile. Still, academic medical centers have been complaining that those&nbsp;<a href="http://www.npr.org/templates/transcript/transcript.php?storyId=323998618">adjustments are insufficient</a>&nbsp;given the especially complicated cases they handle, such as organ transplants.</p><p>&quot;To lump in all of those things that are very complex procedures with simple things like pneumonia or hip replacements may not be giving an accurate result,&quot; said Dr. Atul Grover, the chief public policy officer of the Association of American Medical Colleges.</p><p>Medicare levied penalties against a third or more of the hospitals it assessed in Colorado, Connecticut, Delaware, Nevada, New Jersey, New Mexico, Rhode Island, Utah, Washington and the District of Columbia, a Kaiser Health News analysis found.</p><p>A separate analysis of the penalties that Dr. Ashish Jha, a professor at the Harvard School of Public Health, conducted for Kaiser Health News found that penalties were assessed against 32 percent of the hospitals with the sickest patients. Only 12 percent of hospitals with the least complex cases were punished.</p><p>Hospitals with the poorest patients were also more likely to be penalized, Jha found. A fourth of the nation&#39;s publicly owned hospitals, which often are the safety net for poor, sick people, are being punished.</p><p>&quot;I&#39;ve worked in community hospitals. I&#39;ve worked in teaching hospitals. My personal experience is teaching hospitals are at least as safe if not safer,&quot; Jha said. &quot;But they take care of sicker populations and more complex cases that are going to have more complications. The HAC penalty program is really a teaching hospital penalty program.&quot;</p><p>You can download the full list of hospital penalties&nbsp;<a href="http://cdn.kaiserhealthnews.org/attachments/HACPenaltyChart.pdf">here</a>.</p><p>&mdash; <a href="http://www.npr.org/blogs/health/2014/12/19/371862146/teaching-hospitals-hit-hardest-by-medicare-fines-for-patient-safety"><em>via NPR</em></a></p></p> Fri, 19 Dec 2014 12:22:00 -0600 http://www.wbez.org/news/teaching-hospitals-hit-hardest-medicare-fines-patient-safety-111272 Morning Shift: Recent rainstorms taint Chicago River http://www.wbez.org/programs/morning-shift-tony-sarabia/2014-07-07/morning-shift-recent-rainstorms-taint-chicago-river <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/TexasExplorer98.jpg" alt="" /><p><p>We talk about the safest and worst hospitals in Illinois. And, why Chicago&#39;s hospitals are some the lowest ranked. And, we look at tips for avoiding skin cancer this summer. Later, we look at the efforts to keep the Chicago River clean.</p><div class="storify"><iframe allowtransparency="true" frameborder="no" height="750" src="//storify.com/WBEZ/morning-shift-cleaning-runnoff/embed?header=false&amp;border=false" width="100%"></iframe><script src="//storify.com/WBEZ/morning-shift-cleaning-runnoff.js?header=false&border=false"></script><noscript>[<a href="//storify.com/WBEZ/morning-shift-cleaning-runnoff" target="_blank">View the story "Morning Shift: Recent rainstorms taint Chicago River " on Storify</a>]</noscript></div></p> Mon, 07 Jul 2014 07:46:00 -0500 http://www.wbez.org/programs/morning-shift-tony-sarabia/2014-07-07/morning-shift-recent-rainstorms-taint-chicago-river Hospitals crack down on workers refusing flu shots http://www.wbez.org/news/hospitals-crack-down-workers-refusing-flu-shots-104884 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/AP090901027160.jpg" alt="" /><p><p>Patients can refuse a flu shot. Should doctors and nurses have that right, too? That is the thorny question surfacing as U.S. hospitals increasingly crack down on employees who won&#39;t get flu shots, with some workers losing their jobs over their refusal.</p><p>&quot;Where does it say that I am no longer a patient if I&#39;m a nurse,&quot; wondered Carrie Calhoun, a longtime critical care nurse in suburban Chicago who was fired last month after she refused a flu shot.</p><p>Hospitals&#39; get-tougher measures coincide with an earlier-than-usual flu season hitting harder than in recent mild seasons. Flu is widespread in most states, and at least 20 children have died.</p><p>Most doctors and nurses do get flu shots. But in the past two months, at least 15 nurses and other hospital staffers in four states have been fired for refusing, and several others have resigned, according to affected workers, hospital authorities and published reports.