Standard of Care--Hospitals

June 13, 2019

With seniors, special focus can be beneficial — in tough surgeries and more

Recognizing that seniors face different health challenges than younger folks could help doctors and hospitals better safeguard older patients who undergo complex and demanding surgery.

Paying heightened attention to age’s changes also can be beneficial to older adults in protecting themselves from damaging falls and getting retirees to keep moving to stay fitter — without getting hung up on a mistaken exercise measure.

A specialty group within the American College of Surgeons may be on a beneficial course in recommending new geriatric guidelines for older patients, a rising number of whom undergo extensive procedures that once were considered risky for those of an advanced age, the New York Times reported. This is a significant issue in surgical practice, the newspaper reported:

August 9, 2018

For sick seniors, hospitals and nursing homes can be nothing but bad news

by Patrick A. Malone

In many parts of the developing world, families play a big part in patients’ hospital care. They not only sit for long hours with loved ones, supporting and encouraging their recovery. They also may help with direct services, bathing and cleaning patients, tending to their beds and quarters, and even assisting with their medications and treatments.

Such attentiveness from loved ones— once common in this country, too — may be deemed by many now as quaint and unnecessary, what with the rise of big, shiny, expensive American hospitals.

But think again: As Paula Span reported in her New York Times column on “The New Old Age,” care-giving institutions across the country have become such stressful, disruptive places that seniors, especially, not only heal poorly in them but also may be launched into a downward cycle of repeat admissions.

July 3, 2018

Regulators want to ease safety standards for hospital infections that still sicken millions

by Patrick A. Malone

As many as 2 million already ailing Americans will acquire an infection while hospitalized, with 90,000 of them dying as a result. Hospital acquired infections (HAIs) will add to the cost of an individual patient’s care anywhere from $1,000 to $50,000, while they will impose a direct hit of anywhere from $28 billion to $45 billion for institutions’ bottom lines. If HAIs seem like a problem for U.S. health care, they certainly are — why is Uncle Sam suddenly proposing to retreat on regulations to crack down on them?

USA Today reported that patient safety advocates are sounding alarms about new rules, set to take effect in November, from the Centers for Medicare and Medicaid Services (CMS). The agency, which wields great sway over hospitals because so many patients’ medical costs are covered by Medicaid and Medicare, plans to slash the information it provides to the public on HAIs involving: “super bugs” like MRSA (methicillin-resistant Staphylococcus aureus), post-operative sepsis and surgical site infections, as well as accidents and injuries ranging from bedsores to respiratory failure after surgery.

CMS also would stop informing the public about “never events,” medical mistakes committed in hospitals and considered so ghastly that they “never” are supposed to occur.

April 10, 2018

Hospitals give patients and taxpayers too many causes for high anxiety

by Patrick A. Malone

Hospitals may be providing us all with too many causes for high anxiety, with reports on increasing findings of “nightmare” bacteria stalking more health care facilities than had been known, more disclosures about how taxpayers may foot an even bigger bill to deal with a beleaguered public hospital in Washington, D.C., and a respected reform advocate’s detailing of just how traumatizing many hospital stays may be.

Let’s start with the new research by the federal Centers for Disease Control and Prevention, a study that tried to determine just how many cases there might already be of patients infected in hospitals, nursing homes, and other medical care facilities with so-called Superbugs, bacteria that resist treatment not only with most standard antibiotics but also drugs that are deemed therapies of last resort. These include three types of bacterial infections deemed especially urgent but difficult to control: Clostridium difficile (C. difficile), aka C-diff; carbapenem-resistant Enterobacteriaceae (CREs, as shown above); and Neisseria gonorrhoeae.

CDC officials weren’t sure how many of the Superbug cases — which leave doctors and hospitals little option but to provide only supportive care — they might detect by scrutinizing records from pathology labs nationwide.

November 7, 2017

Why are doctors and hospitals so quick to turn to heart stents and robotic devices?

by Patrick A. Malone

Hundreds of thousands of times each year, doctors install stents (tiny wire cages) in blocked heart arteries, not only to provide better blood flow to the body’s most important muscle but also ostensibly to provide pain relief to patients. Surgeons also perform tens of thousands of different, minimally invasive procedures with the help of elaborate and expensive robot devices.

All these surgeries, which cost patients tens of thousands of dollars and carry real risks, are evidence-based and well-supported in their outcomes, right?

