Patient Care

Nearly 70 elderly patients and vulnerable adults must find new homes because of the planned closure of Harborside Nursing and Rehabilitation Center in Baltimore, a sprawling facility with numerous fire hazards uncovered in a recent state inspection. The nursing home - the first in Maryland to accept AIDS patients in 1985 - will shut down within the next month after Medicaid and Medicare stop paying for patient care. The federal health care programs decided to cut off funding after a March inspection by the state found more than 30 safety violations, primarily due to structural problems.

Harford Community College has received a $25,000 grant from CareFirst BlueCross BlueShield to support development of an electronic health records system that will bolster training of the institution's nearly 2,200 Nursing and Allied Health students. The grant for Harford's Emerging Technologies Project -- Electronic Health Records will enable HCC to acquire the high-tech equipment necessary to launch the project across the Allied Health and Nursing curricula and provide state-of-the-art education in a crucial workforce skill for the health care industry.

The conflict between Raymond Jackson and Mount Washington Pediatric Hospital illustrates some of the emotional issues that hospitals face as families take a more aggressive role in patient care, medical ethicists say."Part of good health care is having family involved in the care," said James Nelson of the Hastings Center, an independent, nonprofit research and educational organization in New York that examines ethical issues in medical and life sciences.But when a family's demands absorb an inordinate amount of staff time, "then it's reasonable to find some alternatives," he said.

On March 13th you published a letter written by reader Lois Raimondi Munchel titled "Stop the spread of deadly bacteria in nursing homes. " The letter was timely. It should send alarm bells ringing not only through the hallways of our nursing homes but also through our hospitals and our operating rooms. Not too long ago, at the NIH hospital, deadly Klebseilla bacteria resistant to all antibiotics, were found. Fifty percent of patients with this bacterial infection will die. These lethal, resistant bacteria have appeared in hospitals up and down the East Coast.

The state agency that licenses doctors may discipline physicians only when their conduct is linked to the diagnosis and care of patients, the Maryland Court of Special Appeals has ruled.The court reversed two of three 1994 findings of misconduct against Lester H. Banks, a Carroll County doctor, by the Board of Physician Quality Assurance. Those findings were upheld last year by the Carroll County Circuit Court.But the state's second-highest court affirmed a finding of sexual harassment against the Westminster physician, based on one woman's complaints.

About 60 newly hired nurse's aides are taking over some duties once handled by much more highly trained registered nurses at Howard County General Hospital, and some nurses say patient care is being sacrificed to save money.The hiring of the nurse's aides -- called patient care technicians (PCTs) -- has alarmed some of the hospital's more than 400 registered nurses, who say the aides are not adequately trained to monitor patients."The patients are getting substandard care," said a nurse at Howard County General who asked not to be identified for fear of retribution.

After more than a quarter-century with little attention from the government, the quality of kidney dialysis in the United States is receiving scrutiny from the Clinton administration and Congress.The administration is preparing proposals to establish quality requirements for dialysis, a life-saving treatment for patients whose kidneys have failed.The proposals, which could be ready by March, would define such things as the results that must be achieved in certain blood tests indicating the quality of dialysis.

State and national health care officials began looking into patient care at Shady Grove Adventist Hospital in Rockville yesterday in connection with allegations that a nurse there might have contributed to the deaths of one or more patients. The Maryland Office of Healthcare Quality and the Joint Commission on Accreditation of Healthcare Organizations spent the day touring the hospital, examining patient charts and interviewing employees and patients about the hospital's delivery of services.

As part of cutbacks at University of Maryland Medical System, the vaunted Maryland Shock Trauma Center is closing one 20-bed unit.John W. Ashworth III, director of the Shock Trauma Center, said the closing was a response to empty beds, as patients are discharged more quickly. The closing will mean a staff reduction in Shock Trauma of 66. Of those, half are nurses, aides and technicians, a reduction of 10 percent in direct patient care staff. The other half are in administration and support such as billing and information systems, a cut of 18.5 percent.

In December, a young man in Newtown, Conn., killed 20 small children and seven adults, including his mother, and then committed suicide. This tragic massacre has prompted legislators to reexamine firearms laws and quickly propose legislation that might prevent future mass murders. Much of it focuses on people who have sought mental health care. The Maryland General Assembly is considering legislation that requires mental health clinicians to report patients who are potentially dangerous for the purpose of restricting their access to guns.