</p><p>In Rhode Island, one of three states with tough penalties behind a mandatory vaccine policy for health care workers, more than 1,000 workers recently signed a petition opposing the policy, according to a labor union that has filed suit to end the regulation.</p><p>Why would people whose job is to protect sick patients refuse a flu shot? The reasons vary: allergies to flu vaccine, which are rare; religious objections; and skepticism about whether vaccinating health workers will prevent flu in patients.</p><p>Dr. Carolyn Bridges, associate director for adult immunization at the federal Centers for Disease Control and Prevention, says the strongest evidence is from studies in nursing homes, linking flu vaccination among health care workers with fewer patient deaths from all causes.</p><p>&quot;We would all like to see stronger data,&quot; she said. But other evidence shows flu vaccination &quot;significantly decreases&quot; flu cases, she said. &quot;It should work the same in a health care worker versus somebody out in the community.&quot;</p><p>Cancer nurse Joyce Gingerich is among the skeptics and says her decision to avoid the shot is mostly &quot;a personal thing.&quot; She&#39;s among seven employees at IU Health Goshen Hospital in northern Indiana who were recently fired for refusing flu shots. Gingerich said she gets other vaccinations but thinks it should be a choice. She opposes &quot;the injustice of being forced to put something in my body.&quot;</p><p>Medical ethicist Art Caplan says health care workers&#39; ethical obligation to protect patients trumps their individual rights.</p><p>&quot;If you don&#39;t want to do it, you shouldn&#39;t work in that environment,&quot; said Caplan, medical ethics chief at New York University&#39;s Langone Medical Center. &quot;Patients should demand that their health care provider gets flu shots &mdash; and they should ask them.&quot;</p><p>For some people, flu causes only mild symptoms. But it can also lead to pneumonia, and there are thousands of hospitalizations and deaths each year. The number of deaths has varied in recent decades from about 3,000 to 49,000.</p><p>A survey by CDC researchers found that in 2011, more than 400 U.S. hospitals required flu vaccinations for their employees and 29 hospitals fired unvaccinated employees.</p><p>At Calhoun&#39;s hospital, Alexian Brothers Medical Center in Elk Grove Village, Ill., unvaccinated workers granted exemptions must wear masks and tell patients, &quot;I&#39;m wearing the mask for your safety,&quot; Calhoun says. She says that&#39;s discriminatory and may make patients want to avoid &quot;the dirty nurse&quot; with the mask.</p><p>The hospital justified its vaccination policy in an email, citing the CDC&#39;s warning that this year&#39;s flu outbreak was &quot;expected to be among the worst in a decade&quot; and noted that Illinois has already been hit especially hard. The mandatory vaccine policy &quot;is consistent with our health system&#39;s mission to provide the safest environment possible.&quot;</p><p>The government recommends flu shots for nearly everyone, starting at age 6 months. Vaccination rates among the general public are generally lower than among health care workers.</p><p>According to the most recent federal data, about 63 percent of U.S. health care workers had flu shots as of November. That&#39;s up from previous years, but the government wants 90 percent coverage of health care workers by 2020.</p><p>The highest rate, about 88 percent, was among pharmacists, followed by doctors at 84 percent, and nurses, 82 percent. Fewer than half of nursing assistants and aides are vaccinated, Bridges said.</p><p>Some hospitals have achieved 90 percent but many fall short. A government health advisory panel has urged those below 90 percent to consider a mandatory program.</p><p>Also, the accreditation body over hospitals requires them to offer flu vaccines to workers, and those failing to do that and improve vaccination rates could lose accreditation.</p><p>Starting this year, the government&#39;s Centers for Medicare &amp; Medicaid Services is requiring hospitals to report employees&#39; flu vaccination rates as a means to boost the rates, the CDC&#39;s Bridges said. Eventually the data will be posted on the agency&#39;s &quot;Hospital Compare&quot; website.