Hospitals/EDs in the News

September 2002
(9/06/02) The American Academy of Pediatrics has launched a new area on its Web site to aid pediatricians, community leaders, parents and others in preparing for and meeting children's needs during a disaster. The site, www.aap.org/terrorism, addresses clinical questions and concerns of pediatricians and other health care providers on issues such as bioterrorism, chemical terrorism, radiological events, and the psychological aspects of terrorism. The project was funded by a grant from the Robert Wood Johnson Foundation.

July 2002
(7/16/02) Health Policy Issues in Popular Culture -- TV’s popular hospital dramas are regularly addressing such important national health policy issues as patients' rights, managed care, the right to die, and racial disparities in health care, according to As Seen on TV: Health Policy Issues in TV’s Medical Dramas, a new study of the 2000-2001 television season. The study was released at a forum in Washington, D.C. entitled John Q Goes to Washington: Health Policy Issues in Popular Culture that explored the role of entertainment media in shaping public attitudes and priorities on health policy issues. Click here for Kaiser web page on this issue. Click here for full-text of press release.

June 2002
(6/17/02) Sentinel Events can Occur in any Department, not just EDs -- A new JCAHO sentinel event alert today shows that while hospital emergency departments are the source of a little more than half of all reported sentinel event cases of patient death or permanent injury due to delays in treatment, JCAHO sentinel event data reveal that such serious problems can occur in any hospital unit, as well as in other health care settings. Of the 55 reported cases of delays in treatment, 29 were ED-related, while 26 cases originated in hospital intensive care units, medical-surgical units, inpatient psychiatric hospitals, freestanding and hospital-based ambulatory care services, the operating room and in the home care setting. Of the 55 cases of delays in treatment, 52 resulted in patient death. Click here for full-text of press release.

(06/2002) Why Pediatric Experts Say Emergency Rooms Can Be Hazardous to Your Children's Health -- Under ideal circumstances, every one of the nation's 5,000-plus emergency rooms would be staffed with pediatric emergency medicine specialists -- they receive three years of pediatrics training and three more years of education in child-specific emergency medicine. But only 50 to 55 specialists graduate annually, not nearly enough to go around. So who's on the job? Board-certified emergency medicine doctors -- the type children are most likely to encounter in the ER -- spend, on average, just 13% of their training on pediatric care, even though kids make up 34% of their caseload, according to a recent survey of 118 emergency medicine residency programs by the Society for Academic Emergency Medicine. Click here for full-text of press release.

May 2002
(5/30/02) Shortage of Nurses Hurts Patient Care, Study Finds-- In hospitals with low numbers of registered nurses, patients are more likely to suffer complications like urinary infections and pneumonia, to stay in the hospital longer and to die from treatable conditions like shock or gastrointestinal bleeding, researchers report today. The nation has a serious nursing shortage, with 126,000 jobs unfilled, 12 percent of capacity, says the American Hospital Association. The shortage is a result of hospital mergers, layoffs and heavy workloads. Many hospital nurses shifted to other work. The average salary, $46,000 a year, has not increased much in a decade. Even though hospitals are trying to hire again, nurses are no longer available. Click here for full-text of press release.

(5/27/02) For-Profit Hospitals in the U.S. Show Higher Mortality Rates than Non-Profits -- A study of data from 26,000 U.S. hospitals coveringoutcomes of 38 million patients has shown that people treated in private for-profit hospitals in the U.S. have a greater risk of dying than those cared for in private not-for-profit hospitals. The data were adjusted for confounders such as teaching status of the hospital, patients' severity-of-illness and hospitals' case mix, and showed that for-profit hospitals were associated with significantly higher mortality. Click here for full-text of press release.

