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ERs finding better way to get addicts into treatment


As the opioid crisis continues, hospital emergency rooms are developing more effective ways to get addicts into treatment. Hit this link to read what’s happening in Greater Philadelphia.

How to best create ER observation units


Michael Silverman, M.D., and Puneet Chopra, M.D., both partners with Emergency Medicine Associates, discuss how to best create  observation units in emergency rooms to improve patient flow.

They say, among other things, that hospital leaders must find out whether an observation unit  properly aligns with the ER and the wider hospital’s goals, and the space, money and staff a hospital would to need to create such a unit.

Luxury space for rich patients raises questions



The expanding provision of special services for rich and/or VIP patients in hospitals in increasingly class-stratified  America is raising some ethical and practical issues.

Some physicians suggest that VIP services are a harmless way to raise money by $1,000-a-night room charges and big donations by patients happy about  being able stay in parts of hospitals  that are set up like luxury hotels  just for them. At some hospitals, some physicians are even trained to get donations from their, er, guests.

Bu  as this New York Times piece says, some argue that “regular patients lose when hospitals dedicate their best spaces to elite units. One study found that patients in a room with a view of nature recovered faster from gallbladder surgery than those who faced a brick wall. Even having a room with more sunlight has been associated with decreased patient stress and use of pain medications. ”

Hospitals that provide faster care to some well-heeled emergency room patients might hurt other patients

“A doctor in Connecticut surveyed the directors of 32 emergency departments around the state on whether they gave faster treatment to VIPs in their emergency rooms. Most responded, and all but one supported the practice. Regular patients who are well enough wait a little longer, which prompted the doctor to call the practice ‘vaguely unethical but necessary.”’

Partners invading urgent-care-clinic business



Prestigious Partners HealthCare,  whose flagship is the Massachusetts General Hospital, will  open as many as a dozen urgent-care clinics over the next three years, in Massachusetts, in a move that helps highlight the more general moves in U.S, healthcare from inpatient to outpatient services and from the use of very expensive physicians to cheaper nurses, nurse practitioners and physician assistants.

It also poses a threat to nearby, Rhode Island-based CVS, whose drugstores are rapidly adding urgent-care centers. The prestige of Partners’  famous hospitals may take some business away from CVS’s urgent-care centers, which it calls MinuteClinics. It may also lighten the load a bit in some area hospitals’ emergency rooms.

Partners is late to urgent care in Massachusetts. Steward Health Care System, Beth Israel Deaconess Medical Center, Lahey Health, and others are already in the business, either directly or with partners, The Boston Globe reports.

But, The Globe reports, “Partners has advantages in its size and reputation. It is the parent of 10 hospitals, including Massachusetts General and Brigham and Women’s, and has 6,000 doctors, the largest network in the state. It also is planning more urgent care locations than most of its competitors.”

“This is more than a pilot for us,” said Dr. Gregg S. Meyer, chief clinical officer of Partners, told The Globe.  “These are meant to be extensions of availability and convenience for patients. We know we are not always as available as possible for our patients.”







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