WBEZ | hospitals http://www.wbez.org/tags/hospitals Latest from WBEZ Chicago Public Radio en 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 Why trauma centers abandoned the South Side http://www.wbez.org/content/why-trauma-centers-abandoned-south-side <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-12/Ambulance_Getty_Kevork Dejansezian.jpg" alt="" /><p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/11Countyward35.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 320px; height: 187px;" title="Before the advent of trauma centers, injured patients would be admitted to open wards like this one. (David Goldberg and Gordy Schoff, courtesy of David Ansell)">Trauma centers take care of the most critically injured people. Car crashes, stabbings and gunshots are the most common wounds that require trauma care. Chicago is served by six trauma centers sprinkled around the city and nearby suburbs – but none is on the city’s South Side. Community members, activist groups and politicians have long suspected that the dearth of trauma centers in that part of town means the area is under-served.</p><p>A <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012">WBEZ analysis</a> suggests that when it comes to ambulance run times from the scene to trauma centers, there are disparities. Put simply, patients living on the Southeast Side face longer ambulance run times than other residents in the city. Specifically, they have to travel an average of <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#MAP">50 percent longer </a>to get from the scene of an emergency to a trauma center. More than half of the trauma-related ambulance runs that originate in that part of town exceed 20 minutes, which is considered a professional standard within the city. Those neighborhoods include Hyde Park, Woodlawn, Pullman, South Shore and the Southeast Side.</p><p>In this, WBEZ’s second part in a series on trauma care in Chicago, we look at why such a large swath of Chicago is without a dedicated adult trauma center.</p><p><a href="http://www.wbez.org/tags/chicago-trauma-series" target="_blank"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-12/trauma-in-chicago-promo.jpg" style="margin-right: 10px; margin-top: 10px; margin-bottom: 10px; float: left; width: 280px; height: 63px; " title=""></a></p><p><strong>A new approach at Cook County Hospital</strong></p><p>Health experts say to understand the layout and makeup of the city’s current regional trauma center network, one should start with a short history lesson. Trauma care has deep roots in Chicago; in fact, the city is considered the home of the country’s first dedicated trauma center, which opened at Cook County Hospital in the mid-1960s.</p><p>David Boyd came to the hospital to run the trauma center in 1968. He said before 1966, trauma service at County was a mess; people waited hours for surgery and were sometimes sent to the wrong surgical specialist.</p><p>“We were treating it on Ward 61 tonight then Ward 62 the next night, and where’s Dr. Jones? We can’t find somebody, and it was just this mini-catastrophe organizationally, and we just didn’t have the people to do it,” Boyd said.</p><p><a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#MAP"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/map-promo.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 300px; height: 190px;" title=""></a>Then a couple of the hospital’s surgeons devised a new model for treating the critically injured. It meant consolidating services in one area – the third floor of Cook County Hospital. Surgical staff was ready, equipment was on the spot and specialists were on call. This was a nascent trauma center.</p><p>Boyd said it was an immediate success.</p><p>“It was a conceptual paradigm change,” Boyd said. “It’s not something you had to explain to somebody it just was– everybody got the gestalt right off the bat. You had to be pretty thick-headed, blind or something not to see that this was different. And not only different, but a heck of a lot better.”</p><p>Boyd eventually used Cook County Hospital’s concept to establish trauma centers around Illinois and, later, he built the first-ever trauma network. This model was replicated across the country, and Boyd went to Washington, D.C., to implement it for the federal government.</p><p><strong>Beyond County Hospital: Chicago establishes trauma network</strong></p><p>Chicagoans are currently served at six trauma centers: four lie in the city and two are in nearby suburbs. Ambulances sometimes deliver Chicagoans to other suburban trauma centers outside the network, but only under certain circumstances. That figure – six – is revealing because there was a time when many hospitals clamored to build trauma centers of their own.</p><p>Creation of Chicago’s own <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#CENTERS" target="_blank">trauma network</a> got underway in the mid-1980s. A city ordinance mandated trauma patients be treated at trauma centers. About 20 hospitals applied.