The Johns Hopkins Hospital and Health System leadership sent this letter today outlining how much federal budget cuts will cost the medical system.   From:  Paul B. Rothman and Ronald R. Peterson [ mailto:jhmedexec@jhmi.edu ]  Sent:  Friday, March 01, 2013 1:50 PM To: Subject:  Update on Sequestration To JHM faculty, staff and students Dear Colleagues,   Yesterday's decision on sequestration and its impact on academic medicine have reverberated throughout our halls.

As a 35-year employee of St. Joseph Medical Center, I have followed with interest your coverage of issues the hospital has faced over the last several years. While overall the reporting has been accurate, the most recent articles have not conveyed a fair or accurate picture of the hospital's efforts to regain its stellar reputation ("St. Joseph center not certified by Medicare," Feb. 13). Under the new management by the University of Maryland, there has been diligent examination of every detail of the hospital's operation by management as well as all staff.

In December, a young man in Newtown, Conn., killed 20 small children and seven adults, including his mother, and then committed suicide. This tragic massacre has prompted legislators to reexamine firearms laws and quickly propose legislation that might prevent future mass murders. Much of it focuses on people who have sought mental health care. The Maryland General Assembly is considering legislation that requires mental health clinicians to report patients who are potentially dangerous for the purpose of restricting their access to guns.

A recent article highlighted the dysfunction resulting from the broken Medicare physician payment system ("End the 'doc fix' charade, once and for all," Jan. 22). Physicians who care for millions of Medicare patients across our nation are weary of the destabilizing series of scheduled cuts and short-term patches, coupled with payment rates that have fallen well below the rate of inflation over the past decade. It is widely agreed that Congress must eliminate this problem once and for all. But this is only the first step.

Doctors are breathing a collective sigh of relief because we again escaped a cut in Medicare payments. But this whole recurrent charade underscores, once again, the unresolved issue of how to pay doctors. The fiscal cliff rescue included the usual "doc fix" - an override of the 27 percent Medicare reimbursement cut required by the Sustainable Growth Rate (SGR) law this year. That law has dictated annual cuts in Medicare reimbursement, which have been overridden by Congress annually. Nevertheless, this escape only postponed the crisis for older patients for another year.

Among the select few physicians honored with the prestigious Patients' Choice Award this year is Dr. David Jaffe, of Havre de Grace. Of the nation's 870,000 active physicians and dentists, just five percent consistently received top scores from their patients on sites like Vitals (http://www.vitals.com), qualifying them for this honor in 2012. Millions of patients go online each year to rate their doctors on various components of care, including accuracy of their diagnosis, the amount of time they spent with the doctor, and the doctor's bedside manner and follow-up care.

Harford Community College has received a $25,000 grant from CareFirst BlueCross BlueShield to support development of an electronic health records system that will bolster training of the institution's nearly 2,200 Nursing and Allied Health students. The grant for Harford's Emerging Technologies Project -- Electronic Health Records will enable HCC to acquire the high-tech equipment necessary to launch the project across the Allied Health and Nursing curricula and provide state-of-the-art education in a crucial workforce skill for the health care industry.

The Johns Hopkins Hospital and Health System leadership sent this letter today outlining how much federal budget cuts will cost the medical system.   From:  Paul B. Rothman and Ronald R. Peterson [ mailto:jhmedexec@jhmi.edu ]  Sent:  Friday, March 01, 2013 1:50 PM To: Subject:  Update on Sequestration To JHM faculty, staff and students Dear Colleagues,   Yesterday's decision on sequestration and its impact on academic medicine have reverberated throughout our halls.

In 2006, when Eugene Semenov was an undergraduate at Johns Hopkins University, he volunteered at the medical clinic of Baltimore Rescue Mission, which provides free medical attention to people who are homeless. He couldn't help noticing that the record-keeping system was stuck in a pre-computer era, with volunteers tasked with taking vital signs and gathering information. The result was a lack of standardization, and a system of physical paper, which could not be transferred electronically to other doctors.

Linda Teixeira, of Laurel, is no stranger to emergency rooms. Her daughter is on dialysis and has other related health issues that require emergency care on a regular basis. What is new for Teixeira is that on this particular evening, she's waiting for her daughter in Laurel Regional Hospital's waiting room. "We live up the street and could walk here, but she was here a couple of times in the past and the service wasn't good, so we had been going to Howard General," Teixeira said.