Disturbing videos posted online paint a grim picture on how hospitals seem to be struggling to deal with bodies as they battle against the wave of coronavirus patients.

Repeat Signage software allows nurses and hospital reception staff to easily update waiting times, clinical and ward patient lists and promote wider hospital services and care

The hospital-at-home model could help coronavirus patients who need sustained medical supervision but don't need to be admitted into a hospital.

Call them victory anthems. Every time a patient with COVID-19 is well enough to be discharged, hospitals in New York and elsewhere play songs of celebration over the intercom. A doctor explains.

Call them victory anthems. Every time a patient with COVID-19 is well enough to be discharged, hospitals in New York and elsewhere play songs of celebration over the intercom. A doctor explains.

When doctors are given N95 masks but the nurses who frequently come into contact with sick patients do not, you know something's wrong.

An anonymous reader quotes a report from NPR: As hospitals were overrun by coronavirus patients in other parts of the world, the Army Corps of Engineers mobilized in the U.S., hiring private contractors to build emergency field hospitals around the country. The endeavor cost more than $660 million, according to an NPR analysis of federal spending records. But nearly four months into the pandemic, most of these facilities haven't treated a single patient. Public health experts said this episode exposes how ill-prepared the U.S. is for a pandemic. They praised the Army Corps for quickly providing thousands of extra beds, but experts said there wasn't enough planning to make sure these field hospitals could be put to use once they were finished. "It's so painful because what it's showing is that the plans we have in place, they don't work," said Robyn Gershon, a professor at New York University's School of Global Public Health. "We have to go back to the drawing board and redo it." But the nation's governors -- who requested the Army Corps projects and, in some cases, contributed state funding -- said they're relieved these facilities didn't get more use. They said early models predicted a catastrophic shortage of hospital beds, and no one knew for sure when or if stay-at-home orders would reduce the spread of the coronavirus. "All those field hospitals and available beds sit empty today," Florida Gov. Ron DeSantis, a Republican, said last month. "And that's a very, very good thing." Michigan Gov. Gretchen Whitmer, a Democrat, said: "These 1,000-bed alternate care sites are not necessary; they're not filled. Thank God." Senior military leaders also said the effort was a success -- even if the beds sit empty.

Read more of this story at Slashdot.

Hospitals need to supply oxygen to more beds than is currently possible, so doctors are searching for hacks.

Netcare St Augustine's and Netcare Kingsway hospitals have been given the green light to reopen.

At a cost of $7.5 million a patient, they were 16 very expensive field hospitals. Yet, according to NPR, those hospitals are now “stand[ing] down.” You probably remember them from headlines early in the pandemic: makeshift medical centers being assembled at breakneck speed by companies contracted by the Army Corps of Engineers in anticipation of…

The post After Treating Barely Any Patients for a Massive $7.5 Million Each, 16 Emergency COVID Hospitals Are Standing Down appeared first on The Western Journal.

(George Mason University) The team's work supports evidence-based decision making, informed by models, to rethink and facilitate hospital operations during the pandemic.

(Michigan Medicine - University of Michigan) Now, as hospitals across the country start to return to doing non-emergency operations that keep their beds full and their books balanced, they need to think carefully about what resources each of those procedures will need as the pandemic continues. A new guide could help them prioritize and plan. Created by poring over seven years' worth of data from 17 common operations in dozens of hospitals, it's available for free for any hospital to use.

The mothballing of Britain’s Nightingale hospitals, some of which have yet to treat a single covid-19 patient, has raised questions about whether resources to fight the pandemic were...

Deborah J. Wexler
Feb 1, 2007; 30:367-369
BR Epidemiology/Health Services/Psychosocial Research

Ontario reported its lowest new COVID-19 case count of the week on Saturday with 346 new confirmed cases of the virus. Meanwhile, the government has issued an emergency order allowing school board employees to be voluntarily redeployed to hospitals, long-term care homes, retirement homes and women's shelters.