Wrong. And here’s hoping, not dead wrong.

November 6, 2017

United Medical Center’s woes deepen as ratings group rips DC-area hospitals

by Patrick A. Malone

Even as District of Columbia officials struggle with deepening woes at the United Medical Center (UMC), advocates from a national, independent, and nonprofit group have offered a dim review of hospitals in the DC area.

The bad news keeps piling on at UMC, a leading provider of medical care for communities of color in the District’s Southeast area and in Prince George’s County, Md.

To its credit, the sometimes locally slumbering Washington Post has put out a disturbing, well-documented report about the death of a 47-year-old HIV-AIDS patient in UMC’s nursing home care. As others witnessing the scene clamored for them to help, UMC nurses, the Post says, let the patient fall to the floor, where he sprawled in his own waste for 20 minutes while his caregivers argued with a security guard. When the patient finally was returned to his bed, he was dead.

September 13, 2017

A new tool for finding how your hospital rates

by Patrick A. Malone

Patrick Malone & Associates has a new tool for patients to easily check out how their hospital stacks up on quality and safety measures.

The tool is on our website here, and covers all hospitals in the Washington D.C. metropolitan area, including northern Virginia, the Maryland suburbs of DC and the District of Columbia itself.

When you click on the link, you will see a map of the DC area with hospital locations pinned. Click on any hospital, and a small window will open up giving you an array of stats. Each statistic has an arrow next to it– up for “better than average” and down for “worse than average. Our site features these quality measures:

September 11, 2017

In hospitals, angry guys with guns (even with badges) are a bad idea

by Patrick A. Malone

Medicine and law enforcement can be a combustible combination, as a widely publicized incident in a Utah emergency room has reminded. The ugly incident has underscored the importance of hospitals keeping big, upset guys with guns cordoned off from caregivers, as well as the importance of front-line medical personnel knowing, respecting, and protecting patients’ privacy rights about their medical treatment.

Nurse Alex Wubbels became a heroine for firmly and politely telling Salt Lake detectives that the law forbade them from ordering blood extraction and testing on patient William Gray. The unconscious truck driver turned out to be a reserve cop in a nearby small town, and he had been involved in a crash connected to a high-speed chase by Salt Lake officers.

August 23, 2017

New disclosures deepen scandal over DC hospital’s risky obstetrics care

by Patrick A. Malone

Doctors and hospitals across the country push the frontiers of medical science every day, finding new ways to improve health care and to change and save lives. But at the same time, some of medicine’s basics—like delivering babies safely and protecting mothers’ well being—also keep getting botched, especially for poor and black women. It’s a national disgrace, and it’s on sad, terrible display in the growing scandal in Southeast Washington’s only full-service hospital, which recently was ordered to stop delivering babies.

Why? The Washington Post, which has done some good digging and needs to do more, says that health regulators for the District of Columbia have provided sketchy details to officials of United Medical Center, which serves the poor and predominantly African American residents of the neighborhoods east of the Anacostia River, as to why the public hospital’s obstetrics unit was shut down for 90 days.

The paper says United’s staff failed to properly care for a newborn to ensure the infant didn’t acquire HIV from the baby’s mother, who was infected and had a high viral load. The hospital didn’t test the baby properly for HIV, failed to deliver the child via cesarean to reduce the chances of HIV infection, and didn’t administer a recommended antiretroviral drug as a postpartum precaution.

June 14, 2017

A new infectious threat at hospitals & nursing homes: deadly Legionnaire’s

by Patrick A. Malone

Hospitals and nursing homes, by failing to properly maintain their water systems, may be putting older patients at high risk of an unusual form of pneumonia, with federal officials tracking 1 in 5 suspected or confirmed cases of life-threatening Legionnaire’s Disease to health care facilities.

Anne Suchat, acting director of the Centers for Disease Control and Prevention, has urged caregivers to redouble their efforts to stamp out Legionella bacteria contamination in areas where poor maintenance may allow infections to flourish, including in water storage tanks, pipes, cooling systems, showers, sinks, and bathtubs. She said Legionnaire’s cases were too widespread, “deadly … and preventable.”

CDC researchers analyzed 2,809 of 6,079 Legionnaire’s cases nationwide in 2015 alone. They found 553 cases in 21 different and targeted jurisdictions, including Virginia, definitely or possibly occurring in a nursing home or hospital. The infections caused 66 deaths.