VOLUME 6, ISSUE 2, SUMMER 2007 AN UPDATE FROM SAINT LUKE’S HOSPITAL OF KANSAS CITY 14 Looking Back Saint Luke’s specialty training prepared young residents to deliver advanced care Prepping for a career in medicine was a hands-on task for young doctors at Saint Luke’s Hospital in the 1950s. Specialty training programs prepared young residents— called “house staff” back then—for real-world situations in internal medicine, general surgery, pathology, obstetrics- gynecology, orthopaedics, radiology, and urology. Medical education at Saint Luke’s started in the early 1920s and still thrives today. As part of its mission as a teaching hospital, Saint Luke’s offers 14 residency programs and 13 fellowships. About 105 doctors participate each month. + c. 1956 Doctors in Training Hitting the SPOT Despite autism, third-grader Lauren Hill has a chance at a normal life, thanks to early intensive therapy at The Children’s SPOT Death-Defying Recovery Saint Luke’s specialists helped Tracy Johnson bounce back from a life-threatening car crash Urgent Action New priority care clinic within the Emergency Department puts the focus back on emergencies Saint Luke’s Hospital of Kansas City 4401 Wornall Road Kansas City, MO 64111 Change service requested
Transcript
VOLUME 6 , ISSUE 2 , SUMMER 2007 AN UPDATE FROM SAINT LUKE ’S HOSPITAL OF KANSAS C ITY
14
Looking BackSaint Luke’s specialty training preparedyoung residents to deliver advanced care
Prepping for a career in medicine was a hands-on task for
young doctors at Saint Luke’s Hospital in the 1950s.
Specialty training programs prepared young residents—
called “house staff” back then—for real-world situations in
internal medicine, general surgery, pathology, obstetrics-
gynecology, orthopaedics, radiology, and urology.
Medical education at Saint Luke’s started in the early 1920s
and still thrives today. As part of its mission as a teaching
hospital, Saint Luke’s offers 14 residency programs and 13
fellowships. About 105 doctors participate each month. +
c. 1956 Doctors in Training
Hitting the SPOTDespite autism, third-grader Lauren Hill
has a chance at a normal life,
thanks to early intensive therapy
at The Children’s SPOT
Death-Defying Recovery Saint Luke’s specialists
helped Tracy Johnson bounce back
from a life-threatening car crash
Urgent Action New priority care clinic
within the Emergency Department
puts the focus back on emergenciesSaint Luke’s Hospital of Kansas City
4401 Wornall RoadKansas City, MO 64111
Change service requested
Table of ContentsC O V E R
Hitting the SPOT 4Natalie and Jeff Hill found a way to make play help theirautistic daughter—and give her a chance at a normal life—at The Children’s SPOT
F E AT U R E S
A Death-Defying Recovery 8Last year, a car crash threatened Tracy Johnson’s life. Today, nothing slows her down, thanks to trauma and surgical specialists at Saint Luke’s Hospital
Urgent Action 10A new partnership gives patients priority care and helpsthe Emergency Department focus on emergencies
D E PA R T M E N T S
New & Noteworthy 2New scanner helps cardiologists see inside arteries; SaintLuke’s Hospital is among the nation’s best for reducingpatients’ risks; palliative care professionals enhance patients’quality of life; new treatment for uterine fibroids offers quick, less painful alternative to hysterectomy; and more
Patient Profile 12Home Grown
Erick and Jackson were born deaf and had been abused. But the toddlers’ health—and spirits—are thriving since being adopted into a loving home with the help of Crittenton Children’s Center
Leadership in Caring 13Community Caregiver
As Director of Patient Care Services for Saint Luke’sCommunity Service Clinics, Kaye Darter helps teachpatients to put health care first
Looking Back 14Doctors in Training
Saint Luke’s specialty training prepared young residents to deliver advanced care
I N D E X
1.5 millionNumber of Americans affected by autism,
the fastest-growing developmental
disability in the United States
S E E PA G E 4
3Number of critical care surgeons who
practice at Saint Luke’s Hospital (Fewer
than 700 practice worldwide.)
