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Featuring hospital and health care headlines from the media and the Web.

Iowa News

We must learn from Indianola tragedy
State lawmakers are redesigning Iowa’s mental health services. For decades, this state made counties responsible for managing and partially funding services for uninsured people with mental illness. That created disparities in care. The hope is a redesigned system will offer more equitable access to services, regardless of where people live. But none of that will matter if people are not willing to use the services. (Des Moines Register)

Hospital CEOs take on weighty Blue Zones challenge
Putting their money where their mouths are, and using those mouths in a much healthier way, the CEOs of Sioux City’s two hospitals are taking on a new challenge in support of the Blue Zones Project. Bob Peebles, CEO of Mercy Medical Center-Sioux City, and Peter Thoreen, CEO of St. Luke’s Regional Medical Center, will work to lose 10 percent of their body weight in three months, following the Blue Zones guidelines. The challenge began Wednesday with a weigh-in at the City Council Chambers — Thoreen at 222 and Peebles at 242 pounds — and it will continue through June 27. (Sioux City Journal)

Colon cancer strikes close to home at Mercy in Centerville
When Mercy Medical Center was looking for a personal story to help build awareness about the importance of screening to prevent colon cancer, little did they know the ultimate story was building in their own organization. Heather McKelvey, health promotion manager at Mercy, was instrumental in visioning and organizing the Colossal Colon event this Friday and Saturday in Centerville.   “I am passionate about encouraging people to have regular screenings to help prevent diseases before it becomes serious,” she said.  But colon cancer is especially important to her because her mother, Judy Bailey from Centerville who died of the disease when she was just 57 years old. (Centerville Daily Iowegian)

Dubuque’s Mercy Medical Center reaches fundraising goal
Dubuque Mercy Health Foundation is pleased to announce the $3 million goal has been reached for Campaign ICU, the capital campaign for new intensive care and cardiovascular units at Mercy Medical Center – Dubuque. The new units are scheduled to open in August. “The extraordinary generosity of the people of Dubuque never ceases to amaze,” said Russell M. Knight, Mercy’s president and CEO. “Once again, individuals, corporations, and foundations have risen to the occasion in support of the heart program at Mercy.” (Eastern Iowa Health)

Now is not the time to let your health goals slip away
Breaking a habit takes time, dedication and support. Remember back to why you made that healthy New Year’s resolution. Was it for you, your family or to save money? Exercise, nutrition and preventative measures such as smoking cessation are truly the most important actions that you can do for your health. The benefits are exponential, with up to 75 percent of cancers caused by tobacco use, lack of exercise and poor diet. We know the benefits of healthy choices. (Des Moines Register)

National News

The Supreme Court will decide on the health care law soon; it will tell you later
If the usual process occurs, the justices of the Supreme Court will gather around a large rectangular table Friday morning and, one by one, cast their votes on the constitutionality of President Obama’s health care law. They will let the rest of us know the outcome in due time. The justices give no notice about when a decision is to be announced. It would seem most likely that their ruling on the sprawling trio of cases concerning the Patient Protection and Affordable Care Act will be one of the last announced this term, in the last week of June. (Washington Post)

Obama targets groups that would be hurt by overturned health care law
Even before the Supreme Court heard arguments about the constitutionality of the federal healthcare law, President Obama’s campaign had begun targeting key voter groups that might be most affected by a loss. If the justices rule against the law — an outcome that many think they strongly signaled during arguments Tuesday and Wednesday — the way those slices of the electorate respond could go a long way toward determining the political impact. (Los Angeles Times)

Like the U.S., Europe wrestles with health care
The U.S. has been absorbed by the Supreme Court case this week on the future of health care. But Americans are not alone. Several European nations, where universal health care has been the norm for decades, have been waging their own intense debates as they also deal with aging populations and rising costs. Britain passed a new health care measure earlier this month, after more than a year of rancorous debate. Can the European experience cast some light on the American debate over health care? (National Public Radio)

