Tag Archives: health care providers

Modern Medicine

‘Good Old Days’ Of Medicine Are Best As Fond Memories: New Technologies Are Helping All Patients

It’s not unusual to occasionally hear people refer to the good old days when doctors made house calls, or they might wax nostalgic about TV’s Marcus Welby, M.D., whose main character came across as the perfect embodiment of medicine.

There’s no denying that the 1960s and ‘70s were simpler times in many ways, but for health care in particular, they weren’t necessarily better. Medicine has come a very long way over the past 40 years, and we’re all beneficiaries of numerous medical discoveries and innovations that have not only improved our health and well being, but just as importantly, have made us safer and more informed health care consumers. Marcus Welby notwithstanding, doctors and the hospitals that they work in are not perfect.  So adieu to Dr. Welby, but spare us from “House” (unless we need his expertise).

Patient safety was not a major topic in health care during the last century, but today it is a top priority for all health care providers, government agencies and payers. The complexity of technology and care have caused many entities to invest many millions of dollars in new technology, such as Electronic Medical Records (EMR), Computerized Physician Order Entry (CPOE), simulation training, remote ICU monitoring and other innovations to make hospitals as safe as possible for patients.

Even before the U.S. Department of Health and Human Services reported in 2001 that more than 770,000 people were injured or died each year in hospitals from Adverse Drug Events (ADEs), Banner Health was at the forefront of proving the benefits of an electronic ADE alert system. In 1998, a team of faculty from Banner Good Samaritan Medical Center conducted and published the results of the first-ever study to prospectively evaluate a computer support system with real-time intervention for reducing injury from a broad range of ADEs.

In those “early days” of the electronic record, phone calls and faxes to and from the laboratory, pharmacy and physician served as a way to catch issues before they occurred. Today, every Banner hospital in Arizona is equipped with an EMR that includes electronic alerts to help prevent ADEs from happening. Patients should feel assured that if they receive care in one Banner hospital and then go to another, their medical history with tests, as well as medications, will be easily accessible at every location. This is important, because the general public may not be aware of the number of drugs that have similar sounding names, such as Clonidine for high blood pressure or Klonopin for seizures; Celebrex for arthritis pain or Celexa for depression. If you’re at a Banner Hospital and a drug is ordered for you, an ALERT will pop up right at the nursing station and require immediate attention if it doesn’t match your medical condition or if it might cause a reaction with your other medications. At a point in the not too distant future, if it hasn’t already occurred, your physician’s office will be tied into a system that provides your medical record and safety features at all sites of care.

But, even with all of these innovations, patients should know that they have an important role and responsibility for ensuring their own safe care during a hospitalization. First and foremost, if at any time something doesn’t feel right, or if you’re unsure about something, SPEAK UP! You have the right to question anything. Also, proper hand hygiene is critical. Make sure that all caregivers and visitors, including your own family and friends, who come into your room wash their hands with soap and water or use antibacterial gel. Here are some other tips for ensuring your safe care:

  • Provide your complete and accurate health history information at the time of admission, including all allergies you might have
  • Know your medications and tell your care providers what you’re taking, including herbal and over-the-counter supplements, and how the drugs affect you.
  • Always confirm your identity — all hospital staff should check your wristband and ask your name before they draw blood, administer tests, give medicine or provide any treatments
  • Follow your health care instructions — never tamper with your IV pump, monitors or other devices. When you are ready to go home, get your health care instructions in writing and make sure you understand how to follow them. Again, ask questions.

The safest medical care occurs when everyone is working together as a team, including the patient, and utilizing all of the tools available to ensure the most successful outcome.

Woman in medical clothing sitting at a laptop

AzHHA Expands Its Online Job Board To Encompass The Full Spectrum Of Health Care Jobs

At a time when economic news is dominated by downsizing and layoffs, the Arizona Hospital and Healthcare Association (AzHHA) is expanding its efforts to recruit new employees for positions ranging from janitor to physician.