S E E PA G E 8
40%Percentage of patients who visit Saint
Luke’s Emergency Department with
conditions that aren’t truly emergencies
S E E PA G E 1 0
118,000Estimated number of children in
foster care waiting to be adopted
S E E PA G E 1 2
43,000Number of patients treated at Saint Luke’s
Community Service Clinics last year
S E E PA G E 1 3
Sources: Administration for Children and Families,Autism Society of America, Saint Luke’s CommunityService Clinics, Saint Luke’s Hospital
SUMMER 2007
Saint Luke’s Hospital Leadership
The Right Rev. Barry R. Howe CHAIRMAN
SAINT LUKE’S HOSPITAL
Robert H. West PRESIDENT
SAINT LUKE’S HOSPITAL
G. Richard Hastings CHIEF EXECUTIVE OFFICER
SAINT LUKE’S HOSPITAL
Mark S. McPhee, M.D. CHIEF OPERATING OFFICER
SENIOR VICE PRESIDENT
SAINT LUKE’S HOSPITAL
Saint Luke’s Report Editorial Advisory Board
Candace L. F. McDowell
Mark S. McPhee, M.D.
Edward T. Matheny Jr.
John T. Russell
John D. Yeast, M.D.
Corrine D. Everson
Editorial Management
John C. Francis EXECUTIVE EDITOR
Caroline Millard MANAGING EDITOR
Candice Blackwell PRODUCTION ASSISTANT
Tanya Carson PRODUCTION ASSISTANT
Mark McDonald PHOTOGRAPHER
Wylie Communications Inc. EDITORIAL CONSULTANT
Draw The Line DESIGN CONSULTANT
Advertising and Design
Saint Luke’s Report is published three times a year by Saint Luke’s Hospital Foundation and Saint Luke’s HealthSystem Marketing and Public Relations. Address corre-spondence to 4225 Baltimore Ave., Kansas City, MO 64111.
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“PATIENCE ISN’T A VIRTUE WHEN IT COMES TO
HELPING CHILDREN CATCH UP TO THEIR PEERS.”
Ellen Hockaday
Campaign for the New Saint Luke’s Co-Chair,
Women’s and Children’s Services Committee Chair
Saint Luke’s VoicesDon’t Delay with Delays
Early treatment can keep delays from turning into a lifetime of disabilities for young children
I’ve known about The Children’s SPOT for many years, but I didn’t fully comprehend its
importance until my own granddaughter became a patient there.
She was born with viral pneumonia and spent her first month in the Neonatal Intensive Care
Unit at Saint Luke’s Hospital. Her doctors recognized her illness put her at risk for nerve
problems that might hinder her development. They suggested she get help from The
Children’s SPOT. The center, which is part of Saint Luke’s Health System, offers speech,
physical, and occupational therapy for infants and preschoolers with developmental delays.
Thanks to the therapy my granddaughter
received, she’s now a teenager doing quite well
in middle school. She’s an avid basketball fan
who can recite statistics on her favorite teams
and plays on a team herself.
The Hill family featured in our cover story also
learned how important early intervention could
be when their infant daughter exhibited the first
signs of autism.
We’ve both learned that, with children, there’s
only a brief window of time when you can really
affect a problem.
We are just two of the 5,000 families who have
passed through the doors of The Children’s SPOT
during the past 25 years. Watching the therapists
gently guide and shape their young charges
through the act of play, you have to marvel at the
work they do.
Even the construction workers who helped build the new facility for The Children’s SPOT
turned into admirers. They were so taken with the program—and with the children—that
they donated many hours of labor and started raising money on the SPOT’s behalf.
I can’t imagine another place that could offer more to children who face developmental
challenges. So, if your infant or young child is struggling, don’t wait to get help. The problems
are most treatable right now. +
Bright beginnings As Ellen
Hockaday’s family learned, patience
is not a virtue when it comes to treating
children’s developmental delays.
Fortunately The Children’s SPOT at
Saint Luke’s Hospital could help.
