Tag Archives: Hospital

Kitsap’s JELLY ROLL BLUES – Part Two: Smiles, Giggles, Tears at Harrison’s Emergency Preparedness BB Meeting

Kitsap’s  JELLY ROLL BLUES – Part Two:  Smiles, Giggles, Tears at Harrison’s Emergency Preparedness BB Meeting

We live in earthquake country.  We’ve jellied to varying degrees in the past and no doubt will again in the future.  So far we haven’t had a quake over magnitude 7.0 and that was in 1949.

More jelly jiggles and Shake, Rattle and Roll are in store for Kitsap County and surrounds.  What are we doing to prepare to take care of ourselves at least 72 hours?

Another quake or natural disaster – such as the last freeze and two day power outage in Silverdale is coming.  I don’t want to repeat the last one where everything we counted on, failed, including the generator and we lived inside where the temperature dropped to 40 degrees over the two days without heat or bi-pap and concentrator.

Smiles, Giggles, Tears at Harrison’s Emergency Preparedness BB Meeting

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“Earthquake activity:

Kitsap County-area historical earthquake activity is slightly above Washington state average. It is 235% greater than the overall U.S. average.

 

On 4/13/1949 at 19:55:42, a magnitude 7.0 (7.0 UK, Class: Major, Intensity: VIII – XII) earthquake occurred 26.2 miles away from the county center, causing $80,000,000 total damage

On 2/28/2001 at 18:54:32, a magnitude 6.8 (6.5 MB, 6.6 MS, 6.8 MW, Depth: 32.2 mi, Class: Strong, Intensity: VII – IX) earthquake occurred 36.5 miles away from the county center, causing $2,000,000,000 total damage and $305,000,000 insured losses

On 4/29/1965 at 15:28:43, a magnitude 6.6 (6.6 UK) earthquake occurred 25.1 miles away from the county center, causing $28,000,000 total damage

On 7/3/1999 at 01:43:54, a magnitude 5.8 (5.4 MB, 5.5 MS, 5.8 MW, 5.3 ME, Depth: 25.2 mi, Class: Moderate, Intensity: VI – VII) earthquake occurred 47.5 miles away from Kitsap County center

On 5/3/1996 at 04:04:22, a magnitude 5.5 (5.2 MB, 5.3 MD, 5.5 ML, Depth: 2.5 mi) earthquake occurred 44.2 miles away from the county center

On 2/14/1981 at 06:09:27, a magnitude 5.5 (5.1 MB, 4.8 MS, 5.5 ML) earthquake occurred 84.8 miles away from the county center

Magnitude types: body-wave magnitude (MB), duration magnitude (MD), energy magnitude (ME), local magnitude (ML), surface-wave magnitude (MS), moment magnitude (MW)”

Read more: http://www.city-data.com/county/Kitsap_County-WA.html#ixzz1CFUSNERU

A few key points from the outstanding and powerful program put on by Pamela O’Flynn, RRT, MBA Respiratory Care Department, Harrison Medical Center and the American Lung Association’s, Better Breathers (BB) caught my attention.  For a super reference booklet – get the 12-month Preparedness Calendar for the full story.

Contact your local hotels/motels for their pet policy.  Next time, should the generator fail us again, we’ll pack up the dogs and head for a dog friendly hotel and drag the bi-pap and concentrator along.

We were told to pack what we generally eat for our 72 hour Comfort Kit – the total opposite of what I used to pack and take in the mountains during the old horse packing and hiking years.   Food that was lightweight, easy to cook and nutritious for the weight was key in what I chose for such trips…not necessarily what I ate at home.

The difference will show up in our bodily functions – “Eat what the body is used to…” And the interesting Poo Bags were mentioned.

The go anywhere toilet kit includes:

  • Waste bag pre-loaded with Poo Powder gelling deodorizing agent.
  • Outer zip-close disposal bag.
  • Natural odor control and decay catalyst
  • 1 hand sanitizer
  • 1 toilet paper

I bought mine online at REI, but they are probably sold locally at any of the sports stores.

Our homes should be earthquake proofed including anchoring furniture to the walls. Laura Jull, CEM, CHSP, Emergency Preparedness Coordinator at Harrison Medical Center, uses Museum Wax to anchor down small items to the shelf.

600 thousand pets were never found or missing after Katrina – no one was prepared for the magnitude of the storm.  A lesson learned there carries over here…and provisions are being made for our pets in case of a disaster.

For those on oxygen, bi-pap, c-pap or concentrators, register to be on a Special Needs list and shelter.  Contact the Fire Department and get on the Power Company list.

Contact your Oxygen Company and ask what provisions they have in place for their clients during a disaster.