</p><p>Several leading doctor groups support mandatory flu shots for workers. And the American Medical Association in November endorsed mandatory shots for those with direct patient contact in nursing homes; elderly patients are particularly vulnerable to flu-related complications. The American Nurses Association supports mandates if they&#39;re adopted at the state level and affect all hospitals, but also says exceptions should be allowed for medical or religious reasons.</p><p>Mandates for vaccinating health care workers against other diseases, including measles, mumps and hepatitis, are widely accepted. But some workers have less faith that flu shots work &mdash; partly because there are several types of flu virus that often differ each season and manufacturers must reformulate vaccines to try and match the circulating strains.</p><p>While not 100 percent effective, this year&#39;s vaccine is a good match, the CDC&#39;s Bridges said.</p><p>Several states have laws or regulations requiring flu vaccination for health care workers but only three &mdash; Arkansas, Maine and Rhode Island &mdash; spell out penalties for those who refuse, according to Alexandra Stewart, a George Washington University expert in immunization policikfriedenes and co-author of a study appearing this month in the journal Vaccine.</p><p>Rhode Island&#39;s regulation, enacted in December, may be the toughest and is being challenged in court by a health workers union. The rule allows exemptions for religious or medical reasons, but requires unvaccinated workers in contact with patients to wear face masks during flu season. Employees who refuse the masks can be fined $100 and may face a complaint or reprimand for unprofessional conduct that could result in losing their professional license.</p><p>Some Rhode Island hospitals post signs announcing that workers wearing masks have not received flu shots. Opponents say the masks violate their health privacy.</p><p>&quot;We really strongly support the goal of increasing vaccination rates among health care workers and among the population as a whole,&quot; but it should be voluntary, said SEIU Healthcare Employees Union spokesman Chas Walker.</p><p>Supporters of health care worker mandates note that to protect public health, courts have endorsed forced vaccination laws affecting the general population during disease outbreaks, and have upheld vaccination requirements for schoolchildren.</p><p>Cases involving flu vaccine mandates for health workers have had less success. A 2009 New York state regulation mandating health care worker vaccinations for swine flu and seasonal flu was challenged in court but was later rescinded because of a vaccine shortage. And labor unions have challenged individual hospital mandates enacted without collective bargaining; an appeals court upheld that argument in 2007 in a widely cited case involving Virginia Mason Hospital in Seattle.</p><p>Calhoun, the Illinois nurse, says she is unsure of her options.</p><p>&quot;Most of the hospitals in my area are all implementing these policies,&quot; she said. &quot;This conflict could end the career I have dedicated myself to.&quot;</p></p> Sat, 12 Jan 2013 14:32:00 -0600 http://www.wbez.org/news/hospitals-crack-down-workers-refusing-flu-shots-104884 Campaign aimed at bacteria in health facilities http://www.wbez.org/story/campaign-aimed-bacteria-health-facilities-97086 <p><p>Illinois health officials have kicked off a campaign to fight the spread of the deadly bacteria C-diff in hospitals and other health facilities.</p><p>C-diff is the short name for Clostridium difficile. Some infected patients suffer mild diarrhea, but others can develop more severe condition and die. Government estimates suggest C-diff is responsible for up to 15,000 deaths annually.</p><p>The Illinois Department of Public Health has launched an educational campaign for hospital workers and health care personnel on preventing the spread of C-diff.</p><p>So far, 137 facilities statewide have signed up.</p><p>C-diff is commonly spread from person to person via contaminated surfaces or the unwashed hands of health care workers, patients and visitors.</p><p>The project is called the Illinois Campaign to Eliminate Clostridium difficile, or ICE C-diff.