Facing limitationswith hope
When severe illness strikes, patientsand their families can be overwhelmed by physical, emotional, and spiritual challenges. That’s why Saint Luke’sHospital employs a team of caregiversspecially trained to offer hope.
Unlike hospice care, which focuses on the last stages of life, Saint Luke’s palliative care professionals help patientsplan for a future with the highest possiblequality of life. They provide support and guidance in making treatment decisions, communicating with familymembers, reviewing home-care options,and locating community resources forpatients suffering from such life-limitingillnesses as cancer, congestive heart failure,and renal disease.
Saint Luke’s palliative care team members include doctors, a nurse practi-tioner, a social worker, and a chaplain.When necessary, they can call on a physicaltherapist, pain management specialist,respiratory therapist, pharmacist, ordietitian for additional support. +
Bouncing backfrom fibroids
A new minimally invasive treatmentfor uterine fibroids can have patients outof the hospital in 23 hours and back ontheir feet in just a few days—a vastimprovement over the recovery time oftraditional surgical options.
Available at Saint Luke’s Hospital,Saint Luke’s South, and Saint Luke’sNorthland Hospital, the treatment, called“uterine artery embolization,” shrinksfibroids by cutting off their blood supply.
An interventional radiologist inserts acatheter that delivers tiny plastic pellets,which lodge in the arteries leading to thetumors. The procedure is performed whilethe patient is sedated but conscious. Thesmall incision doesn’t require stitches.
“My patients are universally veryhappy with this treatment and its quickrecovery time,” says Ellen Yetter, M.D.,interventional radiologist.
Many women resume light activitiesin a few days, and most are able toresume normal activities in a week to 10 days. Recovery from a traditional hysterectomy typically takes six weeks.
Before recommending uterine arteryembolization, Dr. Yetter evaluates thepatient’s history and an MRI of the pelvisand screens for cancer. The procedure isn’trecommended if the uterus or fibroids aretoo big or if the patient has infection issuesor certain kidney problems. +
Informed consentThink you need a medical degree to
decipher that patient-consent form yourdoctor wants you to sign? Not anymore.
A new, individually tailored form ishelping Saint Luke’s patients better under-stand how a specific cardiac proceduremight affect them.
Launched last fall at Saint Luke’sMid America Heart Institute, the formuses easy-to-read language and graphicsto explain patients’ risk of complications
based on their age, height, weight, currentmedications, lifestyle, and other medicalconditions. A Web-based program calledPREDICT uses several national databasesto create each individualized risk analysis.
“This tool helps us to more accuratelypredict an outcome for each patient andto communicate before the procedure,”says John Spertus, M.D., M.P.H., Directorof Cardiovascular Outcomes Research atSaint Luke’s Mid America Heart Institute.“There are lots of medical risk models,but nothing like PREDICT exists anywhere else in the world.”
Dr. Spertus designed the programafter focus groups helped researchersidentify ways to improve the standardconsent form, which was written at a16th-grade reading level. Patientsreport that the new form, written at aneighth-grade level, is much easier tounderstand and that it decreases theiranxiety before procedures.
The form is now being used for inpatient and outpatient cardiovascularprocedures at all Saint Luke’s HealthSystem hospitals.
“This is an example of the standard of care we’re setting at Saint Luke’s,” Dr.Spertus said. “Millions could benefit.” +
An “A” for patient safety
Patients are safer at Saint Luke’sHospital than at 95 percent of U.S. hospitals, according to an independentstudy of 40 million Medicare patientrecords from nearly 5,000 hospitals.
As a 2007 Distinguished HospitalAward for Patient Safety recipient, SaintLuke’s ranked among the top 5 percent
of hospitals for reducing patients’ risk ofpreventable death, post-operative frac-tures, infections, respiratory failure, andother adverse events. Only 242 hospitalsreceived the distinction; Saint Luke’s hasearned it for three consecutive years.
“This honor is evidence of the skilland dedication of our nurses and doc-tors,” said G. Richard Hastings, CEO of Saint Luke’s Health System. “Weknow patients deserve and expect nothing less.”
