Explore BMC’s Trauma Annual Report 2012
Explore BMC’s Trauma Annual Report 2012
BOSTON — The spotlight intensifies Tuesday night for Boston Mayor Thomas Menino as he delivers his 20th State of the City address.
There is much speculation about Menino’s political future, following a series of health setbacks that have kept him out of the public eye.
“I know a lot of people will be on the edge of their seats to see what he says and how he says it,” said South Boston City Councilor Bill Linehan.
Linehan echoed sentiments heard across the city in recent months. Menino’s health problems kept him hospitalized for the better part of two months, and still limit some of his activities.
“I think people are going to be looking at his physical appearance as much as what he says,” Councilor Frank Baker of Dorchester said. “I think, like everybody, we’re looking to see not only what the mayor says and what his vision for the upcoming year is, but also his physical, the way he looks, the way he carries himself — if we think that he has it in him for another four years.”
At-Large Councilor and Council President Stephen Murphy had no doubts about Menino’s ability to fulfill his duties.
“You know, I’m one person that sees him pretty regularly,” Murphy said. “He’s doing much better. I think that people’s fears about about whether or not he’s up to the job will be allayed when they catch sight of him and listen to him.”
Roxbury Councilor Tito Jackson agreed.
“He’s looking better and sounding better and very much back to his old self,” Jackson said.
Murphy is first in line if the mayor leaves office early. Murphy expected Menino to use the speech to outline the fiscal challenges facing the city due to potential federal and state funding cuts.
“We need to know where our resources are coming from and how much we’re going to have to spend,” Murphy said. “So I think the mayor will talk about that being his most pressing challenge.”
At-Large Councilor John Connolly expected the mayor to focus on school reform and reducing gang violence, but said it’s what happens after the speech that counts.
“But the real question is will action match the rhetoric,” Connolly said. “And when you are trying to push change in our schools and new approaches on violence, you have to ask yourself will the action follow when you’ve presided over the status quo for 20 years.”
Courtesy of wbur Boston’s NPR Station.
Boston Medical Center sees surplus after 3 years of losses.
Boston Medical Center, the state’s largest safety net hospital, expects to post a modest financial gain for its 2012 fiscal year, reversing three consecutive years of losses.
While it won’t file financial results until next month, the 496-bed teaching hospital managed to eke out “a small but symbolically important operating surplus” of $817,000 for the year ended Sept. 30, chief executive Kate Walsh said Tuesday.
BMC’s net gain, which also reflects profits from investments, is anticipated to be $7.1 million for the most recent fiscal year, she said, citing unaudited data. BMC, an affiliate of the adjacent Boston University School of Medicine, posted an operating loss of $32.1 million and a net loss of $26.9 million — among the largest in Massachusetts — for the previous fiscal year.
Walsh attributed the turnaround to multiple factors, including an increase in federal funding for hospitals that serve large numbers of low-income patients, higher reimbursements from commercial insurers, new billing codes that let government insurers better measure BMC’s range of care, and moves to aggressively cut costs by, among other things, consolidating operations at its South End campus and closing a 12-bed inpatient rehabilitation unit.
“We did this the old-fashioned way — lots of small improvements,” said Walsh, a former chief operating officer at Brigham and Women’s Hospital who took the top job at BMC at the start of 2010. “We think we’re part of the solution to health care costs in Massachusetts.”
Bond rating agencies have also taken note of the improved financial picture at BMC, with Moody’s Investor Service and Standard & Poor’s both boosting their outlook for the Boston hospital from negative to stable. In a report last year, Moody’s public finance group analysts Daniel Steingart and Kimberly Tuby cited the positive impact on BMC of a federal plan that extends supplemental Medicaid funding under a so-called waiver program and changes how hospitals that treat a lot of low-income patients are paid.
The analysts said the improved outlook could be attributed to “the extension of the waiver for three years until June 2014, which provides up to $103 million in annual revenue to BMC, and to the significant progress BMC has made in improving core operating performance.”
Despite the better outlook, S&P analyst Jennifer Soule cautioned that BMC’s operating earnings are heavily dependent on its Medicaid managed care health insurance arm, BMC Health Net Plan, and its “ability to absorb additional funding reductions [is] limited.”