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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Hard to read tea leaves on tossing whole health law vs. parts
During Tuesday’s arguments, Justice Kennedy made it clear that he is wrestling with the question of whether the individual mandate is unconstitutional (unlike most of his colleagues, who apparently have already reached their own conclusions on that question), said Todd Pettys, a university of Iowa law professor. One of the main issues debated at the Court today was what should happen if the Court does indeed strike down the individual mandate: should the rest of the 2700-page statute be allowed to stand, should the whole thing be struck down, or should only parts of it be struck down (and, if so, which parts?). (Des Moines Register)

Another big day for the Blue Zone Project in Sioux City
Vote Blue. That’s what the City of Sioux City is urging people to do Thursday. It’s the next big push towards becoming a Blue Zone Demonstration site for the state. Right now, Sioux City has 4,700 votes in support of making Sioux City a Blue Zone Demonstration site. And their goal is to reach 10,000 by next week. “It shows our state…the board that is looking at this… that our community is energized and interested. It cares about its own health and its own future. And that’s what were asking,” says Paul Eckert, city manager. (KCAU)

Mason City hospital mourns death of nurse
“Gretchen touched many lives and not just those in critical care, but in so many places with her excitement around life, nursing and leadership.” Chief Nursing Officer Kim Chamberlin speaks passionately about Gretchen Crooks. Crooks was killed Saturday evening in rural Osage. Now, her 13 year-old son Noah Crooks is in custody and facing charges for murder and assault with intent to commit sexual abuse. Gretchen was a crinical care nurse at Mercy Medical Center-North Iowa. (KIMT)

Lung cancer still tops cancer deaths in Iowa
Health experts say Iowa will fall short in its “healthiest state” goal if legislators continue to slash tobacco control funding. That funding is necessary to combat the state’s leading fatal cancer: lung cancer, according to the State Health Registry of Iowa. The tobacco industry spent $100 million in Iowa last year, as the Legislature halved the tobacco prevention and control budget to about $3 million, said Dr. Christopher Squier, University of Iowa professor of oral pathology. (KCRG)

National News

Hospitals fear loss of insurance payments if mandate is struck down
The American Medical Association argued in a brief to the court that the bill could hurt hospitals’ finances if the individual mandate is the only portion of the law to be struck down or altered. Hospitals expected a wave of newly insured patients to offset cuts to government reimbursement for programs like Medicare and Medicaid called for under the law. They fear they may be squeezed by declining payments without the benefit of an influx of new patients. If the court finds the law unconstitutional, the government may press ahead on plans to cut reimbursements in a effort to rein in spending. (Chicago Tribune)

Pittsburgh hospital could be liable in fatal shooting
The mentally ill gunman who killed a nurse and wounded several others at a University of Pittsburgh Medical Center psychiatric hospital had previously threatened staff at an affiliated hospital with a baseball bat, according to a prosecutor who is trying to determine whether UPMC could be held criminally liable. Medical records and other information show 30-year-old John Shick, held a grudge, believing he had misdiagnosed illnesses ranging from a bad ankle to pancreatitis to erectile dysfunction. Shick twice went to UPMC Shadyside hospital in February with the bat and threatened the staff, and yet Pittsburgh police were not called, said Allegheny County District Attorney Stephen Zappala Jr. (Washington Post)

Hospital pay incentives fail to help patients: study
A program to pay hospitals bonuses for hitting key performance measures, or dock them if they miss, failed to improve the health outcomes of patients, according to a large, long-term study. The study could lead to a re-examination of financial incentives in health care, as policymakers seek ways to reward results rather than paying doctors and other providers for each service they provide, such as a diagnostic test. Such an incentive program for hospitals is a key provision of the U.S. health care overhaul law that is being challenged this week before the Supreme Court. (Reuters)

Cleveland Clinic seeks to hire 600 nurses
Cleveland Clinic this week is using the city’s professional football stadium to field a three-day recruiting blitz to hire 600 new registered nurses.  The Stanley Shalom Zielony Institute for Nursing Excellence organized the job fair both to fill vacant posts and to proactively prepare for anticipated new demands that will come with health care reforms. (HealthLeaders Media)

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The U.S. Supreme Court enters the third and final day of opening arguments on the various challenges to the health care reform law.  Yesterday, the court heard arguments concerning the individual insurance mandate, Monday on the topic of whether or not a challenge can be raised against a tax that has not yet been imposed and today on the Medicaid expansion and whether the federal government overstepped its authority by requiring states to expand Medicaid programs nationwide.  Finally, this afternoon the court will hear arguments on whether or not certain pieces of the law can be struck while leaving other intact - also known as “severability.”