More than 34,000 deaths, 206,000safety incidents, and $1.74 billion inexcess costs could’ve been avoided if allMedicare patients had been treated atthe award-winning hospitals from 2003to 2005, according to HealthGrades, thefirm that conducted the study.
HealthGrades researchers analyzedpatient records from teaching and non-teaching hospitals in all 50 states andWashington, D.C. +
New and Noteworthy
2 3
Crystal clear Cardiac patients will now better understand their health risks, thanks to a new
customized form created by John Spertus, M.D., M.P.H., Director of Cardiovascular Outcomes Research
at Saint Luke’s Mid America Heart Institute.
An unprecedented peekinside arteries
Patients’ chances of avoiding a heart
attack just got a big boost at Saint
Luke’s Hospital, thanks to a new
scanner that lets Mid America Heart
Institute doctors see inside blood
vessels without making a single cut.
Saint Luke’s is among only a handful
of sites worldwide to offer the Siemens
Somatom Definition Dual-Energy
scanner. It gives cardiologists a state-
of-the-art view inside arteries and
enables them to examine plaque
deposits that might otherwise escape
detection for years.
In the past, the only way doctors could
see an artery’s interior was with an
angiogram, a procedure that involves
inserting a catheter into the blood
vessel. The old procedure was invasive.
Also, it didn’t allow doctors to determine
what the plaque was composed of and
how stable it was. Unstable plaque in the
walls of the arteries can rupture without
warning and lead to a heart attack.
Seek and find A new scanner will allow Timothy Bateman, M.D.,
and other Saint Luke’s cardiologists to peer inside
patients’ arteries and determine potential problems.
The new scanner requires no cutting,
takes just 20 minutes, and provides
more useful information about plaque
deposits.
“Besides providing a quicker, painless
diagnostic alternative, the technology
will allow us to identify plaque
deposits earlier, reducing costs and
patient risk,” said Timothy Bateman,
M.D., Cardiovascular Imaging Medical
Director. Traditional treatment has
focused on advanced stages of
cardiovascular disease. This disease
causes 39 percent of U.S. deaths each
year and indirectly contributes to 60
percent of all deaths.
Under the direction of Dr. Bateman,
imaging specialists at the Heart
Institute are pursuing an ambitious
research agenda with the new device.
“We’re essentially helping to write
the book on how this technology will
be used in cardiology practice in the
future,” said Dr. Bateman. +
Natalie and Jeff Hill found a way to make play help their autistic daughter—and give her a chance at a normal life—at The Children’s SPOT
Lauren Hill was a lethargic baby. She didn’t want to do
anything. She didn’t try to roll over, sit up, or crawl. But she was a lucky baby, because she had parents with energy
to spare when it came to helping their daughter.
“Where do we start?” Natalie asked.The Children’s SPOT at Saint Luke’s
Hospital was his answer.
A window of opportunity
The Children’s SPOT (Speech,Physical, and Occupational Therapy)treats infants and preschoolers withautism, Down syndrome, cerebral palsy,complications from premature birth,and developmental delays. The facility,which is part of Saint Luke’s Hospital,has 11 therapists who work to developlearning, speech, social, and motor skills
in infants and preschoolers. They provideindividual therapy as well as a develop-mental preschool.
The staff evaluated Lauren at 6 monthsof age and determined she was behind in reaching important developmentalmilestones. She couldn’t lift her head andchest while on her stomach, roll from herback to her stomach, or hold a bottle. Shedidn’t coo or babble.
The therapists worked out a programdesigned to help her learn the skills shewould eventually need for school and fora normal life.
Lauren worked with a physical therapistwho squeaked, rattled, and rolled toys thatwould awaken her curiosity to explore andmove. An occupational therapist usedblocks, balls, and rattles to entice Laurento reach out and grab for objects, whichwould improve her eye-hand coordina-tion. And a speech-language pathologistencouraged Lauren to make sounds thatwould later become language.
Natalie and Jeff reinforced the lessonswith play therapy every day at home.They made sure Lauren got to experiencenew settings and had lots of visual stimu-lation. They took her on dozens of roadtrips and three Caribbean cruises beforeshe was 5. When she was old enough totolerate several hours of therapy, theyenrolled her in The Children’s SPOTDevelopmental Preschool where shecould receive treatment five days a week,50 weeks a year.