Additional information and to get your 12-month Preparedness Calendar:

‘Our Better Breathers support group meets quarterly monthly  in the Rose room at Harrison Silverdale. Please call 360-744-6685 for dates and information. ‘   http://www.harrisonmedical.org/home/calendar/4885

Sheriff Boyer is Kitsap County’s emergency coordinator – I hope he/department will see Pam’s Katrina slide presentation and get her viewpoints based on her real life experiences working in a hospital so badly affected during and after Katrina – as were they all badly affected.  Her hard earned insight should prove helpful for that day coming in our future….in my opinion.

I am still unable to get the photos here from this computer … later

More later… Sharon O’Hara

Smiles, Giggles, Tears at Harrison’s Emergency Preparedness BB Meeting

Greetings:  What I thought would be an easy chat about the need for patients to prepare for a natural disaster has turned out quite the opposite and it won’t be done in one blog post.  This is part One of Two.

Kitsap County got lucky.  Pamela O’Flynn, RRT, MBA Respiratory Care Department Director, Harrison Medical Center has firsthand experience what happens when we’re not prepared for a disaster.  She is a whirlwind force fighting to get all of us prepared as best we can – NOW.

Harrison Respiratory Center’s Emergency Preparedness meeting on Wednesday, 19 January was the most intense learning experience I’ve had in years.  We alternated tears, laughter, even giggles when Pam tried to look disheveled as she shuffled along the wall demonstrating how the exhausted medical staff moved and worked during the Katrina natural disaster and the weeks and months following the good, bad and ugly aftermath of a storm and disaster no one was prepared for as Pam, along with others, lost her home 40 miles inland from the hurricane storm surge.

The good was the bonding of the medical staff and all who worked for the common cause of helping others without supplies to do it.

We sat shocked, saddened and teary as Pam described why Emergency Preparedness was vital for our survival here and briefly described how, during the horrific Katrina disaster they were not prepared for the scope of the disaster.  Pam described how oxygen patients came to the hospital asking for oxygen and she was forced to turn them away knowing their fate without it.  The hospital ran out of what they had…no one was prepared…they didn’t know anything could turn out so badly.  They learned from it and that experience will help us here, now.

We got firsthand glimpses of a hospital and medical providers under siege and unimaginable duress.

On the flip side we got glimpses of powerful bonds forged out of desperate need and innovative creative means to help patients.

Laura Jull, CEM, CHSP Emergency Preparedness Coordinator at Harrison Medical Center was full of vital information and came prepared with essential handouts, including al  12-Month Preparedness Calendar Courtesy of Washington State Emergency Management Division http://www.emd.wa.gov/

Contact respiratorycare@harrisonmedical.org for the packets and specific information.

For starters sign up for emergency alerts and newsletter:

https://www.piersystem.com/go/site/1082/

Kitsap County Department of Emergency Management

KCDEM’s Alert and Warning Sign-Up Page

Following are a few photos.

Hopefully my desktop will work smoothly from here on out – thanks to my husband, the Old Guy.  He spent the past two days trying to get it to work.

More later, including the photos I couldn’t get in…  Sharon O’Hara

COPD, Professor William MacNee Clicked for this COPDer

FLASH

Ref:  Early detection public COPD Spirometry,  World Spirometry Day and World COPD Day

I called our health district yesterday and spoke with  Cris Craig, Kitsap County Health District Public Information Officer.  She couldn’t answer my question about the health department offering free spirometry to the public.  She did say in a cheerful voice she would call in about three weeks with a response.  THAT is good news and she didn’t ask what COPD was – even better..  A hopeful sign and may mean that Spirometry will be offered and made available to the public.  I believe in miracles.

Professor William MacNee and the Royal Infirmary of Edinburgh Scotland, UK website has superb graphics – the best explanation of COPD (Chronic Obstructive Pulmonary Disease) I’ve seen in one place.  His ‘The Latest Trends in COPD Research’ graphically shows why early detection Spirometry is important.

For many of us COPD is an ongoing magnet for other disease, including some really difficult stuff.  COPD and lung disease can be the beginning of a long list of personal medical challenges expanding the patient’s medical disease library.  Whatever needs to happen to avoid COPD in your life get tested for early detection and do whatever is needed to get it done.

My son, Al and I were visiting family in Northern Norway  in1997.  I didn’t know then my 40 year smoking habit was almost over.  And so was I.   I was beginning to feel sick.  The day after this picture was taken, I had to see a Norwegian doctor.  She examined me and prescribed medications for Pleurisy and Chronic Bronchitis.  The medication worked, the pain receded and we were back on schedule.   Within a couple weeks after this picture was taken and five days after returning home, I was in the hospital.

Life as I’d known it was over.

COPD is a friendly disease.  For me, once Emphysema (COPD) got settled in my lungs and got comfortable, she began to invite her Other Stuff Disease buddies for a sleep over.  Trouble is, they stayed over and didn’t go home.  They joined COPD trying to play Havoc with my health and life.