Although the state’s unemployment rate hovers at just under 10 percent, Arizona health care facilities added 1,700 jobs in January alone. To meet that continuing need, the association launched an enhanced interactive Internet job board — www.AzHealthjobs.com — that reaches from coast to coast.

Originally launched about 10 years ago, the Web site was created by AzHHA to enable member hospitals to post open positions, much like Monster.com and Jobing.com, but was targeted strictly to hospital positions. Now, with an expanded scope that was launched on Feb. 1, the Web site is open to all segments of the health care industry, including nursing homes and doctor’s offices.

What’s more, posted jobs don’t necessarily have to be in the medical field. For example, CPAs and others who want to work in health care facilities are encouraged to post their resumes.

“The more that we get the word out for our enhanced Web site, the more jobs will be available,” says Patricia Weidman, director of work force and staffing services for AzHHA and who oversees the job board. “This is how we’re helping people who are looking for jobs. A lot of people don’t know about it, because previously it was limited to hospitals. We have marketed the Web site at conventions. We tell people to check it out. Hospitals use engineers, CPAs, janitorial, housekeeping, laundry positions. A lot of non-clinical positions are listed.”

Health care used to be considered recession proof, but that changed somewhat during this past brutal downturn. Weidman says the expanded job board can help make the hiring process more cost efficient for health care providers.

“We’re very excited about the enhancements of AzHealthjobs.com,” she says, “because we know how critical it is for employers in the health care industry to attract first-rate talent with a minimum expenditure of time and resources. And it’s important for us to help enable smooth career transitions for those seeking health industry jobs.”

Weidman says the job board has been a valuable tool for Arizona hospitals, which currently employ 73,000 people and generate $11.5 billion to Arizona’s gross state product.

Job seekers pay nothing to post their resumes on AzHHA’s Web site, but fees are paid by employers with positions to fill. Positions can be posted for 30 days for a fee of $350. At any given time, hospitals and other employers list 1,000 to 1,500 jobs, with direct links to individual career sites, Weidman says.

As part of the expansion, AzHHA joined the National HealthCare Career Network (NHCN). The NHCN partnership brings together the best sources of highly qualified talent from leading professional and trade associations representing skills in all sectors of health care.

AzHHA also is partnering with Boxwood Technology, a leading provider of career center services for the association industry. Boxwood, which administers and manages AzHHA’s jobs site, is the only such provider endorsed by the American Society of Association Executives. Boxwood also provides technical support, customer service, accounting, content management and ongoing product development. Weidman says Boxwood has a network of more than 185 leading health care associations and professional organizations.

Any money generated from the Web site goes back to the nonprofit side of AzHHA and helps keep dues down, Weidman says.

“So hospitals are benefiting, even though we are opening the Web site up,” she adds. “Some hospitals had expressed concern, but we were able to reassure them.”

It’s still too early to tell how effective the newly expanded Web site will be, Weidman says. It will take time to get the word out, which she does on a monthly basis at nursing conventions and job fairs around the country.

“I tell everyone to get their resumes on there if they’re looking for a health care position in Arizona,” Weidman says. “This is the place to be.”

Especially for nurses. In the past, some nurses Weidman met at conventions would say they didn’t want to work in a hospital, but preferred something else, such as a nursing home. For a nurse, working in a hospital is not the same as in a nursing home, school, doctor’s office or prison. Different skills are required, and the pace is much quicker, for example, in emergency rooms and intensive care units. With the expanded Web site, nurses looking for a position can zero in on specific career opportunities.

And despite the sorry state of the economy, hospitals, not as hard hit as other industries, are still hiring nurses.

“Hospitals have been using a lot of temporary staff, some nurses are taking additional shifts, and some part-timers are going full-time to fill any shortages,” Weidman says. “We wouldn’t have this program if they weren’t still hiring.”

A recent survey indicates that one-third of the RNs in Arizona are 55 or older.