Indeed, while Walsh said BMC is ahead of projections so far for its 2013 fiscal year, ringing up a $700,000 surplus in the first quarter, she stressed that anticipated cuts in funding for Medicare and Medicaid — the government health insurance programs for older and low-income patients — will cast a shadow over the hospital’s finances. Particularly worrisome, she said, is $40 million in potential federal cuts for Medicare, medical training payments, and research programs.
“The risks are real,” Walsh warned. She said almost all Massachusetts health care providers, ranging from rural hospitals to academic medical centers, are likely to be affected by the cutbacks being contemplated at federal and state levels to address budget constraints.
BMC, formed through the 1996 merger of Boston City Hospital and neighboring University Hospital, was forced to close one emergency room and eliminate 200 full-time jobs between 2010 and 2011. Over the past year, it added more than 60 jobs, bringing the workforce to 4,480.
Walsh said another concern for BMC was state legislation passed last year to hold down health care costs, partly by limiting payment increases from health plans to providers.
BMC, which relies heavily on government payers and historically has been underpaid by commercial insurers, could be hurt if the effect of the state’s payment overhaul is to “lock some [hospitals] in the penthouse and others in the basement,” Walsh said.
Robert Weisman can be reached at email@example.com.
© Copyright 2013 Globe Newspaper Company.
*Article Courtesy of Boston.com
In 2011, an average of two people were killed each day — and one person was injured every 11 minutes — in a motor-vehicle crash in Arizona.
Besides the human suffering, the financial toll is staggering: nearly $2.9 billion in economic losses, according to the Arizona Department of Transportation’s 2011 “Motor Vehicle Crash Facts” report.
As a trauma surgeon, I see the devastating impact of unsafe driving every day. The sad thing is that much of the injury and death could be prevented if drivers simply altered their behavior. While seat belts have proven to be a very effective way to decrease death and injury, technological advances and underage drinking have significantly contributed to the increase in crashes resulting from distracted driving.
The epidemic of traumatic injuries in Arizona and across the nation is an enormous public health concern. It also is a major threat to our youth, not just in lives lost but in disability and expense. Unlike heart disease and cancers that predominantly affect older individuals, trauma is a disease that most affects persons in their second and third decade of life. The result is many years of life lost.
The Eastern Association for the Surgery of Trauma Injury Control and Violence Prevention Committee will be reaching out to teen drivers Tuesday at Thunderbird Adventist Academy. Trauma surgeons from EAST will collaborate with representatives from Maricopa Medical Center, Good Samaritan Medical Center, local law enforcement, the National Transportation Safety Board, National Highway Traffic Safety Administration and the Howard University Injury Prevention and Alcohol Research Center for a program that provides an opportunity for students to learn the hazards of distracted driving due to texting and alcohol use.
Nationally, 11 percent of all drivers under the age of 20 involved in fatal crashes were reported as distracted at the time of the crash. While distractions are dangerous to drivers at any age, this age group is particularly at risk because they are a generation who has grown up in an age of multitasking but also lack significant driving experience.
We were all daring teens once, but as parents and communities, we need to send a clear message that driving is not a place for taking risks. EAST’s goal for this outreach activity at Thunderbird Academy is to share the truth with teens about the risks involved with driving — without condescension. If changes in behavior that result from their experience save one life — or prevent one crash — the effort will be well worth the time spent.
Jeffrey P. Salomone is the trauma medical director at Maricopa Medical Center and president of the Eastern Association for the Surgery of Trauma.
Courtesy of azcentral.com
Mayor Thomas M. Menino and the Inspectional Services Department today issued a reminder to Boston residents to prepare for frigid temperatures by making homes weather tight, and ensuring heating systems are running properly and adequately fueled. In the month of December, Inspectional Services received 129 “no heat” calls.
“As temperatures drop in Boston, we’re encouraging residents, landlords and property managers to be proactive in servicing their home plumbing and heating systems,” Mayor Menino said. “We’re also asking neighbors to look out for one another, and to take appropriate safety measures to prepare for the cold. Our 24-hour hotline is always on hand to help with any concerns residents may have.”