CNA Staff, May 4, 2020 / 12:01 pm (CNA).- The Congregation for the Doctrine of the Faith has ordered 15 psychiatric hospitals in Belgium which belong to the Brothers of Charity to cease identifying as Catholic institutions after they allowed the euthanization of patients in 2017.

The hospitals are managed by a civil non-profit corporation with the same name as the Brothers of Charity religious congregation which owns them.

The CDF decision was communicated in a letter dated March 30, stating that "with deep sadness" the "psychiatric hospitals managed by the Provincialate of the Brothers of Charity association in Belgium will no longer be able to consider themselves Catholic institutions."

In a statement responding to the CDF's decision, the superior general of the Brothers of Charity, Br. René Stockman, said that "with a heavy heart" the religious congregation "must let go of its psychiatric centers in Belgium."

Br. Stockman pointed out that it is "painful" that the psychiatric centers of the Brothers of Charity in Belgium have lost their Catholic status, considering also that the brothers "were among the pioneers in the field of mental health care in Belgium."

At the same time, Stockman said he recognizes that "the congregation [the Brothers of Charity] has no choice but to remain faithful to the charism of charity, which cannot be reconciled with the practice of euthanasia on psychiatric patients."

The decision by the Vatican's doctrinal office ends three years of disputes between the Brothers of Charity and the corporation which manages their hospitals in Belgium.

In 2017, the board decided to allow euthanasia to be carried out in its hospitals in Belgium, where the euthanasia law is among the most broad.

At the time of the decision, the board of the corporation was composed of 15 members, with only three of them religious brothers of the congregation. 

Two of the three religious brothers among the board members, Luc Lemmens, 61, and Veron Raes, 57, supported the euthanasia decision. Their terms on the board ended at the end of September 2018 and were not renewed.

The religious congregation, especially Stockman, protested the decision, reiterating the Brothers of Charity's rejection of euthanasia in their hospitals.

The brothers appealed to the Vatican, which asked the psychiatric hospitals to change their protocol allowing euthanasia as “a medical act” under certain conditions.

The hospital management responded with a long statement in September 2017, in which it contested a lack of dialogue and maintained the hospital was "perfectly consistent" with Christian doctrine.

The CDF's direction that the hospitals must no longer identify as Catholic was communicated in a letter signed by CDF prefect Cardinal Luis Francisco Ladaria Ferrer and secretary Archbishop Giacomo Morandi.

The letter retraced the developments of the story, recalling that the document allowing euthanasia in the brothers' hospitals "refers neither to God, nor to Holy Scripture, nor to the Christian vision of Man."

According to the letter, the CDF had spoken with the Brothers of Charity and had also informed Pope Francis of the gravity of the situation.

Other audiences had also taken place beginning June 2017, including with the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life, the Secretariat of State, the representatives of the Brothers of Charity and the managing corporation, as well as representatives of the Belgian bishops' conference.

The Holy See also sent Bishop Jan Hendriks, auxiliary of Amsterdam, as an apostolic visitor, but he did not register any steps forward nor a desire to find "a viable solution that avoids any form of responsibility of the institution for euthanasia."

The request of the CDF to the Brothers of Charity and to the managing corporation was clear: “affirm in writing and in an unequivocal way their adherence to the principles of the sacredness of human life and the unacceptability of euthanasia, and, as a consequence, the absolute refusal to carry it out in the institutions they depend on."

The corporation "did not give assurance on these points."

The CDF therefore reiterated that "euthanasia remains an inadmissible act, even in extreme cases," and strengthened the statement by citing St. John Paul II's 1995 encyclical Evangelium vitae, and a Jan. 30 speech by Pope Francis to the CDF.

The CDF stressed that "Catholic teaching affirms the sacred value of human life," the "importance of caring for and accompanying the sick and disabled," as well as "the Christian value of suffering, the moral unacceptability of euthanasia" and "the impossibility of introducing this practice in Catholic hospitals, not even in extreme cases, as well as of collaborating in this regard with civil institutions."

