Sunday, 5 November 2017

One of dangerous doctor's mission in children hospital in poston

It is not uncommon for a couple immersed in their profession to decide that children may not be in their future. Lisa Buckmiller, M.D., and her husband, Richard Hinkle, were at that time when they met an orphan girl who would change the course of their lives.

The Fall 2006 issue of Children's Hospitals Today featured the story of Gong Lu, an orphan from Fenyi, China. The administrators of the welfare center where she had lived since birth were looking for a doctor to remove the vascular tumor that covered Gong Lu's nose. They wanted the treatment done before making it available for adoption.

Buckmiller, who had made several mission trips to China with doctors at the Arkansas Children's Hospital, offered help. At the time, Gong Lu was 5 years old and with the help of Love Without Boundaries, she went to the United States for surgery where Buckmiller and the vascular anomalies team removed 95% of the tumor. .


After his recovery, Gong Lu returned to the health center in China. She told the administrators that she dreamed of having no more tumors, going to school and being adopted into a loving family. She did not know that the adoption process was going on.

Fast forward one year, and Gong Lu is in the United States, now Anna Gong Lu Hinkle, the adopted daughter of Buckmiller and Hinkle. "It was incredible," says Buckmiller. "This has probably been the most rewarding thing in our lives to have adopted it." Within three months of arriving in her new home, Anna underwent further surgeries, one of 16 hours, to begin rebuilding her nose.

His parents say they had to quickly find some words in Chinese to communicate urgent needs and information. "It was shocking how quickly she learned and became fluent in English," says Buckmiller. "The language barrier has never been a problem."

Ablation and reconstruction of her nose required six separate surgeries, and Anna had her last surgery at the age of 9 years. "I always wanted to get rid of my big red nose," says Anna. "When I saw my face without that nose, I did not recognize myself, it was a new look for my new life, I feel like all the other kids now."

The family also checked Anna's dream of going to school. Gong Lu had not been sent to school in China, so she was two years behind school. Anna worked with a guardian to catch up a year, then she studied alone. Today, she is a sophomore in high school.

The family moved to Texas where Buckmiller is the head of the pediatric division of the ears, nose and throat of the San Antonio Children's Hospital and continues to give time to those who need it on missions. In the last 18 years, Buckmiller has traveled to Kenya to repair the clefts and palates of children. Anna went with her mother for the first time last March. "I fell in love with that," says Anna. "I'm delighted to be able to make children feel good about themselves, just as I wanted to feel good.

Today, Anna has a new nose and the life she dreamed of, while her parents enjoy a family they did not expect to create. "It worked beyond what my husband and I could have hoped for," says Buckmiller. "And, he reiterated my belief to be available to help these children with facial deformities have a more normal life. We were just able to go further and bring Anna into our family.

Allowing families to be with their child during anything inside Children's hospitals

You work every day to provide the best care for children. But imagine being on the other side and receiving this phone call that you never want to get. Hear those words you never want to hear: Your child has had a terrible accident. You are told that your child has been transported to the emergency room. All you want to do is hurry, so you can be close to your child while the medical teams are working to treat the injuries, and possibly save your child's life.

Although this is a natural parental reaction, not all hospitals allow parents to stay in the room with their child during trauma care. But new research on child health in Dallas; National Child Health System in Washington, D.C .; and the Philadelphia Children's Hospital highlights a hospital policy that allows it, bringing benefits to patients, families and medical teams.

The study revealed that:

94 percent of families with their child during trauma care said they provide emotional support to their child
92 percent reported giving information about their child to the medical team
81% remember having an interactive relationship with the trauma team, asking questions about their child's care
"It's my job"

In general, the results show that parents felt that attendance was an opportunity to fulfill their role as advocate and advocate for their child.

"Families have the right to be present with their child during trauma care," says Lori Vinson, Senior Director of Trauma Services, Emergency Services, EMS, PESN, Emergency Management and Disaster Management. injury prevention.

"They feel they have a better understanding of their child's prognosis by looking at and observing it," says Vinson. "They feel less anxious to be in the room than to be somewhere else, where they are not aware of what's going on, and they feel like supporting their child simply by being physically present.

Benefits for health care teams

Vinson says the families in the room are also helping medical teams better explain what's going on because the family has witnessed the condition and care of the child. It can also help teams better prepare and support families while their child is undergoing trauma care, she says.

Good policy but not widely accepted

While family-centered care is a pillar of children's hospitals nationwide, the practice of family presence during pediatric trauma care is still lagging behind areas of care for diagnosed children. This is because, says Vinson, of the nature of the trauma itself.