At this juncture, it appears as if there are deep divisions between justices, in particular among the key “swing-vote” justices, those that generally tip the scale in favor or against an issue.  With 9 justices, 5 are required to agree.  The court is expected to rule on these issues in June.

For more information, IHA has developed a “Policy Brief” on the issues providing an in-depth view of the cases before the court.


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Featuring hospital and health care headlines from the media and the Web.

Iowa News

Iowa’s role in the health care debate
One reason that Governor Bandstand filed suit against the federal government was because of the burden he says the reform plan will place on Iowa’s budget in dealing with Medicaid. Most of the people helped by Medicaid are disabled and low-income children and their parents. Under the Affordable Care Act, that aid will be expanded to adults, many of whom up until now have been uninsured. The number of Iowans who are affected by this bill could reach 150,000. The Federal Government will help pay for these added insurance costs for the first couple of years. But then a lot of the burden will be shifted to the state. (WOI)

Johnson County on mental health service waitlist
Those seeking mental-health aid in Johnson County may have to wait. The county has joined 10 others placing such residents on a waiting list this year for mental-health services. And after the Iowa Legislative Services Agency predicted a $51.4 million shortfall next year in Medicaid and non-Medicaid services, local mental-health officials are worried treatment options will be in short supply. (University of Iowa Daily Iowan)

Mental health training for Iowa law enforcement approved by Senate
Iowa law enforcement officers would be required to participate in training at least once every four years about responding to people who may have mental health illnesses under a bill being considered in the Legislature. The bill additionally would change current detention and hospitalization procedures to allow for an emergency application to detain a person to take place even during times other than regular court hours. (Des Moines Register)

Director hired for mental health program
Central Iowa Recovery, a multi-county agency that will provide intensive psychiatric rehabilitation to residents of those counties, has hired an executive director to manage the program. Patti Treibel, Hamilton County Social Services executive director, said that Tim Bedford had been hired as executive director of the new agency. He will likely be based in Webster City, she said. The counties include Hamilton, Hardin, Boone, Madison, Franklin, Greene, Guthrie, Marshall and Audubon. (Webster City News)

National News

Supreme Court considers severability, Medicaid expansion
The Supreme Court will complete its review of President Obama’s health care law Wednesday by considering whether all of the law must fall if part of it is found unconstitutional, and whether the law’s proposed Medicaid expansion violates the federal-state partnership. The Supreme Court has said there is a limit to what the government can force states to do in order to receive federal funds — a condition cannot be “so coercive as to pass the point at which pressure turns into compulsion.” But the court has yet to find a case where the federal government has gone too far. (Washington Post)

Mandate’s fate seems to rest on Kennedy, Roberts
At the U.S. Supreme Court on Tuesday, hostile questioning from key justices seemed to imperil the individual mandate, the central provision of the Obama health care overhaul. Conservative Justices Antonin Scalia and Samuel Alito pounced almost immediately. Alito suggested if health care can be mandated, funeral insurance would be next. And Scalia said the young and the healthy are paying way more than is needed for their own immediate care. He said young people are not “stupid” and should be able to buy insurance when there is a “substantial risk of incurring high medical costs.” But for supporters of the law, the worrisome questions came from Justice Anthony Kennedy, the justice who most often swings the court in 5-4 decisions. (National Public Radio)

Health executives unfazed by Supreme Court debate
Insurance companies and hospital chains brushed off concerns Tuesday the Supreme Court could strike down a requirement in the health-care law that would create millions of newly insured customers. For hospital operators, the court’s decision could make a huge difference for an industry already pinched by government cutbacks and a downturn in Americans’ use of health services. The hospital industry planned for 2014 to bring a huge influx of newly-insured patients. Many companies have been investing in doctor practices, including primary care, so they can serve the full spectrum of health needs. (Wall Street Journal)

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Crumpled vehicles sit along Highway 20 near Webster City.