Following COPD was an open lung biopsy and Sarcoidosis – Sleep Apnea – RLS – Psoriasis – Venous Stasis Dermatitis  – Cellulitis – High Blood Pressure – Lymphedema – and  bone-on-bone Arthritis, left hip followed – to name a few.

Early detection Spirometry can stop COPD early – before it’s too late.  Ask your doctor.

This is where it gets tricky.  Health care is a huge problem.  COPD generally  takes twenty years developing before a person mentions symptoms to the doctor and by then about fifty percent of the lungs are destroyed….leading the patient to a long slow smother and the taxpayer choking form the cost.

Offering free Spirometry testing for early COPD detection gives the individual  warning.  If the problem is not genetic, it can be turned around. Telling isn’t enough – SHOW people what COPD can do to them and their families.  Let them meet willing patients who can show and tell… a real reality show.

Exercise works and muscle utilizes oxygen better than flab.  We can breathe better and move easier.  Exercise and understanding COPD gives us a quality of life back – to be the best we can be.  The recumbent trike takes us places we couldn’t easily go without one – fun stuff,  building muscle at the same time. We must keep moving … ask your doctor.

I did not qualify for lung reduction surgery or I would have opted to get it ..not enough good lung and I heard rave reviews from patients who had had one.  One COPDer told me the lung reduction surgery restored his life back to ‘normal’ and lasted about five years before time and COPD danced ahead.  Ask your doctor about it.

Pursed lip breathing training is a must for COPDers – it keeps us out of the panic mode and out of the hospital.  It has for me…and I tested it with my oximeter.Talk to your doctor about pulmonary rehab.  It is never too late to get better through our own efforts…what does your doctor say?

Photo taken by the photographer who traveled with the Trek.  This photo shows me on my recumbent trike flying the  COPD/EFFORTS safety flag and pedaling over Deception Pass with the American Lung Association of Washington’s three day bike ride – the Trek Tri Island.

It was the first time I had been away overnight from my house in seven years – since Harrison Hospital in 1997.  A slow trike rider, it is thanks to the wonderful volunteers who hop scotched me and my trike ahead of the other 200 plus bike riders time after time that enabled me to pedal 50 miles of the 137 mile trip. I felt free again.

Key motivators were the Shortness of Breath Study at the University of Washington Medical Center that I was lucky enough to qualify for and my online support group, EFFORTS.  Proof to me that  educating COPD patients work.

Stroke patient, Mary Griffith and her butterfly and gold star fingernails caught my eye the other day – more about Mary and husband, Doug later)

Kitsap County Health District … Will you be the first county health district in the nation to see the fiscal benefit of early detection Spirometry to protect citizens of ALL ethnic background.

The Kitsap County taxpayer and COPD future could rest in your hands.

Thank you Professor William MacNee for a great COPD informational website and allowing me to use it here.

http://www.efanet.org/activities/documents/WMcNeeLatestTrendsinCOPDResearch. pdf

More later… Sharon O’Hara

Part 4 of 4

Harrison Medical Center Works with DRG/1

What is YOUR Hospital DRG?

“Part 2 deals with the $11,376.32 loss to Harrison after two insurance companies paid $1,100.00 and $5,109.58.
How long can any business survive if they are compelled to absorb such losses?”

I discovered answers from Harrison’s new Patient Financial Supervisor, Christine Warner. Additionally, I learned that Harrison offers deep discounts, and has other programs in place via a “Contractual Allowance.”
Contact them and see what they can do for you.

According to Christine Warner, my DRG is 300 thus accounting for their low Medicare payment reimbursement.

The Tricare reimbursement is based on the Medicare rate of return and other insurances may pay more.

Medicare will also pay more than the hospital charges for other patients with lower numbers helping offset the high numbered patients like me.

As more baby bloomers enter Medicare, Harrison and other hospitals will be hard pressed to cut costs….and, I hope, get more into preventative issues and using patients to help each other.

Something I think would help cut future costs and that is to educate the patient by was of a genetic support group, meeting once a week. The issues are much the same for patients with multiple medical conditions and the emphasis should be on nutrition, and physical fitness. We could invite speakers from around the county…even from among the patients.

I have found a similar mindset among the best professionals I have met and been challenged by all. Patients teach each other and most medical professionals would be happy to help the cause of better health.

To name a few: Yvonne Kerstad with Janice McFarland’s, Body ReForm, Silverdale’s Pilates and Physical Therapy Studio. Yvonne altered many of the exercises to suit my physical condition Yvonne can also address firsthand, exercising pre and post around a hip replacement.