The Brothers of Charity is a religious congregation of lay brothers founded in 1807 in Belgium, whose specialization is care for the sick and those with psychiatric diseases.

At the congregation's July 2018 general chapter the group stressed that the Brothers of Charity "believes in sacredness and absolute respect for every human life, from conception to natural death. The general chapter requires that each brother, associate member and others associated with the mission of the congregation adhere to the doctrine of the Catholic Church on ethical issues."

Changes in resident work hours are believed to have an impact on resident education and patient safety.

This study provides an understanding of the impact of changes in resident work hours on the staffing strategies of children’s hospitals. (Read the full article)

Clinical guidelines for the evaluation of suspected physical abuse in young children emphasize performing radiologic imaging to screen for occult fractures. Little is known about the degree of adherence to guidelines for screening for occult fractures among pediatric hospitals.

Adherence to guidelines related to screening for occult fractures in young children diagnosed with physical abuse varies significantly among pediatric hospitals. Use of screening in infants who have injuries associated with a high likelihood of abuse also varies among pediatric hospitals. (Read the full article)

Previous studies suggest that hospitals under the greatest financial strain may be more prone to adverse events because they have limited resources to invest in quality and safety.

The patient population served, rather than hospital category, best predicts measured quality, underscoring the need for robust risk adjustment when incentivizing quality or comparing hospitals. Thus, problems of quality may not be systemic across hospital categories. (Read the full article)

In the era of widespread conjugate vaccine use, the prevalence of bacterial meningitis has declined. However, the impact of this decline on the rate of emergency department visits for viral meningitis and cost of caring for these children is unknown.

There was a decline in the rate of diagnosis of viral meningitis in US children’s hospitals between 2005 and 2011. Most children diagnosed with viral meningitis are treated with antibiotics and are hospitalized, accounting for considerable health care costs. (Read the full article)

Clinically significant bleeding in pediatric immune thrombocytopenia (ITP) is rare. Evidence-based guidelines for the management of pediatric ITP recommend that patients with mild or no bleeding be followed with observation alone.

Many pediatric patients with newly diagnosed ITP continue to be managed in the inpatient setting. Bleeding events are rare in this setting. Although geographic variability exists, intravenous immunoglobulin is the most commonly used inpatient ITP treatment in the United States. (Read the full article)

Electronic health record (EHR) uptake by US hospitals has been slow, including among children’s hospitals. The Health Information Technology for Economic and Clinical Health program, which began in 2011, offers incentives for adoption and meaningful use of EHRs.

Using an annual survey, we evaluated how children’s hospitals have progressed in EHR adoption from 2008 through the start of the Health Information Technology for Economic and Clinical Health program and assessed their ability to meaningfully use EHRs. (Read the full article)

Hospitalizations under observation status are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied.

Children’s hospitals use observation status with great variation. Resource utilization for pediatric patients under observation status overlaps substantially with inpatient-status utilization, calling into question the utility of segmenting pediatric patients according to billing status. (Read the full article)

Diabetic ketoacidosis (DKA) is a short-term complication of type 1 diabetes and is a major cause of preventable hospitalization in children. Hospital resource utilization and readmission rates for DKA across the US are not known.

Readmission for DKA within a year of hospitalization is common, accounting for one-fifth of all DKA admissions. Resource use, hospital length of stay, and readmission rates vary widely across major US children’s hospitals, even after adjusting for hospital differences in patients. (Read the full article)

Over the past 10 years, children’s hospitals increasingly have established pediatric palliative care programs, but little is known about the prevalence of these programs or their geographic distribution, range of services offered, staff composition, or funding.