</p></p> Thu, 08 Mar 2012 15:10:00 -0600 http://www.wbez.org/story/campaign-aimed-bacteria-health-facilities-97086 Women’s hospital aims for ‘baby friendly’ status http://www.wbez.org/story/women%E2%80%99s-hospital-aims-%E2%80%98baby-friendly%E2%80%99-status-96224 <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2012-February/2012-02-09/breast feeding_Flickr_thekmancom.jpg" alt="" /><p><p><img alt="Northwestern Memorial’s Prentice Women’s Hospital in Chicago. (AP/File)" class="caption" src="http://llnw.wbez.org/story/insert-image/2012-February/2012-02-08/Prentice.jpg" style="margin: 9px 18px 6px 1px; float: left; width: 254px; height: 380px;" title="The facility, part of Northwestern Memorial Hospital, delivers about 12,000 babies a year. (AP/File)">A hospital that delivers more than a quarter of babies born in Chicago is entering an international program that aims to improve the health of both newborns and their mothers. The program focuses on breastfeeding.</p><p>Prentice Women’s Hospital, part of Northwestern Memorial Hospital, is planning to follow 10 guidelines set by the Baby-Friendly Hospital Initiative, a program sponsored by the World Health Organization and the United Nations Children’s Fund, also known as UNICEF.</p><p>The guidelines include helping mothers begin breastfeeding within an hour of birth, providing infants no food or drink other than breast milk unless medically necessary, giving no pacifiers or artificial nipples to breastfeeding babies and allowing mothers and newborns to room together around the clock.</p><p>Prentice, one of eight Chicago hospitals to apply for the baby-friendly status so far, delivers about 12,000 infants a year, more than any other facility in the city. The path toward the designation includes extensive staff training and new hospital policies. The process could last years.</p><p>“All the staff in the hospital will get some exposure to what it means to be a baby-friendly hospital,” said Adam Becker, executive director of the Consortium to Lower Obesity in Chicago Children, a federally funded group that works with the city to help hospitals enter the international program. “Then there are many categories of staff that do more hands-on training.”</p><p>“If Prentice takes all these steps,” Becker added, “roughly 27 percent of babies born in Chicago and their mothers will have access to the most supportive environment possible to encourage breastfeeding from birth.”</p><p>But the program has a downside, according to Dr. Maura Quinlan, vice chairwoman of the Illinois section of the American Congress of Obstetricians and Gynecologists. “The main issue is time, especially documenting the whole process and the 10 steps,” she said. “I don’t think many smaller hospitals have the resources to go through the application.”</p><p>“The designation is something the hospital can show on its website but it doesn’t mean that other hospitals don’t provide the same services,” said Quinlan, who delivers babies at MacNeal Hospital in Berwyn.</p><p>Prentice’s quest for baby-friendly status marks a turnaround of sorts. Years ago the hospital eliminated many of its lactation-specialist positions.</p><p>Illinois birth-certificate data for the six months ending last July 31 suggest that about 80 percent of Prentice newborns breastfed there. By that measure, the hospital ranked sixth among 19 facilities that deliver babies in the city.</p><p>The first hospital in Chicago to apply for the baby-friendly status was Holy Cross last summer. <a href="http://www.wbez.org/story/after-wbez-report-hospital-steps-breastfeeding-efforts-90006">A top official there said a WBEZ report</a> about the hospital’s breastfeeding performance made improvement a priority.</p><p>The other Chicago applicants include Mount Sinai Hospital, St. Anthony Hospital, the University of Illinois Medical Center, St. Joseph Hospital, Resurrection Medical Center and Roseland Community Hospital.</p><p>More than 15,000 facilities in 134 countries have earned the baby-friendly status since the program’s 1991 launch, according to UNICEF. In the United States, just 125 hospitals had received the designation by December, according to New York-based Baby-Friendly USA Inc., a chapter of the international program. The only two in Illinois are Pekin Hospital in downstate Pekin and St. John’s Hospital, further south in Springfield.</p><p>U.S. health officials say breastfeeding helps newborns avoid infections, obesity and chronic diseases such as diabetes and asthma. For mothers, they say it reduces risks of breast and ovarian cancer. The American Academy of Pediatrics recommends that babies get no solids or liquids other than breast milk for the first six months of life.</p></p> Thu, 09 Feb 2012 11:12:00 -0600 http://www.wbez.org/story/women%E2%80%99s-hospital-aims-%E2%80%98baby-friendly%E2%80%99-status-96224