"With trauma, most of these children have never been sick, and they usually do not have any long-term health problems, so their families may never have been in the ER," he says. she. "And with trauma, there is blood, there are visible injuries, there may be a distortion of the appearance of a child, these things are not there in medical conditions as in trauma."

Building on previous research

In 2006, Vinson co-authored a study in the Journal of Emergency Nursing that assessed the family's presence during resuscitation and other trauma procedures, finding that:

In 100% of cases where the family was present, patient care was uninterrupted
Parents believed that their presence helped their child and said that it alleviated their fears
92% of nurses and 78% of physicians supported the presence of the family
Daily practice for children's health

The Emergency Department of Child Health in Dallas has a policy that allows for family presence during pediatric trauma care, and Vinson and the team there would not have it otherwise.

"We really want to put the family at the center of everything we do, so to put families in the center, we really need to get them involved from the start," she says. "We do not think about it anymore, it's just what we do."

how one hospital is helping everyone of children

In traditional hospital safety initiatives, errors are reported to leadership through a formal reporting tool, and managers determine which mistakes merit private discussion with the employee or broader discussion with the team. In 2015, using a different approach, a group of USIP nurses from the Dell Children's Medical Center of Central Texas began publishing a monthly newsletter with "good catches" (near misses) and reports from formal and informal medical care. and medication errors.

The strategy behind this newsletter is 100 percent of the errors present teaching opportunities for 100 percent of staff members. The newsletter, published monthly by the Medical Director, is now distributed to all USIP medical and nursing staff. This model of open and blind declaration of all errors has improved reporting and improved safety of culture in intensive care units. In a November 14 webinar, the team will describe how it works. They also shared this work during the conference on the quality and safety of children in 2017.

A new approach

Using the newsletter moves the team beyond the traditional error response. "With traditional approaches, the assumption is that the person who made the mistake is the problem," says Michael Auth, M.D., D.O., medical director of the USIP. "It also discourages people from reporting things, we all go ashamed, and maybe the only person who learns is the nurse who made the mistake.

Monica Smith, RN, a critical care nurse with Dell Children's, began publishing the Critical Care Safety Bulletin in 2015. Each monthly email includes good catches and all the errors that occurred that month. By compiling errors, it deletes information about staff and patients and sends the edited description to the staff members who have been involved to ensure that it is a fair representation of what has happened.

Then the reviewers validate the information and add any follow-up training that the staff should know. "Then we take another look at the e-mail and take off any blame or tone we feel when we read it," says Smith. In the middle of the month, the e-mail is sent to the list of 200 staff members, including all critical care nurses, floating nurses, physicians, respiratory therapists, pharmacists and quality analysts.

Get results

The newsletter follows the same format each month. "All events are shared in a spirit of improvement and awareness, and then there is the wrong sandwich," says Smith. "It starts with good catches and ends with positive behavior, but in the middle is a list of everything that went wrong: medication errors, side effects of patient care, falls, or events we learned from. another unit. of."

She says it works because every mistake deserves the attention of everyone in the team. "It also helps eliminate the gossip that occurs with events because they are anonymous, and helps reduce the negative emotions and shame that occur when you make an event," she says. "We give the same amount of screen time to every bad thing that happens on the unit, resulting in increased reporting."

Lessons learned

Now in its third year of publication, the newsletter has become a valuable resource for staff. "We are receiving constant feedback that staff are forced to change through anecdotal experiences, not aggregated data," says Smith. A hospital-wide safety bulletin is being prepared and other units are also launching their own versions.

Few adults think everywhere of children hospital

According to a new study by the Journal of American Pediatrics, most adults do not think children are better off than they were when they were growing up. Mental health, bullying, security and obesity issues are more pronounced than in previous generations, and these and other challenges present a discouraging picture: a generation that seems worse than its parents.

The study found that less than one-third of adults report that today's physical health of children is better than theirs as children, and only 14% think children's mental health is better now.

The study, conducted by C.S. Mott Children's Hospital and the Children's Hospital Association, used data from a 2016 national survey of children's health at C.S. Mott Children's Hospital. The researchers analyzed the aggregate opinions of the adults interviewed and examined the responses of the generational groups, using: Generation Y (aged 18 to 34), Generation X (35 to 50), Baby Boomers (51 to 70 years) and baby boomers (70 years and over). The study found:

While 30% of baby boomers believe that children's physical health is better than when they grow up, less than 20% of Millennials feel the same way.
Neither Generation Xers nor Generation Y believe that the quality of health care for today's children is better than that of children
Compared to adulthood, less than 15% of adults think that children's chances of growing up with good mental health in adulthood are better.
Providing children with a better future than the generation before them is an important part of the American dream. The authors of the study say that these perceptions among adults mean that society must invest more in the physical and mental health of children.