</p><p>Gary Merlotti, a trauma director at Mt. Sinai Hospital, helped set up the city’s network. He said at the time, health professionals considered trauma centers “good business” and thought trauma centers would attract prestige, patients and dollars. The phenomenon was called “trauma creep.”</p><p>Merlotti said it only took six months for hospitals to realize that “trauma creep” doesn’t really happen.</p><p>“We’re gonna get a fair number of severely injured people with a fair number of uninsured patients,” Merlotti said. “They began to lose money and they began to lose interest in providing trauma care.”</p><p>Hospitals quickly started to drop out of the network.</p><p>A prominent example — and one raised by activists through the present day — is the University of Chicago. It opened its trauma center in 1986, but closed it in 1988 after hemorrhaging $2 million a year. At the time doctors said a majority of patients had no health insurance.</p><p>Stephen Weber, the hospital’s current chief medical officer, wasn’t around to see the closure in 1988, but cites other benefits the U of C hospital system provides.</p><p>“I think that the pride we feel around our pediatric surgery and trauma program is all encompassing,” Weber said.</p><p>The hospital said it’s made tough choices about where to spend money on specialty health care. The upshot is that the University of Chicago has maintained a trauma center for children, but not adults.</p><p><strong>Support for trauma care evaporates</strong></p><p>The U of C’s departure was part of a cascade of hospitals pulling out: Weiss on the North Side; Loyola on the West Side (although it’s still a trauma center, it’s not part of Chicago’s trauma network); and Michael Reese Hospital on the South Side. That meant the only center left to serve Chicago’s South Side was at Advocate Christ Hospital in southwest suburban Oak Lawn.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/RS4387_P1090014-scr.JPG" style="margin: 10px; float: right; width: 310px; height: 233px;" title="Advocate Christ Medical Center in suburban Oak Lawn accepts trauma patients from Chicago's South Side. (WBEZ/Gabriel Spitzer)">Merlotti said doctors needed to rejigger things to share the burden. People were afraid the whole trauma center system would unravel and Advocate Christ would be the next domino to fall.</p><p>“It would have put Christ in a position where it was not able to provide any services besides a trauma,” he said. “The volume they were seeing was already straining the emergency department and the capacity in the intensive care unit. This would have represented at least a two-fold increase and would have put them underwater.”</p><p>So they regionalized the network in such a way that Advocate Christ and the centrally-located centers (Mt. Sinai, Stroger and Northwestern Memorial Hospitals) agreed to divvy up the stream of South Side trauma patients. Merlotti said the current system works well, but he still wishes the University of Chicago would reenter the trauma center fold. He said it’s the South Side hospital that’s best equipped to take on the financial burden of trauma care.</p><p>The university has clearly stated that’s not going to happen. Instead, it’s focusing on other care specialties such as its burn unit.</p><p>WBEZ summarized findings on trauma-related ambulance run times and discussed them with university staff. They said the school ran its own numbers and concluded the South Side doesn’t need another trauma center.</p><p>“We’re blessed with some great trauma centers,” said Steven Weber. “As it exists right now, there’s not one of those that’s physically located on the South Side. In terms of whether that creates a disparity in outcome, there’s really not evidence. But happily for the patients that are affected —&nbsp;whether it’s a penetrating injury or blunt injury —&nbsp;it’s comforting and reassuring to know that they do have access to expert care within a short period of time.”</p><p>In the final installment of WBEZ’s series on trauma care in Chicago, we’ll take a closer look at whether disparities in ambulance run times affect patient health or survival.</p></p> Wed, 12 Oct 2011 10:00:00 -0500 http://www.wbez.org/content/why-trauma-centers-abandoned-south-side Trauma patients on Southeast Side take more time to reach trauma centers http://www.wbez.org/content/trauma-patients-southeast-side-take-more-time-reach-trauma-centers <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-11/RS4384_AP090327026010-scr[1].jpg" alt="" /><p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-10/RS4383_AP100504160936-scr.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 300px; height: 273px;" title="Stroger Hospital is home to one of six facilities in Chicago's adult trauma care network. (AP/Charles Rex Arbogast)" />If you&rsquo;re ever faced with a life-threatening injury in Chicago, you might not know that paramedics have to decide the best kind of hospital to send you to. That&rsquo;s because some emergency rooms offer more intense care than others. The ones called Level I trauma centers handle the most severe injuries. Chicago is served by six adult Level I trauma centers, four of which lie within the city. They are not spread around equally, and some Chicagoans claim this trauma center layout leaves their neighborhoods vulnerable.