(5/20/02)USP Report Finds Medication Errors Abound; Few Cause Harm -- A new report released today finds that 184 health care facilities reported 41,296 medications errors last year, 92% errors that occurred and 8% potential errors. The U.S. Pharmacopeia's MedMARx 2000 report says that out of 37,999 medication errors that occurred, 97% didn't harm patients. Errors most frequently originated during administering, documenting, and dispensing. In the 2000 report, as with the 1999 report, USP said, distractions, workload increase, and inexperienced staff are the most common contributing factors to medication errors. But in the 2000 report, staffing issues accounted for 33% of records and were one of the five most frequently cited reasons for medication errors. AHA Senior Vice President Don Nielsen, M.D, called the analysis an important tool for hospitals to learn from, noting that "hospitals across the country devote much energy and effort to ensure that patients receive the right medication at the right time." Click here for full-text of press release.

April 2002
(4/22/02) Visits to the Emergency Department Increase Nationwide -- The latest national data on the use of hospital emergency departments show that there were 108 million visits in 2000, up 14 percent from 95 million visits in 1997. Because the number of hospitals providing emergency care decreased from 4,005 to 3,934 between 1997 and 2000, the number of annual visits per emergency department has increased about 16 percent since 1997 from 24,000 to 27,000 and waiting time for non-urgent visits has increased 33 percent, according to a new report released today by the Centers for Disease Control and Prevention. Click here for related CDC press release.

(4/8/02) Overcrowded EDs Leading to More Diversions, Longer Wait Times -- A majority of the nation's emergency departments (EDs) are full, often operating "at" or "over" their capacity. One-third of hospitals are forced to go "on diversion" - rerouting ambulances to nearby EDs - according to a new survey from The Lewin Group, Inc. conducted for the American Hospital Association. Click here for full-text of AHA press release or survey results. Click here for related AHA press release.

(4/1/02) Strengthen U.S. investment in rural hospitals -- Small and rural hospitals across America are struggling to survive. At many rural hospitals, Medicare, Medicaid and uninsured patients account for more than 80% of the people entering their doors for care. But Medicare and Medicaid do not fully cover the costs of providing care, and inadequate reimbursements are forcing many hospitals to close, or reduce or delay services vital to the community. Contributing to these problems is the shortage of skilled caregivers, especially nurses, in rural areas. Click here for AHA News article.

March 2002
(3/29/02) Calif. Data Shows Surge in Serious ER Cases -- California emergency departments saw 59% more critically ill patients and 36% more urgent patients in 1999 than in 1990, according to a study that the American College of Emergency Physicians describes as the first objective data on the widespread problem of emergency room overcrowding. Click here for Modern Healthcare newsbrief.

(3/22/02) Situation Critical: Hospitals Grapple with an Increasing Shortage of Registered Nurses -- Doing the best they can is no longer good enough for RNs who are leaving the nursing profession in droves, causing a nationwide shortage of nurses. Locally, hospitals are so desperate to fill nursing vacancies they are offering signing bonuses to experienced nurses of as much as $10,000 -- and they're recruiting nurses from as far away as Canada, the Philippines and other countries. Click here for Bizjournals article.

(3/22/02) Health Education Centers Encourage Med Students to Work in Rural Areas -- Since the early 1970s, the federal government has been making an effort to improve health care in areas considered to be "underserved" by doctors, nurses, aides, technicians and other health care workers. In 1998, New York became the 40th state to join this effort. The program is designed to correct the maldistribution of health care workers with the goal of producing better health outcomes for those in inner city, rural and low-income areas. Click here for Bizjournals article.

(3/21/02) U.S. Short on Hospital Staff -- The hospital work force shortage around the nation is getting worse, according to a recent survey by the American Hospital Association. To combat that trend, area hospitals, including Easton and Phillipsburg-based Warren, are taking steps to overturn a serious shortage. The association’s survey found that vacancy rates for nurses, pharmacists and radiology technologists in hospitals are all above 10 percent and getting worse, particularly in nursing. The average vacancy rate for registered nurses is 13 percent, but one in seven hospitals nationwide report those vacancies higher than 20 percent, and 60 percent of all hospitals have seen more and more nursing jobs go empty since 1999. Hospital pharmacists are right behind nurses, with a vacancy rate of 12.7 percent. Radiology techs are the scarcest of all hospital staff, with an average vacancy rate of 15.3 percent. Click here for full-text of The Express-Times article.