Anna Marx, Kitsap Physical Therapy, Silverdale, is another who thinks outside the circle. She proved to me that I COULD increase the range of motion of my left hip. Additionally, Sara is a recumbent bike rider and entered in the 2010 Seattle – Portland ride

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“Medicare Prospective Payment System

Introduction

The Medicare Prospective Payment System (PPS) was introduced by the federal government in October, 1983, as a way to change hospital behavior through financial incentives that encourage more cost-efficient management of medical care. Under PPS, hospitals are paid a pre-determined rate for each Medicare admission. Each patient is classified into a Diagnosis Related Group (DRG) on the basis of clinical information. Except for certain patients with exceptionally high costs (called outliers), the hospital is paid a flat rate for the DRG, regardless of the actual services provided.

Each Medicare patient is classified into a Diagnosis Related Group (DRG) according to information from the Medical Record that appears on the bill:

• Principal Diagnosis (why the patient was admitted)
• Complications and Comorbidities (CCs – other secondary diagnoses)
• Surgical Procedures
• Age
• Gender
• Discharge Disposition (routine, transferred, or expired)

How it Works

Diagnoses and procedures must be documented by the attending physician in the patient�s medical record. They are then coded by hospital personnel using ICD-9-CM nomenclature. This is a numerical coding scheme of over 13,000 diagnoses and 5,000 procedures.

The coding process is extremely important since it essentially determines what DRG will be assigned for a patient. Coding an incorrect principal diagnosis or failing to code a significant secondary diagnosis can dramatically effect reimbursement.

There are over 490 DRG categories defined by the Centers for Medicare and Medicaid Services (CMS, formerly known as HCFA). Each category is designed to be “clinically coherent.” In other words, all patients assigned to a DRG are deemed to have a similar clinical condition. The Prospective Payment System is based on paying the average cost for treating patients in the same DRG.

Each year CMS makes technical adjustments to the DRG classification system that incorporate new technologies (e.g. laparoscopic procedures) and refine its use as a payment methodology. CMS also initiates changes to the ICD-9-CM coding scheme. The DRG assignment process is computerized in a program called the grouper that is used by hospitals and fiscal intermediaries.

Each year CMS also assigns a relative weight to each DRG. These weights indicate the relative costs for treating patients during the prior year. The national average charge for each DRG is compared to the overall average. This ratio is published annually in the Federal Register for each DRG. A DRG with a weight of 2.0000 means that charges were historically twice the average; a DRG with a weight of 0.5000 was half the average.

Top 10 DRGs
The ten highest volume Medicare DRGs represent about 30% of total Medicare patients. Each of these higher volume DRGs represent from about 2% to 6% of total Medicare volume.

DRG DRG Description % Total Rel Wt

1 127 Heart Failure & Shock 5.99 1.0234
2 089 Simple Pneumonia & Pleurisy Age>17 w/CC1 3.85 1.1447
3 014 Specific Cerebrovascular Disorders except TIA 3.18 1.2056
4 430 Psychoses 3.18 0.9153
5 088 Chronic Obstructive Pulmonary Disease 3.11 1.0067
6 209 Major Joint & Limb Reattachment Procedures, Lower Extremity 2.78 2.3491
7 140 Angina Pectoris 2.33 0.6241
8 182 Esophagitis, Gastroent & Misc Digest Disorders Age>17 w/CC1 2.09 0.7617
9 174 G.I. Hemorrhage w/CC1 2.07 0.9657
10 296 Nutritional & Misc Metabolic Disorders Age>17w/CC1 1.93 0.9313

Note: “CC” signifies a significant complication or comorbidity
Source: Health Care Financing Administration, 1994.
DRG-based Payments
The DRG payment for a Medicare patient is determined by multiplying the relative weight for the DRG by the hospital�s blended rate:…”
DRG PAYMENT = WEIGHT x RATE

Read more: http://pugetsoundblogs.com/copd-and-other-stuff/2010/06/26/harrisons-strength-is-in-her-volunteers-and-staff/#ixzz0s42zrGV0

http://www.ahd.com/pps.html

More later… Sharon O’Hara

Sarcoidosis Support Group

Sarcoidosis Support Group for our area (Sarcoidosis Networking Association) is having a meeting this Saturday, 10 April 2010 from 1:00 pm – 3:00pm in the Mt. St. Helen’s Room at Good Sam Hospital in Puyallup.

Lynn Short asks that we bring our questions and ideas to share with other Sarcoidosis’ites.

Anyone need a ride to the meeting? Let me know.

http://maps.google.com/maps?daddr=407%2014th%20Ave%20SE+Puyallup+WA+98372

Lynn Short, Director
Sarcoidosis Networking Association
5302 South Sheridan Avenue
Tacoma, Washington 98408 USA
http://www.sarcoidosisnetwork.org/

More later…. Sharon O’Hara