</p><p>WBEZ took a close look at those claims in a three-part series, the first of which profiles critics who are clamoring for the South Side to have its own facility.&nbsp;</p><p>So, what exactly is an adult, Level I trauma center?</p><p>POTTER: First of all, trauma centers have to have 24-hour-a-day readiness, whether they have a patient or not.</p><p>Nurse Connie Potter is president of the National Foundation for Trauma Care, a kind of trauma trade group. Potter says trauma centers are not regular hospital emergency rooms. They have many more players, most with specialized training.</p><p>POTTER: They have to have surgeons, neurosurgeons, orthopedists, plastic surgeons, ear nose and throat, urologists, opthamologists.</p><p>Potter says this level of up-to-the minute care is pricey. Research shows that the average lifetime patient cost at a trauma care center is 30,000 dollars more than at a nontrauma center. And, it so happens that the centers tend to serve poor, minority communities. Potter says cities like Atlanta, Washington, D.C., and Los Angeles, all grapple with financing trauma centers.</p><p><a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#MAP"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/map-promo.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 300px; height: 190px;" title="" /></a>POTTER: There&rsquo;s an issue of equity.</p><p>There are Chicagoans who wonder if trauma care is fair and equal here, too. Right now, none of Chicago&rsquo;s four adult trauma centers is on the South Side.</p><p>That bothers U.S. Congressman Bobby Rush, who serves a South Side district. For Rush, the issue became personal in 1999.</p><p>RUSH: My awareness became much more intense when my son was killed right across the street from a hospital.</p><p>Rush&rsquo;s son had been shot, and that nearby hospital did not have a trauma center to treat his serious wounds. Instead, Rush&rsquo;s son had to travel from 79th Street to a center at Christ Hospital in south suburban Oak Lawn. The congressman says he feels things could have been different for his son, if the South Side had had its own trauma center.</p><p>RUSH: He might still be alive today.</p><p>Once upon a time, the South Side had several adult trauma centers. Michael Reese and the University of Chicago hospitals each had one.</p><p><a href="http://www.wbez.org/content-categories/97768" target="_blank"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-12/trauma-in-chicago-promo.jpg" style="margin-right: 10px; margin-top: 10px; margin-bottom: 10px; float: left; width: 280px; height: 63px; " title="" /></a> They eventually closed, leaving a gap on the city&rsquo;s South Side. Rush wants adult trauma care to return, and he&rsquo;s proposed that the federal government fund a center, preferably in his district.</p><p>RUSH: When you take the whole issue of access to health care in poor, minority and black communities, then it&rsquo;s always not a high priority. It&rsquo;s always it&rsquo;s too expensive. I just have to say if there weren&rsquo;t a Level I trauma center in a middle-class white communities, there&rsquo;d be all kind of outcries.</p><p>Congressman Rush is not the only advocate of bringing a trauma center to the South Side. In fact, WBEZ decided to look at the issue closely because some South Side youth organized around the issue.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/RS4384_AP090327026010-scr.jpg" style="width: 250px; height: 379px; margin: 5px; float: right;" title="The University of Chicago closed its short-lived adult trauma care center in 1988. It still operates a pediatric trauma facility. (AP/Charles Rex Arbogast)" />ACTIVISTS (chanting): &nbsp;Damian, this is all for you. We will get a trauma center for you.</p><p>Damian Turner was a youth activist who was killed by a stray bullet in 2010. He was hit while he was on the South Side, near the University of Chicago. But he was transported downtown to an adult trauma center at Northwestern University.</p><p>A group called Fearless Leading by the Youth believes if the university had it&rsquo;s own trauma center, Damian Turner would have gotten treatment sooner and lived.</p><p>ACTIVISTS (chanting): What do we want? Trauma centers! When do we want it? Now!</p><p>Protesters continue to clamor for the hospital to reinstate its adult trauma center. The university has said that&rsquo;s not going to happen and touts its trauma center for children as well as other health initiatives. The youth activists say they are inspired by Damian Turner, and their persistence is unwavering.</p><p>Kandice Denard is Turner&rsquo;s sister.</p><p>DENARD: We want a trauma center out of it. We want what&rsquo;s best for this community. Because at the end of the day, the people is the most important thing. The community is what&rsquo;s important. We don&rsquo;t want to fight. We don&rsquo;t want to rebel. We want to actually partnership and get a trauma center and get what&rsquo;s best for our community.</p><p>Turner&rsquo;s mother is Sheila Rush &mdash;&nbsp;no relation to Congressman Rush. She recalls a conversation she had prior to her son Damian&rsquo;s death.