As residents brace for winter weather, Inspectional Services encourages both property owners and tenants to prepare by doing the following:
Service Your Plumbing and Heating Systems:
Planned Repairs Are Cheaper Than Emergency Repairs
- Make sure your heating systems are up to code and working properly – minimize the chances of them breaking down
- Do not run out of fuel, try to keep no less than a quarter tank of oil
- Keep service plan handy in case of emergency
- Property owners should have an emergency list of contractors(electrician, plumber and general contractor)
Heat Your Home, Not Outdoors:
Keep the Cold Out
- Close and secure all storm windows and doors
- Install door guards on all exterior doorways
- Apply weather stripping to windows and doors
- Properly insulate all pipes exposed to cold temperatures
- Cover vents
- Disconnect water hose and wrap or cover exposed spigot
- Caulk or putty windows
- Ensure kitchen and bathroom dampers close properly
According to the Massachusetts State Sanitary Code, landlords and property managers must supply functioning heating systems from September 15 through June 15. During this time the temperature of units must be maintained at 68 degrees during the day (7 a.m.to 11 p.m.) and 64 degrees in the evening (11:01 p.m. to 6:59 a.m.). Tenants experiencing problems with heating systems should contact a landlord or property manager immediately. If they are unresponsive, tenants should contact the Inspectional Services Department (ISD) at 617-635-5300 to file a complaint. Complaints made outside normal business hours should be called into the Mayor’s 24-Hour Hotline at 617-635-4500.
In partnership with MassSave, NSTAR and National Grid, Renew Boston provides no-cost energy assessments and 75% off – up to $2,000 – on qualified insulation improvements for households in 1-4 unit buildings. There are no income qualifications and renters and landlords are encouraged to participate. Those interested in learning more about the program should call 617-635-SAVE. For more information regarding home heating regulations log onto: http://www.cityofboston.gov/isd/housing/pdfs/winter.pdf.
City emergency management organizations have compiled a list of personal and home safety tips for cold weather preparation, available at www.cityofboston.gov/cold. The site also acts as a central location for residents filing service requests for cold-weather related issues, including insufficient heat, gas or electric problems, smoke and carbon monoxide detector inspections, and reporting oil truck issues.
The Elderly Commission reminds residents to check on their elderly neighbors. Additional information is available by calling the Elderly Commission at 617-635-4366. The City’s Shelter Commission asks that any resident who sees a potential medical emergency involving a homeless person dial 9-1-1.
As witnesses to the consequences of gun violence on a daily basis and in response to the recent horrific events of December 14th, we feel strongly that a frank discussion of the role of firearms in our society is overdue.
Trauma providers see injuries and deaths due to firearms first-hand. The 16-year-old who will never again move his lower extremities after being shot multiple times will never become a statistic worthy of the media’s attention; his future is limited and punctuated by further suffering due to his condition. Or the 20-year-old shot multiple times in the head whose mother does not recognize him due to the damage to his face as the trauma team fights to save his life. This young man dies despite the heroic efforts of every component of the medical community. Such people come to us on a daily basis and for each one that dies there are hundreds more who are forever altered by sublethal firearm injuries and who go unnoticed by society at-large.
We also witness the collateral damage that gun violence layers on family members, friends, loved ones and the community. This secondary trauma is an underappreciated burden of our gun violence, fracturing families and, in many instances, tearing them apart. The mother who cannot sleep because she has nightmares of her child being gunned down or another parent whose grief is so severe that they can barely eat, or find the energy to take care of their other children. We know parents who are so fearful for the safety of their children that they keep them indoors at all times. Numbness and fear are prevalent effects of gun violence. Members of the community are too scared to go to work or school due to possible gun violence—others have become so numb to the violence that they have accepted it into their daily lives. Surviving victims, family members, peers, loved ones and in some respects the greater community has been rendered helpless and hopeless by gun violence.
We do not want silence on our part to be interpreted as acceptance of the status quo. We insist on a meaningful discussion of the role of firearms in our society. We believe that military grade/assault type weapons and high-capacity ammunition clips that have the sole purpose of taking human life should have no role in a society at peace. The easy access to them by an individual represents an unnecessary and unacceptable threat to our society and to the individuals within it.
Like any viable organization there are among us differing opinions. We, the undersigned, hold with the above.