“When they retire, we still will have a nursing shortage,” Weidman says. “We’re telling hospitals that this is a perfect time to build their own resume database, so when those positions do come up, they can tap into that database and be ready to go when they have the need.”

AH Endovascular OR Suite

Executives From West Valley Hospitals Assess The Impact Of The Current Economy

The need for health care services continues to grow across the state, including the West Valley. And under the current recession, hospitals are being asked to do more with less.

Jon Bartlett, CEO of Arrowhead Hospital, says the health care industry is not immune to the impact of the bad economy, but he remains optimistic about the current and future state of the market.

“There are plenty of challenges, but we remain focused and disciplined,” he says.

In fact, he believes West Valley communities are home to some of the finest hospitals around, and the members of the community wouldn’t have it any other way.

“Today, people expect the very best health care outcomes, but they also demand world-class service,” Bartlett says. “It is our responsibility to meet their expectations.”

Arrowhead Hospital has been recognized with three stars in the Society of Thoracic Surgeons’ national database in 2007 and 2008 for its superior cardiovascular surgery outcomes.

Tom Dickson is CEO of Banner Thunderbird Medical Center, a 413-bed acute care hospital that specializes in cardiovascular care, neurology care, pediatrics, obstetrics and emergency medicine. He says the slowing economy has actually allowed West Valley hospitals to catch up with their demands.

“Generally, the West Valley has been underserved in terms of acute care beds,” Dickson says. “Now that the economy has slowed and several hospitals have added additional beds, we are not in as critical condition as we were in recent years.”

With a recent expansion of the South Tower, which can grow to accommodate 600 beds, Dickson says his biggest challenge is retaining existing employees and recruiting additional workers to staff the additional beds and programs and services that are growing as a result of the tower.

“The most critical area of need is registered nurses,” he says. “We also have an acute shortage of physicians and other medical professions, including physical therapists, respiratory therapists, pharmacists and medical technologists.”

Jo Adkins, CEO of West Valley Hospital, says the West Valley currently has an adequate amount of hospital beds, but that may not be the case for very long.

“As growth returns to the West Valley, we will need to look at growth of both beds and services,” she says. “We need to stay in touch with the communities’ needs and grow the services so that we can remain a hospital of choice.”

Meanwhile, West Valley Hospital is already very strong in a number of specialties, including its heart and vascular center, chest pain center, emergency room, electrophysiology and obstetrics. But Adkins doesn’t mince words when it comes to the challenges facing the health care industry.

“(It has) taken a large hit,” she says.

Naming two recent 5 percent budget cuts, she adds, “That has had a $3.6 million impact on West Valley Hospital alone.”

Beyond working to overcome the challenges facing the industry as a whole, the leaders of these hospitals are 100 percent dedicated to providing the superior service they believe their community members deserve.

Bartlett notes that the emergency department at Arrowhead Hospital is making a concerted effort to decrease wait times, promising that patients are seen in less than half an hour.

“Our average wait time is 19 minutes,” he says.

And while Arrowhead Hospital does have plans to expand from 220 beds to 260 within the next 18 months, Bartlett explains that he doesn’t just want to grow, he wants to make sure the hospital is getting consistently better.

Lee Peterson, CEO of Sun Health Services (formerly Sun Health Properties), which recently merged with Banner Health, agrees that providing the utmost services and results for its patients is the hospitals’ top priority.

“Banner has a best-practice strategy that is very much in line with our passion for making a difference in people’s lives,” he says.

Boswell and Del E. Webb medical centers are now Banner Boswell and Banner Del E. Webb.

“By coming together with Banner we were able to bring some immediate technologies, such as electronic medical records, in addition to research institutes, which are such a major part of Banner Boswell and Banner Del E. Webb, to the West Valley,” Peterson says.

