Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.
MONDAY NOVEMBER 10, 2014
I’ve worked in a number of different places and have even been the boss at a few of them. And I can tell you that few things have brought more “feel-good” spirit to a workplace than NJHA’s hiring of 25 U.S. veterans last year.
These smart and dedicated men and women have served our country at home and abroad. And today, they’re on a new mission as “Certified Application Counselors.” Their job is to help uninsured New Jerseyans navigate the healthcare marketplace and sign up for health insurance under the Affordable Care Act.
It is a job they have taken on with energy, commitment, good humor and a great esprit de corps. They really care about this mission, but most importantly, they really care about the people they are helping. One of our CACs helped a woman who was ready to halt her cancer treatments because she had lost her health insurance; he quickly guided her through the online Health Insurance Marketplace and helped her find coverage under another plan. Several of our CACs were on the ground in Atlantic City to assist the thousands of casino workers who lost their jobs.
All told, our CACs have reached nearly 60,000 New Jerseyans in the past year with information on their health insurance options. They’re now gearing up for Nov. 15 – the start of the ACA’s next open enrollment period.
For the rest of us working at NJHA, this program has made us feel good, plain and simple. We’ve helped people access healthcare. We’ve supported our veterans. And we’ve welcomed some wonderful new co-workers like:
- Norm Glover of East Windsor, who served in Vietnam and who remains active with the Military Order of the Purple Heart
- Piertus Esperience of North Brunswick, who not only served two tours in Iraq with the Marines but also served a tour in Afghanistan with the Army. He and his wife recently welcomed their second child.
- Hilda DeMello of Edison, a Navy veteran who now serves as one of our CAC team leaders.
- John Rodriguez of Bayonne, an Army veteran who served in Operation Iraqi Freedom.
- And Fred Kariuki of Phillipsburg, who grew up in Kenya and later became a U.S. citizen and joined the Air Force. He continues to serve in critical missions as a member of the Air Force Reserves.
I would love to list each one of our CACs but suffice to say that every one of our veterans has a legacy of service.
NJHA is fortunate to have these dedicated individuals on our side, not just on Veterans Day but every day. So to them and to all the veterans out there, thank you for your service.
THURSDAY OCTOBER 16, 2014
Let me take an opportunity to share some thoughts on Ebola. It’s on all of our minds – and certainly has been at the top of every newscast. The nation is worried.
But I would urge everyone to take a deep breath and keep some perspective. The flu kills more than 20,000 people in the United States in an average year – about four times more than the number of Ebola deaths in this outbreak. I’m only noting those numbers to make the case that worrying about Ebola is understandable, but panicking about it is not.
NJHA and New Jersey’s hospitals have been gearing up for weeks as they have watched Ebola spread in West Africa. Fortunately, New Jersey has no known cases of Ebola at this time.
Ebola is not an airborne disease. It can only be spread through direct contact with the bodily fluids of an infected individual. And an individual with Ebola isn’t contagious unless that person is showing symptoms. But Ebola, especially in its advanced stages, can be very contagious in direct contact situations. That’s why isolation precautions and personal protection for healthcare workers is so important.
Our hospitals are on high alert to watch for a potential Ebola case that could come to their facilities and to take immediate action to isolate that individual and implement full precautions to protect their staffs and their communities.
To that end, our hospitals have reviewed all appropriate policies and protocols; identified areas in the hospital that would be used for patient isolation; inventoried supplies including personal protective equipment for employees; and provided training and best practices to staff on patient identification, isolation, infection prevention and use of protective suits.
In addition, NJHA has joined with the state Department of Health in strongly encouraging all New Jersey hospitals to conduct Ebola drills in their emergency departments by Oct. 17. We have been in near-constant contact with the state’s public health officials since Ebola arrived in our country, and we appreciate that access and collaboration. In an emergency response, it’s important that we’re all working from the same playbook in protecting our patients, our healthcare workers and our broader communities.
And speaking of healthcare workers, I want to send a most heartfelt thank you to the nurses, physicians, laboratory workers, EMS personnel and others who have chosen a career of caring for others – even if that care could place them in harm’s way. Not only in this situation, but every day, they put their well-being at risk for all of us.
This Ebola situation is changing every day, every hour in fact. But each new development helps our healthcare system improve its preparedness. Public health officials have learned a great deal from the situation in Dallas, and lessons learned from that initial experience will be used to make our response better – and safer – for both our patients and our staff. Every acute care hospital in the state has the responsibility to be prepared to care for an individual with this virus – and that’s a role we take very seriously.
FRIDAY OCTOBER 3, 2014
Guest blog by Aline Holmes, RN, DNP, Senior Vice President of Clinical Affairs
It’s hard to miss the news reports about Ebola and enterovirus (EV-D68). People are understandably nervous and anxious. But New Jersey residents can rest assured that our hospitals are well prepared to deal with these types of public health threats. In fact, they have been preparing for months, in close cooperation with public health authorities at the Centers for Disease Control and Prevention and the N.J. Department of Health.