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-10/natalie photo.JPG" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 300px; height: 226px;" title="Activists on Chicago's South Side are pushing for the University of Chicago to reopen its adult trauma center. (WBEZ/Natalie Moore)" />RUSH: The year before the injury happened to Damian, he had a friend named Tommy. Tommy was also murdered the same way, on the same streets. Did the same way. They took him to Northwestern hospital and it really affected him. Because that was his best friend. He was telling me &lsquo;I wish I could do something about that&#39; because if they had a trauma center down there, they probably could&rsquo;ve saved his life, too. At the time he was telling me that, but the following year the same thing happened to him.</p><p>Politicians and activists aren&rsquo;t the only people concerned that there&rsquo;s no adult trauma center on the South Side: Some health professionals are worried, too.&nbsp;Dennis Kosuth is with the local branch of the National Nurses Union.</p><p>KOSUTH: You see the trauma situation as part of a wider problem of inequality when it comes to health care and this is an issue we feel very strongly about. You have this health care reform, which has passed in 2010. But even with that, you&rsquo;re going to see massive disparities in health care.</p><p>WBEZ has heard clear cries for someone to step in and address the lack of adult trauma care on the South Side.&nbsp;But we haven&rsquo;t heard clear indications of whether there&rsquo;s a real need.</p><p>The arguments we hear are pretty straightforward: If South Side patients could get to a South Side trauma center, ambulances would move faster, and that would save lives.</p><p>So, we grabbed hold of data about how quickly ambulances pick up patients and drop them off at Level I trauma centers in the city and suburbs.&nbsp;Our analysis suggests the slowest trauma-related ambulance runs begin in Chicago ZIP codes that roughly correspond to the South Side neighborhoods of Woodlawn, Hyde Park, South Shore, Pullman and the far Southeast Side. The fastest run times are downtown or very close to the North Side.&nbsp;</p><p>In coming installments of this series, we take a closer look at these findings and how the current dispersion of trauma care got this way. Later, we look at whether the situation is putting lives at risk.</p><p><strong><a name="DATA"></a>Notes on data</strong></p><p>WBEZ analyzed data regarding trauma-related ambulance runs. For these purposes, an ambulance run is defined as an ambulance&#39;s trip between departure from an emergency scene to the placement of a patient at a Level I trauma center. Run times are reported in minutes. The analysis included data provided by the Illinois Department of Public Health. The reporting period was between January 2008 and December 2010. Geographic data included in the analysis are limited to Chicago ZIP codes. Per suggestions from health professionals, WBEZ eliminated records that included obvious errors, such as run times that lay outside the realm of possibility, e.g., run times that were listed as being months-long.</p><p>Citing federal health privacy regulations, IDPH did not grant WBEZ&rsquo;s request for more finely-honed geographic data. A similar request to Chicago&rsquo;s Office of Emergency Management and Communications returned records over a similar reporting period, but the data were not useful in our analysis; like IDPH, OEMC cited federal regulations, but the Chicago agency did not provide geographically specific data, including ZIP codes.</p><p><strong><a name="MAP"></a>Median run times</strong></p><p>Darker areas denote slower ambulance travel times between emergency scenes and patient drop-offs at Level I trauma centers. Lighter areas denote faster run times. Clicking on a ZIP code reveals the median run time within that part of the city.</p><p align="center"><iframe height="500" scrolling="no" src="https://www.google.com/fusiontables/embedviz?viz=MAP&amp;q=select+col2%3E%3E1+from+1768105+&amp;h=false&amp;lat=41.836117168853214&amp;lng=-87.73349879101562&amp;z=10&amp;t=1&amp;l=col2%3E%3E1" width="575"></iframe></p><p><b><strong>Proportion of ambulance runs lasting 20 minutes or more</strong></b></p><p>Darker areas denote higher proportions of trauma-related ambulance runs that took 20 minutes or more. A run time of twenty minutes or less is considered a professional standard within Chicago. Clicking on a ZIP code reveals the percentage and number of trauma-related ambulance runs that lasted 20 minutes or more.</p><p align="center"><iframe height="500" scrolling="no" src="https://www.google.com/fusiontables/embedviz?viz=MAP&amp;q=select+col2%3E%3E1+from+1767975+&amp;h=false&amp;lat=41.836117168853214&amp;lng=-87.73349879101562&amp;z=10&amp;t=1&amp;l=col2%3E%3E1" width="575"></iframe></p><p><strong>Proportion of ambulance runs lasting 30 minutes or more</strong></p><p>Darker areas denote higher proportions of trauma-related ambulance runs that took 30 minutes or more. A run time of twenty minutes or less is considered a professional standard within Chicago. Clicking on a ZIP code reveals the percentage and number of trauma-related ambulance runs that lasted 30 minutes or more.