Among the 162 hospitals that responded to this survey (71.7% response rate), 69% have a pediatric palliative care program, with substantial variation across programs in terms of how they are staffed and funded and what services they provide. (Read the full article)

Tonsillectomy is one of the most commonly performed surgeries in children and is one of the most cumulatively expensive conditions in pediatric hospital care. Little is known about how the quality of tonsillectomy care varies across hospitals.

In a large cohort of low-risk children undergoing same-day tonsillectomy, there was substantial variation in quality measures of process, dexamethasone and antibiotic use, and outcome, revisits to the hospital within the first 30 days after surgery. (Read the full article)

Congenital heart disease is known to be a commonly treated and resource-intense condition across children’s hospitals, yet knowledge regarding the degree of cost variation across hospitals and associated factors is lacking.

Using a linked clinical and administrative data set, we establish benchmarks for hospital costs for common congenital heart operations, and demonstrate wide variation in cost between hospitals related in part to differences in length of stay and complications. (Read the full article)

There is substantial variation in the medical care provided to pediatric patients across diverse clinical settings. This variation raises concerns about whether every patient is receiving optimal care and whether more standardized approaches around clinical decisions are needed.

We observed wide variation in admission rates for common pediatric conditions across US children’s hospitals. Our findings highlight the need for greater focus on the standardization of decisions regarding hospitalization of patients presenting to the emergency department. (Read the full article)

Antibiotic overuse is common and is a major public health threat. The prevalence of antimicrobial stewardship programs in children’s hospitals is growing. Single-center studies reveal that antimicrobial stewardship programs are effective in reducing unnecessary antibiotic use. Multicenter evaluations are needed.

Antibiotic use is declining overall across a large network of freestanding children’s hospitals. Hospitals with formalized antimicrobial stewardship programs experienced greater reductions in antibiotic use than other hospitals, suggesting that these interventions are an effective strategy to address antibiotic overuse. (Read the full article)

Hospitalized pediatric patients are often exposed to many medications during an inpatient admission. Drug–drug interactions may increase the risk of developing medication-related adverse drug events, leading to serious clinical morbidity and mortality.

Exposure to "major" potential drug–drug interactions occurs in 41% of pediatric hospitalizations in children’s hospitals. One-half of all these exposures were due to less common specific drug pairs (≤3% of patients exposed per hospital day) and thus may be less clinically familiar. (Read the full article)

Meaningful use (MU) incentive payments have been developed to encourage adoption and use of electronic health records (EHRs). Several studies have revealed children’s hospitals have unique barriers to the use of EHRs but were relatively early adopters of information technology.

Although a minority of children’s hospitals have succeeded with MU incentives, freestanding children’s hospitals are significantly more likely to succeed. Improvement of EHRs for pediatric use should focus on information exchange, quality reporting, and MU relevance to pediatrics. (Read the full article)

Distribution of infant formula discharge packs to breastfeeding mothers is common practice in maternity care facilities in the United States. Receiving discharge packs is associated with shortened exclusive breastfeeding duration. Many efforts have been made to discourage this practice.

From 2007 to 2013, there has been a marked reduction in distribution of discharge packs containing infant formula to breastfeeding mothers in hospitals and birth centers in the United States. (Read the full article)

Given the efforts to decrease the use of ionizing radiation in pediatric patients, there is significant variability in head computed tomography (CT) scan use in pediatric emergency departments for minor head trauma.

This study characterized variability in CT scan rates for all body regions in emergency department, observation, and inpatient encounters across 30 tertiary pediatric hospitals. Two-fold variation remained after case-mix adjustment, with higher volume hospitals having lower rates of CT scanning. (Read the full article)

Penn State Health has enrolled its first COVID-19 patient into an experimental treatment program called convalescent plasma therapy.

It is crucial that all children are provided with high-quality and safe health care. Pediatric inpatient needs are unique in regard to policies, equipment, facilities, and personnel. The intent of this clinical report is to provide recommendations for the resources necessary to provide high-quality and safe pediatric inpatient medical care.