Wednesday, 25 October 2017

California hospital files for bankruptcy after missing payroll

The Tulare Regional Medical Center (CA), a 112-bed hospital run by Tulare-based HealthCare Conglomerate Associates, filed for bankruptcy on Saturday in Chapter 9 bankruptcy.

The hospital declared bankruptcy a few days after HCCA, which is being paid by the local hospital district, said it had been done to pay the hospital bills. "HCCA has provided substantial revolving funding to the hospital over the years, totaling $ 14 million," said Benny Benzeevi, MD, President and CEO of HCCA at a board meeting on September 28, according to Valley Voice. "But in light of the current destructive political environment, HCCA will not continue to do so."

Tensions have erupted between HCCA and the hospital district board since last year, and this battle is partially responsible for a recent deterioration in the credit rating by Fitch Ratings.

On September 29, less than 24 hours after Dr. Benzeevi stated that HCCA would no longer provide financial support to the hospital, several nurses and other staff members left work after being paid. HCCA said a cash shortage by the hospital district was the reason why it was unable to finance the entire payroll.

The bankruptcy petition of the Tulare Regional Medical Center revealed that the hospital has no money on its bank accounts. The shortage of cash poses a risk to public health and safety, as the hospital does not have the funds to purchase adequate medical supplies and the "critical vendors" have interrupted hospital service for lack of payment, according to the report. bankruptcy documents.

Chapter 9 of bankruptcy is a bankruptcy procedure that provides municipalities in difficulty with creditor protection while a repayment plan is negotiated.

Tennessee hospital closes after falling 94% short of GoFundMe goal

The Copper Basin Medical Center, a critical access hospital in Copperhill, Tennessee, closed on Sunday.

The Copper Basin Medical Center has been in dire financial straits for months. The hospital suspended hospitalization services on May 9 and laid off more than 15 nurses, according to the WRCB.

Officials launched a GoFundMe page earlier this year to help keep the hospital afloat. They hoped to raise $ 100,000 through the campaign, but they fell to about 94% of their goal. On Monday, the hospital received donations of 77 people, totaling $ 5,559.

Copper Basin Medical Center is behind payroll, which means some workers will be waiting for paychecks after being fired, said Dan Johnson Hospital CEO WTVC.

Regarding closure, Johnson told WTVC, "We are a small rural hospital and it's hard for us to adapt to all the changes in health care.

7 hospitals with strong finances

Seven hospitals and health systems with strong operating metrics and strong financial positions, according to recent reports from Fitch Ratings, Moody's Investors Service and S & P Global Ratings.

Note: This is not an exhaustive list. The names of hospitals and health systems have been compiled from recent credit rating reports and are arranged in alphabetical order.

1. Ascension Health, based in St. Louis, has a rating of "Aa2" and a stable outlook with Moody's. According to Moody's, the health care system has manageable leverage, limited debt structure risk and a large portfolio of large hospitals.

2. Baylor Scott & White Health, based in Dallas, has an "Aa3" rating and a stable outlook with Moody's. According to Moody's, the healthcare system has strong cash margins and a favorable commercial position as the largest nonprofit health system in Texas.

3. The Children's Hospital of Philadelphia has a rating of "Aa2" and a stable outlook with Moody's. According to Moody's, the hospital has strong financial capabilities and fundraising capabilities.

4. The Greenville (S.C.) health system has an "AA-" rating and a stable outlook with Fitch. The system has seen a dramatic improvement in its operations, posting $ 18.6 million in operating income for fiscal 2016 and $ 20.9 million for the first six months of fiscal 2017, according to Fitch .

5. Kaiser Permanente has an "AA-" rating and a stable outlook with S & P. ​​The Oakland, California-based system has a strong corporate profile with a favorable integrated business model, according to S & P.

6. Bryn Mawr, based in Pennsylvania Main Line Health has a rating of "Aa3" and a stable outlook with Moody's. According to Moody's, the healthcare system has a strong market position and additional support from independent foundations.

7. Albuquerque, MN-based Presbyterian Health Services, has a "AA" rating and a stable outlook with S & P. ​​The system has a strong financial profile and modest debt, according to S & P.