Remember that Ebola actually arrived on U.S. soil almost two months ago when Emory Healthcare leaders in Georgia decided to fly in a pair of missionaries who’d gotten ill treating Ebola patients in Africa.
Ebola is not an air-borne disease. It’s spread through fluids – not casual contact – so that helps limit its spread. Here’s how you can protect yourself:
- Wash hands frequently and use an alcohol-based hand sanitizer.
- Avoid contact with blood and body fluids (sweat, vomit, diarrhea, saliva, semen, etc.) of any person, particularly someone who is sick.
- Do not handle items that may have come in contact with an infected person's blood or body fluids.
- Seek medical care immediately if you develop fever and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
The enterovirus is different; it’s an airborne virus, meaning that it can be transmitted through contact with an infected person or by touching objects or surfaces that are contaminated with the virus and then touching the mouth, nose or eyes. EV-D68 likely spreads from person to person when an infected person coughs, sneezes, or touches a surface that is then touched by others. Good hand hygiene is your best defense against getting infected with enterovirus:
- Wash hands with soap and water for 20 seconds, especially after changing diapers. Hand sanitizers are not effective against enteroviruses.
- Avoid touching eyes, nose and mouth with unwashed hands.
- Avoid kissing, hugging and sharing cup or eating utensils with people who are sick.
- Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
- Stay home from work or school if you’re sick or running a fever.
Our hospitals and healthcare providers routinely follow precautionary procedures such as wearing gloves, gowns, masks and other protective gear to prevent spreading infections when caring for patients. All of our hospitals are equipped to isolate patients as needed and help prevent a virus from spreading. And all are well primed by public health officials to be on the watch for Ebola and enterovirus D68, based on many factors including a patient’s recent travels.
Our healthcare system is taking these public health emergencies very seriously. Our healthcare professionals know how to recognize these illnesses. And they know how to care for patients infected with them.
MONDAY AUGUST 18, 2014
Senate President Steve Sweeney has toured some of New Jersey’s hospitals this summer to tout the excellence of healthcare in New Jersey. I was gratified, but not surprised. Why? The measurements are in and they are rock solid:
- New Jersey ranks 9th in the nation for the quality of its hospital care by the U.S. Agency for Healthcare Research and Quality.
- In the most recent rankings from U.S. News and World Report, 21 of the top hospitals in the New York Metro region are actually in New Jersey.
- New Jersey boasts 21 hospitals to achieve the prestigious Magnet award for nursing excellence, one of the highest numbers in the nation.
- New Jersey hospitals met or exceeded national averages in 25 of 26 “process of care” measures, according to the Department of Health’s most recent Hospital Performance Report. Those measures assess how well hospitals adhere to best practices across the industry.
New Jersey healthcare leaders devote a lot of time ensuring that they provide quality healthcare to the patients we serve. It’s the right thing to do for the patient.
I’ve been doing two different tours myself this summer. First, I resolved to meet with every health system leader in New Jersey and every accountable care organization leader. Great things are happening in our state’s healthcare community, and I learn a tremendous amount during these visits. My second tour is a personal health tour, making sure I do the appropriate primary and preventive care visits. So far so good with both tours.
THURSDAY JUNE 19, 2014
My son is graduating from the 8th grade and will enter high school next fall. It’s a major change in our household, and frankly, he’s handling it much better than I am. It’s made me think about change in general, and how difficult change can be for people. Now, consider something as complex as our healthcare system. In that scenario, change becomes an enormous challenge.
But here we are nevertheless, with our healthcare system in the midst of historic change. Much of it is driven by the Affordable Care Act, and some of it is driven by the changing demands of consumers and the growing pressures in the healthcare marketplace. Whether you love or loathe the ACA, virtually all economists and healthcare policy experts agree that change was needed to redesign our healthcare system and ensure its sustainability into the future.
In a nutshell, the changes we seek are: Improved quality of care. Healthier communities. Lower healthcare costs. It’s a pretty simple formula, but achieving it is not simple at all.
For those viewing this change from the outside, some of the differences you’ll see are a growing transition from inpatient care in a hospital to more outpatient care (part of the shift to less costly settings.) Or you’ll see hospitals working in cooperation with physician practices to coordinate care and share data regarding patient care (a move toward greater efficiency.) Or – as we’ve experienced a great deal in New Jersey – you’ll see hospitals merging and affiliating with other hospitals. That promotes sharing of resources and services, gives hospitals access to more capital and gives communities greater access to services that may not always be available from a single hospital.
What’s not as visible behind the scenes is the hard work going on within our hospitals and health systems to adjust to these changing times. Taking care of our communities 24/7/365 is difficult enough without these added pressures of monumental change. I am very impressed with the leadership within our hospitals and health systems and the unwavering focus of their staffs. With one eye on the future, they continue the daily responsibility of caring for their patients. For someone struggling with change, I think I can learn something from their excellent example.