Peter Burke, MD
Andrew Glantz, MD
Andy Ulrich, MD
Catherine Chen, MD, MPH
Gerard Doherty, MD
Ingrid Erikson, PNP
Jonathan Olshaker, MD
Kate Mandell, MD
Keith Gilliam, LMHC
Kofi Abbensetts, MD
Lisa Allee, LICSW, MSW
Tracey Dechert, MD
Gerald V. Denis, Ph.D
Elizabeth Gibb, RN
Cheryl Melzar, RN
Carole Harris, RN
Kerry LaBarbera, RN
Jordan Spector, MD
Barbara M. Magill, RN
Jillian Perry, MD
Keri Fromm, RN
Renee Rolfe, RN
Amy Peterson, RN
Maura Dickinson, DO
Joseph Pare, MD
Joan Kalaher, RN
Neil Hadfield, MD
Abbas Kothari, MD
Elizabeth Mitchell, MD
Gerri McGee, RN
Michelle Record Contini, MD
Tara Coles, MD
Dena Dwyer, RN
Amy Harrington, MD
Michele Blinn, CNAII
Elissa Schechter-Perkins, MD, MPH
Edward Bernstein, MD
Carl Bromwich, MD
Jeanne Mase, MD
Alexa Kaskowitz, MD
Kristen Olson Lahner
Ronnie Dearden, RN
Nancy Johnson, RN
Daniela Ramirez Schrempp, MD
Shannon E. Bryson, RN, CNOR
Gloria Mendez-Carcamo, RRT
Farnaz Pezeshki, PharmD
Biren Saraiya, MD
Karen Gregory, RNC
Esther K. Choo, MD, MPH
Charlotte Page Wills, MD
Pam Corey, RN, MSN, CHSE
Patricia Seymour, MD, MS
Lia Losonczy, MD MPH
Megan Mickley, MD
Dennis Hsieh, MD, JD
Michele Hollar, RN
Erika Zingmond, RN
Claire Santos, RN
Atsuko Koyama, MD, MPH
Kristen M. Kelley
Rona Tananbaum, Ph.D.
Marie Macomber, Ed.D.
Joanna Horobin MB ChB
Kathy Dardeck, Ed.D., Licensed Psychologist
Jennifer Bodnick, MD
Bronwyn Baz, MD, FAAP
Jennifer Kelley, RN
Tami Ritsema MPH, MMSc, PA-C
Carolyn Stone, Ed. D.
Helen Grace, DO
Catherine Grinnell, RN
Cindy J Scribner, MSN
Joan Brady, RN
Frank Dilworth, RN
Jen Kelley, RN
Patrice Ruelle, RN
Anita Borbely, RN
Rob Elloyan, RN
Renee Miner, RN
Kristen Keaney, RN
Jennifer Lawrence, MSW, LICSW
Katy Corea, RN
Janet L. Orf, RN, MS, ACNP
Tricia Charise, RN, MSN, ACNP-BC
Judith P. McCaffrey, Ed.D
Andrea Forman, RRT-NPS
Patrice Ruelle, RN
Rachel Bender Ignacio, MD
Tracy Bowen, ER Tech
Deborah J. Williams
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Flu season is especially bad in the United States this year, and young children with the flu tend to suffer more than others because they can’t take over-the-counter medications to help relieve their symptoms.
Cough and cold medications can have serious side effects if taken by young children, including a rapid heart rate and convulsions.
“These medications should never be used by children under the age of 4 and only under a physician’s supervision if under the age of 6,” Dr. Bridget Boyd, a pediatrician and assistant professor of pediatrics at Loyola University Chicago Stritch School of Medicine, said in a university news release.
Unable to use medications, parents may feel helpless. But there are ways they can safely relieve their children’s flu symptoms, Boyd said.
Children 3 months to 12 months old should be given warm, clear fluids such as water, apple juice and an oral electrolyte solution such as Pedialyte. Children who are 1 can be given a half to a full teaspoon of honey, which is a natural cough suppressant that helps thin secretions. Children over 6 years old can be given cough drops.
Children of all ages can get relief from a warm mist humidifier or exposure to steam from a shower, Boyd added.
“The best way to protect yourself and your family from the flu is a flu shot. The vaccine provides protection from three different strains of influenza,” she said. “It is possible for you to become ill with the flu more than once a season, so just because you had the flu doesn’t mean you can’t get sick again.”
Along with the flu shot, correct hand washing is another effective way to prevent the spread of the flu. Boyd said parents and children should:
Flu patients should try to cough into a tissue. If that’s not possible, cough into your flexed arm at the elbow. This will help reduce the spread of flu germs.
“Remember, antibiotics do not stop or limit viral infections such as the flu,” Boyd said. “If you suspect your child has the flu, talk to your pediatrician about medications that lessen the symptoms and shorten the duration of the illness.”
For more information, visit the U.S. Centers for Disease Control and Prevention.