Katherine H. Burns
Oct 1, 2010; 126:638-646
ARTICLES

Penn State Scranton recently donated personal protective equipment (PPE) to two local hospitals, Geisinger Community Medical Center and Commonwealth Health Moses Taylor Hospital, to help them during the growing coronavirus pandemic.

Amid a spurt in coronavirus cases in the national capital, the Delhi government has roped in three more private hospitals with a total of 150 beds to treat COVID-19 patients.

Kerala has flattened the coronavirus curve 100 days after the first case was confirmed, state Finance Minister Thomas Isaac tweeted Saturday morning, adding that there were only 16 active cases in...

SHORT messaging services (SMS) on mobile phones will be restored in Jammu and Kashmir Tuesday midnight, the 150th day since the government suspended it in the erstwhile state.

Both hospitals had further enhanced their disinfecting and decontaminating programmes of all facilities on their premises. Doctors would be again be consulting from their rooms as from Monday.

Farhan Akhtar recently won the hearts of fans as a result of his generous donation to hospitals in India

LAHORE: A sharp increase in confirmed Covid-19 cases across Punjab has further burdened state-run health facilities, taking their bed occupancy ratio to 54 per cent.

The rate increased during the last two weeks or so due to widespread transmission of the virus.

Official figures reported by the health department portray a grim picture as 3,693 people contracted the virus during the last seven days in the province.

Punjab had reported around 3,686 positive cases for the virus during a period of one month starting from March 15, when the first Covid-19 case was spotted.

Most of the confirmed patients were taken care of in Lahore where the 1,000-bed Expo Centre Field Hospital is housing 450 patients, with 45pc bed occupancy.

Ratio may touch 80pc in two weeks

Similarly, the Mayo Hospital houses 420 patients (70pc bed occupancy) while the Pakistan Kidney and Liver Institution 100 patients (100pc bed occupancy).

The health authorities believe that this percentage is likely to reach 80pc in coming two weeks if cases continue to grow at the same rate.

The Pakistan Medical Association (PMA) is very much concerned over the increasing number of coronavirus patients and rising death toll.

“We are extremely disturbed that how our hospitals would mange the load of corona patients in future because of the scale of transmission of the virus,” said PMA Secretary Dr Qaisar Sajjad.

He said the government would have to revisit the current health system in order to remove flaws and create more space for coronavirus patients, keeping in view the future requirements.

While sharing the fresh report, a spokesperson for the Primary and Secondary Healthcare Department said Punjab reported a record 961 confirmed cases of the virus on Friday and it was the highest figure in a single day so far since the pandemic surfaced in the province.

“The government has allocated 7,753 beds for the corona patients at all the teaching, district and other field hospitals across the province,” he said. Of them, 4,239 had been occupied by the patients.

“We have 6,744 beds for corona patients at all the teaching and field hospitals that fall under the specialised healthcare and medical education department in Punjab,” SH&MED Additional Secretary (development) Nadir Chattha said.

He said 3,370 of them were allocated in teaching hospitals and 3,374 at field hospitals. Of the 6,744 beds, he said 2,261 (34pc) had been occupied by the patients.

“We are going to make available 984 more beds in coming days,” he said.

Of the total admitted patients, Mr Chattha said 40 were in a critical condition, with 34 of them on ventilators. He said so far 186 corona patients had died in Punjab.

On the other hand, of the total 961 confirmed cases on Friday, 488 were reported from Lahore which was also another record number (of people testing positive) in the provincial capital in just a day. Of them, 87 were reported from Gujrat, 77 from Rawalpindi, 60 Faisalabad, 45 Multan and 67 from Muzaffargarrh besides some other cities.

The total number of confirmed cases in Lahore and Punjab rose to 3,856 and 10,033, respectively, on Friday.

Surprisingly, the health department said only one patient died (in Muzaffargarh) of coronavirus in Punjab during the last 24 hours.

Published in Dawn, May 9th, 2020