“Early intervention can enable manyyoung children with autism to eventuallylead a life with few limitations,” saidJeanette Worthington, Director of TheChildren’s SPOT. Research attests to thebenefits.
One study at the University ofCalifornia-Los Angeles found that almost90 percent of kids who received intensive
Shortly after Lauren was born, herparents, Natalie and Jeff Hill, noticed herhead seemed bigger than other newborns.Their pediatrician determined her headwas growing much faster than it shouldand sent them to a pediatric neurosurgeonwho diagnosed hydrocephalus, a buildupof fluid in the brain. The fluid was dilatingLauren’s ventricles and putting pressureon her brain.
This condition can damage the brainand lead to developmental problems, suchas autism.
“We were in shock. I’d never evenheard of the condition before,” saidNatalie. “We didn’t think about anythingother than getting the pressure offLauren’s brain as soon as possible.”
When she was 1 month old, Laurenunderwent surgery to install a shunt todrain the fluid.
Then the Hills started learning abouthydrocephalus, what to expect, and howto spot problems. Natalie quit her job as a dance instructor to focus full timeon Lauren.
A few months later, they noticed someearly signs of autism.
Lauren didn’t try to speak or make eyecontact and started shaking her hands as ifshe had cramps in her wrists.
Lauren’s neurosurgeon told the Hillsthat she would need behavioral therapy tolearn what other babies might do on theirown, like crawl and walk.
And the window for treatment wasnarrow.
He said the Hills should use the nextfive years to encourage Lauren’s braingrowth and development. After that,autism becomes much more difficult totreat.
“Make sure Lauren gets as much stimu-lation as possible,” the neurosurgeon said.
Hittingthe
SPOT54
Great expectations Natalie and Jeff
Hill, with daughters Lauren (front) and Lily, rein-
forced Lauren’s play therapy with lots of games,
toys, and travel after she showed signs of autism.
76
video she’s seen and is a walking encyclo-pedia of information about animals.
She’s also a whiz on the computer andhas to be pried away from her PlayStationand Game Boy. She takes swimminglessons and dance lessons, plays tennis, andis active in the Girl Scouts. And she andher younger sister, Lily, are “best friends”—most of the time.
There are clinical signs of her progress,as well. Lauren’s recent brain scan was“absolutely normal,” according to her neurosurgeon. Brain mass had filled in thevoids created by the enlarged ventricles.
Lauren scored in the 95th percentile inmath on the Iowa Basic Skills test, which
places her in the “exceptional” category.“Every year, she is more mature and
more independent,” said Natalie.“Can I be a teenager?” asks Lauren.
Her independence will soon bring awhole new set of challenges, but thanks toThe Children’s SPOT, they’ll be the sameones faced by most parents of teenagers.
“We’re not ready for you to be ateenager,” said Natalie. “How about if welet you be a preteen?” +
behavioral treatment in their preschoolyears improved their social, self-help, play,and communication skills. By first grade,almost half were indistinguishable fromtheir classmates.
Pay-off play
Lauren proved the experts right. By kindergarten, Lauren had caught up
to her peers. By first grade, she was able togo to public school.
“The Children’s SPOT changed herlife,” said Jeff.
Lauren is now a lanky third-graderwith finely chiseled features and thought-ful, almond eyes. She remembers every
Autism by the numbersAutism is a complex condition prompting controversy as to itscauses—but there’s universal agreement that it’s on the rise
T H E N U M B E R O F C H I L D R E N
diagnosed with autism has increased
tenfold over the past decade, according
to the Autism Society of America. It
now affects almost 1.5 million Americans
and is the fastest-growing developmental
disability in the country.
Autism occurs in one out of every 150
children, making it more common than
pediatric cancer, diabetes, and AIDS
combined. Boys are more than four times
more likely to have autism than girls.