(3/14/02) House Coalition Urging USDA to Continue Bringing Physicians to Rural Areas -- Reps. Jerry Moran, R-KS, and Mike McIntyre, D-NC, co-chairs of the Rural Health Care Coalition, are urging the Department of Agriculture and other federal agencies to finish processing pending J-1 visa waiver applications for rural physicians and find a way to continue the program. "Since its inception in 1994, the USDA's J-1 Visa waiver program has been integral to bringing 2,000 physicians to many of the most underserved rural areas of the country," the congressmen state in the letter to be sent Monday to USDA Deputy Secretary James Moseley and other federal officials. "In many of these areas, the J-1 physician is the only source of health care." More than 30 members of the House coalition had signed on to the letter as of this morning, said Moran's legislative director, Kim Rullman. Click here for related press release.

(3/8/02) Survey: Healthcare Approaching Capacity 'Crisis' -- Hospitals are on the verge of a crisis in capacity to handle an increasing demand for healthcare services, according to a new survey commissioned by the American Society for Healthcare Strategy and Market Development. Click here for Modern Healthcare newsbrief.

(3/5/02) Most Local Public Health Agencies Making Significant Progress on Post-September 11 Emergency Response Plans -- Several months since September 11, one-fourth (26%) of local public health agencies (LPHAs) have a comprehensive, written emergency response plan completed and in place and over half (55%) have plans that are 80 percent complete. Of those LPHAs who have begun development of a comprehensive response plan, however, only 12 percent indicated they have a bioterrorism-specific portion of an emergency response plan developed and in place according to results from a new survey conducted in December 2001 and January 2002 by the National Association of County and City Health Officials (NACCHO). Click here for NACCHO press release.

(3/1/02) Former South Carolina Governor to Head Rural Health Committee -- HHS Secretary Tommy G. Thompson today named former South Carolina Governor David M. Beasley chairman of the National Advisory Committee on Rural Health. The committee, which was created in 1987, advises Secretary Thompson on health issues affecting rural communities. "As former governors of states with large rural populations, Governor Beasley and I know how important it is for people outside urban centers to have access to quality health care," said Secretary Thompson who has made improving rural health and social services a top HHS priority. Last July, he created a rural task force to assess how HHS programs serve rural communities. The task force is completing work on that assignment and will soon deliver its findings to the Secretary. Click here for HHS press release.

January 2002
(2/19/02) The whole purpose of an emergency department going on critical care bypass is to divert ambulances away from it. If the nearest neighbouring hospital is only 2 minutes farther down the road, it could be argued that an extra couple of minutes of transport time would not have a significant effect on patient outcome. This may be true for many mid-sized communities with more than one hospital, but transport times between institutions may be much longer in large urban centres because of traffic, and in rural areas because of distance...outcome studies involving patients in cardiac arrest that the longer the transport time, the poorer the outcome. Click here for Canadian Medical Association Journal article.

(1/23/01) Severe overcrowding in America's emergency rooms may be a warning sign that the nation's primary care and hospital systems are failing, analysts said Tuesday. Healthcare experts are becoming increasingly alarmed over crowded conditions in hospital emergency departments and the fact that these departments are increasingly being forced to send patients to other hospitals. Most say that the problem is not with the emergency departments themselves, but with the ability of the rest of the healthcare system--hospital inpatient wards, psychiatric hospitals and primary care offices--to handle patient demand. Click here for full-text of Reuters/Yahoo article.

(1/10/02) Critical Access Hospitals program sees banner year -- According to AHA News, the number of Critical Access Hospitals jumped 69% in 2001 as struggling rural hospitals increasingly see the program as a means toward financial viability. The number of CAHs increased by 211 in 2001 to total 526 nationwide, according to data from the Centers for Medicare and Medicaid Services' OSCAR database, supplemented by AHA data. Another 10 hospitals have been designated CAHs already in 2002. Nebraska and other Great Plains states continue to lead the nation in number of facilities. Nebraska has 54, followed by Kansas (40), Iowa (32), North Dakota (24) and South Dakota (23). Iowa saw the biggest increase in number of CAHs in 2001, adding 20 CAHs. Minnesota and North Dakota followed, both adding 14. Click here for five case studies on AHA website noting some of the startup and implementation issues that CAHs have faced.