With the economy putting a freeze on growth for the most part, West Valley hospitals stand poised for continued expansion. All the while, they are not taking their eyes off their mission — to provide the residents of West Valley communities with first-class services administered by highly trained and compassionate health care providers.

nurses, healthcare, doctors

The State’s Health Care Industry Is Strong, But The Recession Is Taking A Toll

Although I have only been in Arizona 11 years, St. Joseph’s Hospital and Medical Center has been providing high-quality care to Valley residents since 1895. And for the past century, St. Joseph’s has been known for two primary missions: Service to the poor and underserved; and outstanding care, particularly in the neurosciences, driven by groundbreaking innovation.

In the past 25 years, the innovations at St. Joseph’s have been significant, and other hospitals in the state have seen significant growth and expansion of services, as well. We have had unprecedented growth in the Metro Phoenix area, and hospitals have tried valiantly to keep up with the demand for acute care services. In the past 25 years, we have seen many new hospitals built, particularly in the suburban areas, and central hospitals have continued to expand.

Arizona was the very last state in the country to adopt a state Medicaid program in the early 1980s, but the Arizona Healthcare Cost Containment System (AHCCCS) has since been considered a national model of cost effectiveness. We missed out on substantial federal funds for the Medicaid system by being the last state to join, but we have nonetheless run an efficient system with the public dollars Arizona has received.

The health care system has continued to evolve in very interesting ways during the past quarter century. We have seen a clear movement to reduce the length of hospital stays, and many procedures are done in outpatient settings that were once only performed in hospitals.

We have made extraordinary progress in diagnostics and minimally-invasive procedures, which help people recover faster and get treated earlier when disease occurs. In a past era, patients who needed lung surgery had to have their ribcage cracked open and had weeks of extended recovery; now they have it laproscopically and are up walking around the very next day. Cancer used to be a death sentence; now it is often a chronic illness that can be virtually cured. We are better at treating chronic illnesses such as diabetes and heart disease, and we now know how important prevention is to limiting the impact of disease.

But significant challenges still remain. We have evolved into a system of “sick care” not “health care,” and although we know prevention pays dividends, that is not what physicians and hospitals are reimbursed for. The system rewards us when we treat the sickest patients, but not always for keeping them well.

In America, the concept of employer-sponsored health care is considered foundational to our economy. Yet, more than 46 million Americans do not have health insurance, and many of them are vulnerable children. In Arizona, the majority of employees work for small businesses that are under a tremendous strain to provide affordable health insurance. When people transition to public insurance, the reimbursements are declining so much that community physicians are refusing to accept new Medicaid and Medicare patients, while safety-net hospitals struggle to treat all who present themselves at their doors.

The boom-and-bust cycle is hard on the economy, but it is also hard on health care providers. We face a physician shortage in the Valley and a dearth of key sub-specialists for a region this size. In a recession, more people turn to public assistance at the same time the state is trying to cut budgets to compensate for diminished reserves.

Still, I remain hopeful for our state and our industry. Health care continues to be a strong economic engine for Arizona; good paying jobs, great career paths for a wide variety of disciplines and many avenues for innovation. Catholic Healthcare West, of which St. Joseph’s is the flagship hospital, is actively working with the new president and Congress to help shape health care reform so all Americans can have affordable and accessible health coverage. I believe there has never been a time when so much good is possible, and that change can help all of us live better.

Nursing Shortage Still Plagues Arizona’s Health Care Industry

Nursing Shortage Still Plagues Arizona’s Health Care Industry

Arizona’s nursing shortage is a very serious problem and it is not going away any time soon. The state is going to need approximately 49,000 new registered nurses by 2017 to keep pace with population growth, RNs retiring and nurses lost to attrition, according to the Arizona RN Shortage: 2007 Results, a report published by the Arizona Healthcare Data Center. The data center was started by the Arizona Hospital and Healthcare Association (AzHHA) in 2007 to study health professions in Arizona.

“I think people are tired of hearing about the nursing shortage,” says Bernadette Melnyk, dean of ASU College of Nursing and Healthcare Innovation. “They don’t understand the adverse effects until they or a family member is hospitalized and they see for themselves the effect it has on the health and safety of people they love.”