</p><p align="center"><iframe height="500" scrolling="no" src="https://www.google.com/fusiontables/embedviz?viz=MAP&amp;q=select+col2%3E%3E1+from+1768059+&amp;h=false&amp;lat=41.836117168853214&amp;lng=-87.73349879101562&amp;z=10&amp;t=1&amp;l=col2%3E%3E1" width="575"></iframe></p><p><strong>Count of trauma-related ambulance runs</strong></p><p>Darker areas denote higher numbers of trauma-related ambulance runs. Clicking on a ZIP code reveals the number of runs within that part of the city.</p><p align="center"><iframe height="500" scrolling="no" src="https://www.google.com/fusiontables/embedviz?viz=MAP&amp;q=select+col2%3E%3E1+from+1767971+&amp;h=false&amp;lat=41.836117168853214&amp;lng=-87.73349879101562&amp;z=10&amp;t=1&amp;l=col2%3E%3E1" width="575"></iframe></p><p><strong><a name="CENTERS"></a>Level I trauma centers in the Chicago area</strong></p><p>Chicago&rsquo;s trauma network comprises six adult facilities (depicted in red), four within the city and another two in the suburbs: Advocate Lutheran General in Park Ridge and&nbsp;Advocate Christ in Oak Lawn. Level I trauma centers outside the network accept Chicago patients under certain circumstances.</p><p align="center"><iframe frameborder="0" height="345" marginheight="0" marginwidth="0" scrolling="no" src="http://maps.google.com/maps/ms?vpsrc=6&amp;ctz=300&amp;ie=UTF8&amp;msa=0&amp;msid=216186475098934228713.0004aef4aafcf9961ada8&amp;t=m&amp;ll=41.902277,-87.720337&amp;spn=0.705251,1.576538&amp;z=9&amp;output=embed" width="575"></iframe><br /><small>View <a href="http://maps.google.com/maps/ms?vpsrc=6&amp;ctz=300&amp;ie=UTF8&amp;msa=0&amp;msid=216186475098934228713.0004aef4aafcf9961ada8&amp;t=m&amp;ll=41.902277,-87.720337&amp;spn=0.705251,1.576538&amp;z=9&amp;source=embed" style="color: rgb(0, 0, 255); text-align: left;">Chicago Area Level I Trauma Centers</a> in a larger map</small></p></p> Tue, 11 Oct 2011 10:00:00 -0500 http://www.wbez.org/content/trauma-patients-southeast-side-take-more-time-reach-trauma-centers Three Illinois hospitals may lose tax-exempt status http://www.wbez.org/story/three-illinois-hospitals-may-lose-tax-exempt-status-90677 <img typeof="foaf:Image" src="http://llnw.wbez.org//archives/images/cityroom/848_20090330g_large.png" alt="" /><p><p>The Illinois Department of Revenue announced Tuesday that three Illinois hospitals are in danger of losing their tax-exempt status. They are Northwestern Memorial's Prentice Women's Hospital in Chicago, Edward Hospital in Naperville and Decatur Memorial Hospital in Decatur.</p><p>The department's ruling comes during an ongoing battle in Illinois over the tax-exempt status of hospitals. An Illinois Supreme Court case from 1968 established five criteria that hospitals have to meet to qualify as "charities."&nbsp;</p><p>Illinois Department of Revenue spokeswoman Susan Hofer says they are: "a charity may not have stock, capital or shareholders; a charity derives its funds mainly from private and public charities; a charity dispenses charity to all who need it and those who apply for it; a charity does not provide gain or profit in a private sense to any person connected with it; a charity places no obstacles in the way of those who need and would avail themselves of that charity."</p><p>If hospitals meet those criteria, the institutions become exempt from taxes on all their property, including everything from hospital rooms, to gift shops, to parking lots. Last year the Illinois Supreme Court ruled that downstate Provena Hospital didn't qualify, and therefore had to start paying property tax.</p><p>The Illinois Department of Revenue now uses the Provena ruling, alongside the 1968 criteria, as a kind of precedent to guide decisions on charity qualifications. The department doesn't have jurisdiction to investigate every hospital, however. Instead, it can only review hospitals that enter their administrative system when a parcel of a hospital changes ownership or changes use.</p><p>Mark Deaton, General Counsel of the Illinois Hospital Association, said decision makers are interpreting the court's definition of charity far too narrowly. He said if more hospitals lose their status and have to pay property taxes, it would be a serious blow to patients and the growing health care sector -- a sector he &nbsp;calls "one of the few bright spots in the Illinois economy."</p><p>Deaton said patient care could be compromised if more hospitals are forced to pay property taxes.&nbsp;</p><p>"[That] could push hospitals into having to cut back, slow down modernization, slow down hiring, slow down plans to expand services," he said.</p><p>The three hospitals being denied tax exempt status have 60 days to ask an administrative judge to review the decision. Illinois Department of Revenue spokeswoman Susan Hofer says her agency is reviewing the charity status of between ten and 15 additional hospitals.</p></p> Tue, 16 Aug 2011 21:29:00 -0500 http://www.wbez.org/story/three-illinois-hospitals-may-lose-tax-exempt-status-90677