December 2001
(12/28/01) Hospitals must prepare for mass casualties -- Sagging payments from government and private health plans and rising costs have long ailed hospital budgets, but for some, Sept. 11 brought an unpredicted expense -- preparing for bioterrorism. Hospitals already had disaster plans for such large traumas as plane crashes or train wrecks, but not everyone had planned for the size of a bioterror attack that now seems possible. "The threat has changed," said Rob Reid, director of support services for University Hospital. "Where most facilities are going to see costs is getting their staff trained and maintaining the appropriate level of competency." Click here for full-text of Business Journal article.

(12/12/01) Land unconscious in an emergency room today and there's no quick way for doctors to verify the medications you take, allergies you have or other vital information to make sure you don't become victim of a medical error. Now an unusual mix of technology companies, consumer advocates and doctors is joining to try to fix that problem: using the confidential computer systems that make online banking work to link certain medical records electronically so a doctor anytime, anywhere can get vital information to treat patients. Click here for full-text of CNN/AP article.

(12/7/01) No more waiting rooms, fewer beds, more operating rooms, friendlier emergency rooms. These are just some of the ways hospitals are redesigning themselves to meet the rapidly changing health care and financial environments. Click here for full-text of Boston Business Journal article.

November 2001
(11/14/01) Over the past five weeks 673 persons have died from medication errors, far outweighing deaths from anthrax and other fatality-associated events combined, says an Institute of Safe Medication Practices' Medication Safety Alert. Such outcomes have been observed among physician, nurse, and pharmacist healthcare teams in hospital environments as well as in community pharmacies. Click here for full-text of Alert and click here for related article on better supervision needed.

(11/13/01) The nation's medical system is getting a life-and-death test. Is it ready for bioterrorism? From the front lines, the nation's emergency rooms and county health departments, the answer is a strong yes — and a realistic no. "We're never ready," says Mark Smith, chairman of emergency medicine at Washington Hospital Center in D.C.. "There will always be events that overwhelm the current system." How many people die from a bioterrorism attack and how many live could hinge on the decisions that are made on this front. One known weakness: the ability of already overcrowded emergency rooms and understaffed hospitals, clinics and health departments to pick victims of a silent terrorist attack out of a sea of patients who appear to have the flu. Click here for to gain access to USA Today article.

(11/9/01) "Biothreats Affecting Hospitals' Budgets". Click here for full-text of bizjournals.com article.

(11/9/01) "Hospitals Strapped for Disaster Cash". Click here for full-text of bizjournals.com article.

(11/9/01) "DCHA: Hospitals not ready for serious biological attack". Click here for full-text of bizjournals.com article.

(11/5/01) Facing the fragility of health care in America -- America's hospitals and health systems are filled with people who, every day, rise to the occasion. Whether they are helping people with the everyday challenges of sickness and injury, or responding to the more dramatic demands of a flood, a hurricane, or a similar type of disaster, hospitals are part of a local and national health care infrastructure that is designed to get care to anyone who needs it. Never has this been more dramatically demonstrated than during our nation's ordeal of terror. Click here to read full-text of article.

(11/1/01) Click here for American Hospital Association "Letter to the Hill" related to "Hospital Resources for Disaster Readiness". Click here for AHA document with assessment of hospitals' readiness to respond to a mass casualty event. This document has been reviewed by AHA members, by experts in the field, and by several independent authorities. In it, AHA outlines the resources and materials that local hospitals will need to be prepared to respond to a nuclear, biological or chemical (NBC) attack.