On Monday, March 5, a routine morning commute on U.S. Highway 20 just east of Webster City changed in a split second when drivers entered a sudden black, smoky fog that brought visibility down to zero.  Many vehicles slowed and or stopped, causing a chain reaction of severe accidents. The number of accidents – ultimately involving more than 30 vehicles – and the severity of each prompted Van Diest Medical Center to activate its “External Code Green” disaster alert.

That morning, Michelle Stapp, the hospital’s emergency services nurse manager, was walking past the emergency department (ED) admitting desk when she heard multiple ambulance tones, similar to pager tests that are performed weekly.  The admitting staff stopped her and said, “Every ambulance in the county has been called out to an accident on the highway.”  The ED nurse on duty confirmed the reports but had little other information.  Stapp notified the director of nursing, Deb Thielen, that additional nursing assistance would likely be needed in the ED.

The original call for the hospital’s emergency medical services to respond came in at 7:38 a.m.

(Left to right) Michelle Stapp and Janet Naset-Payne in one of Van Diest Medical Center's trauma rooms.

Soon thereafter, Stapp was told there was a phone call for her at the ED desk.  Hospital COO Janet Naset-Payne was on the line saying she had witnessed a multiple-car, high-speed crash on Highway 20; there was fire involved, and there would be more injured than our facility could routinely handle.  The decision was made to call an “External Code Green,” the hospital’s disaster code, and prepare for multiple patients.

At 7:45 a.m., Van Diest Medical Center entered into disaster operations and initiated incident command.  Elective procedures were postponed and the same-day surgery department was turned into a treatment area for less severe injuries while the specialty clinic was converted to a treatment area for the walking wounded.  All available intravenous pumps, monitors and stretchers were brought to the ED.  Calls were made to off-duty staff of all the clinical departments as well as the admitting departments to respond while all available staff from every hospital department reported to assist in the ED.

Immediate requests were made for air ambulance support, but almost immediately came a negative reply – fog had made air transport impossible.  All three of Van Diest Medical Center’s paramedic level ambulances had reported to the accident scene and it soon became clear the hospital would not be able to cover additional 911 calls in the city nor handle the multiple transfers of trauma patients that were predicted.  Trinity Regional Medical Center in Fort Dodge responded to Van Diest’s requests for assistance and not only was gracious enough to send a fully staffed ambulance to cover Webster City, but also sent an additional ambulance to transfer a separate trauma patient in Van Diest’s ED, unrelated to the accident.

It was truly amazing how quickly the ED filled with available staff to help and all the supplies that would be needed.  Everyone did as they were instructed, without question, and went beyond what was asked of them.  A quick briefing was held to ensure everyone was on the same page regarding the event at hand, plans for triage and how patient care would be handled.

A general question of, “Is there anything else we need to do?” was shouted out and someone responded that they could use a prayer.  Spontaneously, the staff in the area gathered around and had a quick prayer for those who were injured and guidance for staff as they treated the patients and assisted their families.  The atmosphere in the ED calmed.

At 8:08 a.m., the first trauma patient arrived to a sea of nurses, doctors and technicians ready to transport and treat whatever came through the ambulance door.  In the end, 10 patients from the scene requested treatment and all were transported to Van Diest.  Two patients were injured severely enough to need transport to a Level 1 trauma center after initial stabilization, four patients were admitted to Van Diest and four patients were healthy enough to be sent home.  The prayers were answered: there were no fatalities.

Although Van Diest as an organization is more than 100 years old, Stapp noted that the hospital has only been in its current facility 17 months.  This was its first test of a large-scale event in the new building.  Several days later, Stapp learned this was the largest multiple car crash in Hamilton County history.

“I can say not only for Van Diest Medical Center, but for all the multiple emergency response agencies in Hamilton County, the system worked on Monday, March 5,” Stapp said.

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