Of the approximately 49,000 RNs that will be needed by 2017:

  • 20,000 will be needed to keep pace with the state’s growing population, as well as to close the gap between Arizona’s current average of 681 RNs per 100,000 residents and the U.S. average of 825 RNs per 100,000 residents.
  • 10,000 nurses will be required to replace retiring RNs. More than one-third of Arizona’s current RNs are older than 55 and will retire over the next five to 10 years.
  • 19,000 RNs, or 3.5 percent annually, will be needed to account for the profession’s attrition rate.
  • Twelve of Arizona’s 15 counties also fall below the national average of RNs per 100,000 people, according to the Health Resources and Services Administration (HRSA). The national average is 3.3 RNs per 100,000 people, and Arizona has 1.9 RNs per 100,000 people. The three counties that exceed the national average — Coconino, Pima and Yavapai — still face shortages of RNs.

    Adda Alexander, RN, MBA, former executive vice president of AzHHA, says Arizona colleges have increased their capacity and are graduating more nurses, but it is not enough. Arizona’s nursing programs need to graduate an additional 2,235 students per year just to keep pace with the state’s population growth.

    To help address the nursing shortage, Arizona hospitals contributed $57 million between 2006 and 2007 to the state’s education programs in the form of tuition reimbursements, loan forgiveness programs and in-kind giving (providing space for nursing education programs, sponsoring faculty salaries and tuition reimbursement). In 2005, the Arizona Legislature passed the Arizona Partnership for Nursing Education (APNE) bill, which provided $20 million over five years to double the capacity of Arizona’s college and university nursing education programs by increasing the number of nurse education faculty. As a result of the APNE funding, the estimated number of additional nursing graduates in 2010 will be 1,242. Alexander said APNE was a crucial step in helping the nursing shortage, but it sunsets in 2010 and the funding stops.

    According to Annual Reports from Nursing Education Programs, 2007, Arizona Board of Nursing, there were 41 vacancies for full-time Arizona nursing faculty in 2006, which was a 13 percent increase from the previous year. In addition, there were 38 vacancies for part-time nursing faculty in 2006, which represented a 600 percent increase in vacancies from 2005.

    The report also indicated that due to the lack of capacity, more than one-third of nursing students are wait-listed each year by Arizona nursing programs even though they have met all course prerequisites.

    Joey Ridnour, executive director of the Arizona State Board of Nursing, contends that the lack of clinical space also contributes heavily to the nursing shortage. Thus, many states are looking at using simulations in combination with clinical experience to teach students.

    “This may be a good combination to consider in the future, but faculty needs to figure out how to maximize it so students get a good education,” Ridnour says. “When I was a student, I would have valued doing some of the procedures through simulation rather than on live patients. It would have given me a better understanding and more confidence.”

    Melnyk believes the state has to hit the nursing shortage from two angles: (1) produce more nurses and (2) help them feel satisfied and empowered in their role. She says between 35 and 60 percent of new graduates leave their positions in the first year due to stress from staffing shortages and patient acuity levels.

    “I think nurses get out in the real world and don’t expect their jobs to be so stressful,” she says. “People in hospitals are very sick and oftentimes what the nurses are expected to juggle is too much for them to handle.”

    Melnyk also thinks nurses and other health care providers should be educated in evidence-based practice (EBP), a problem-solving approach that integrates the best evidence from research studies and combines it with patient preferences and the clinician’s expertise.A number of medical studies show that when nurses, physicians and other health care providers deliver care in an evidence-based manner, the quality of care is substantially better and patient outcomes improved.

    “Studies also show that nurses practicing EBP are more satisfied with their role, feel more empowered and make less medical errors,” Melnyk says. “A lot of people don’t realize that 99,000 patients die annually in the U.S. due to medical errors. That’s a staggering number of patients.”