October 2001
(10/30/01) Initial indications are that it would cost more than $10 billion to provide the resources hospitals would have to have on hand to respond to an attack within the short-term (24 to 48 hours), says the American Hospital Association. During the first hours, the hospital would have to rely on internal resources while state and federal help is mobilized. An AHA assessment to be forwarded to Congress this week is based upon a "Hospital Resources for Disaster Readiness" memo the AHA, www.aha.org, circulated to members last week for comment (Click here, if AHA member, to download full-text of memo.) It assumes scenarios in which urban hospitals would receive 1,000 casualties and rural hospitals would face 200 casualties immediately after an incident. It indicates that the following key areas must be addressed to increase hospital readiness: 1) communication and notification; 2) disease surveillance, disease reporting, and laboratory ID; 3) personal protective equipment; 4) facility; 5) dedicated decontamination facilities; 6) medical/surgical and pharmaceutical supplies; 7) training and drills; and, 8) mental health resources.

(10/22/01) Emergency responders assess how the system worked -- The medical response to the Sept. 11 tragedy received high marks, yet there were cracks that became evident and lessons now being learned. As the dust settles in New York City and Washington, D.C., experts are taking stock of how the medical system handled itself in the midst of the Sept. 11 crisis -- figuring out what went right and what went wrong. Hospitals in these cities are debriefing their staffs. Physicians are trying to pull together data for studies and articles. And state and local governments, even those not directly affected by the catastrophic events of that day, are taking a close look at their plans to see if the chaos inherent to a disaster can be minimized. Click here for full-text of American Medical News article.

(10/16/01) Rep. Waxman released a report published by the U.S. House of Representatives titled, "National Preparedness: Ambulance Diversions Impede Access to Emergency Rooms", detailing the national problem of ambulance diversions and its implications for how well emergency rooms are prepared for possible terrorist attacks. By analyzing state and local articles published since January 2000, the report identified 22 states where hospital officials have declared they cannot safely accept emergency vehicles causing delays in patient care. These access problems have occurred under present conditions, demonstrating that additional attention to the emergency care system is needed to prepare fully for future challenges. Click here to download full-text of report.

September 2001
(9/10/01) "Crisis in the ER". Click here to gain access to full-text of U.S. News & World Report article.

July 2001
(7/01) "EDs Unprepared for Terrorism Incidents, Survey Finds". Click here to read full-text of American Hospital Association article.

April 2001
(4/23/01) "Developing Objectives, Content, and Competencies for the Training of Emergency Medical Technicians, Emergency Physicians, and Emergency Nurses to Care for Casualties Resulting From Nuclear, Biological, or Chemical (NBC) Incidents - FINAL REPORT", Office of Emergency Preparedness and American College of Emergency Physicians. Click here to download full-text of report.

Related Links
Click here for American Academy of Pediatrics resource page on Children, Bioterrorism, and Disasters.
Click here for American College of Emergency Physicians home page and click here for Bioterrorism page.
Click here for American College of Cardiology Information Clearinghouse on Biological Threats.
Click here for American Hospital Association Disaster Readiness resource page.
Click here for American Medical Association Disaster Preparedness and Medical Response resource page.
Click here for American Medical News "Terrorism in America" section.
Click here for Association for Professionals in Infection Control and Epidemiology home page.
Click here for Centers for Disease Control and Prevention Public Health Emergency Preparedness and Response home page, click here for info on Anthrax and bioterrorism, and click here for CDC Media Center archives.
Click here for CNN Resources: Web links on terrorism and disaster planning.
Click here for Federal Emergency Management Agency virtual library and electronic reading room.
Click here for Johns Hopkins Center for Civilian Biodefense Stategies home page.
Click here for Journal of the American Medical Association Bioterrorism Articles page.
Click here for Medline Plus Biological and Chemical Weapons page.
Click here for National Academy of Sciences Responding First to Bioterrorism page.
Click here for Office of Homeland Security home page, including Homeland Security Advisory System showing Nationawide Threat Level.
Click here for OKC National Memorial Institute for the Prevention of Terrorism home page.
Click here for Premier Bioterrorism and Disaster Preparedness resource page.
Click here for Rapid Response Information System's Reference Library home page.
Click here for Texas Medical Association Bioterrorism Resource Center and click here for Bioterrorism Toolkit for physicians and patients.