Signs of the developmental disability
typically appear during the first three
years of life. Autistic children may exhibit
problems interacting or communicating
with others. They may have impaired
speech or motor skills.
There is much debate in the scientific
community as to what causes it. Many
suspect genetics. Others insist it’s an
environmental trigger.
The wide agreement, though, is that it’s
treatable with early, intensive therapy. +
New spot for The Children’s SPOTA cheery new facility expands opportunities forchildren to play their way to a more normal life
O N T H E W A L L of The Children’s
SPOT hangs an illustration of a boy hugging
a spotted puppy. The caption: “Everyone
needs their own spot.”
For infants and children with developmen-
tal delays, this is their spot.
From the crayon-patterned carpet and
puppet stage in the reception area to the
jungle gyms, rock-climbing wall, ball pit,
zip lines, trampoline, swings, and monkey
bars, the new facility was made for play.
Paradise with a purpose
“The children don’t know they are coming
to a hospital; they think they are coming
to play,” said Jeanette Worthington, the
facility’s director.
What looks like a playground to children is
really sensory integration equipment. Lots
of movement and activities help build gross
motor skills. And learning to play together
improves socialization.
The new ADA-compliant facility at 4333
Pennsylvania replaced an aging one nearby.
It increased the number of preschool
classrooms and expanded space for
individual therapy and neonatal ICU
follow-up clinics.
Upgrades from the older operation
include a covered drop-off area and
an indoor playground. Observation
windows let parents follow progress
without disrupting treatment.
To date, the SPOT has helped more than
5,000 children with disabilities and
developmental delays increase their
independence and quality of life. +
Child’s play Children look forward to
therapy at The Children’s SPOT’s new facility.
Gifts totaling nearly $3 million were raised
to build the new SPOT, including more than
$1 million in cash and in-kind donations and
services from construction and labor groups.
Having a ball The young patients at
The Children’s SPOT don’t know they’re coming
to a hospital because most of the therapy
involves play.
“As soon as I was hit, I started praying,‘Lord, I need to be here for my son,’” saidJohnson.
Medics rushed Johnson to a nearbyemergency room, where doctors discov-ered an aortic tear—an injury so severethey transferred her to Saint Luke’sHospital’s Level I Trauma Center.
Blunt trauma had caused a tear in thewall of her thoracic aorta, the large ves-sel that carries blood from the heart tothe body at a rate of five to six liters perminute. Blood flowed between the layersof the aortic wall causing it to balloon.
If this balloon ruptured, Johnson facedlife-threatening internal bleeding.
“Say 100 people get into a wreck andhave injuries like Tracy’s. Only six can beexpected to survive,” said Harry Wilkins,M.D, one of Saint Luke’s Acute SurgicalCare Specialists.
A 6 percent chance
Cardiothoracic surgeon MichaelBorkon, M.D., was called to repair heraorta. Instead of opening Johnson’s chest,Dr. Borkon used a catheter to thread a stentfrom her groin to the site of injury. Thisnew minimally invasive procedure—calledan endovascular stent graft—cut Johnson’shealing time and allowed other surgeonsto address her other injuries more quickly.
“Saint Luke’s is one of the few centersin the region doing this innovative stentprocedure for such injuries,” Dr. Wilkinssaid. “Coming to Saint Luke’s for thisprocedure saved her life.”
Johnson also underwent multiple sur-geries for a fractured pelvis, ribs, and rightarm. Then she spent about two weeks inintensive care under the watchful eyes ofthe trauma and critical care team.
The patient patient
Twenty-one days after the crash,Johnson left Saint Luke’s alive but help-less. She couldn’t stand. Breathingbrought a stab of pain. Her right handwas in a sling.
Johnson had been a vibrant 44-year-old single mother, with a job she enjoyedand a passion for singing. Now she couldn’t leave bed without assistance and relied on her family for every need.
“Some nights I cried,” she said. “Thephysical restrictions were really trying.”
Despite her discomfort, Johnsonpatiently followed the orders of her
orthopaedist, Chris Maeda, M.D. Thatpatience paid off: On Nov. 10, she was inhis office when he told her she could tryto walk.
She reached out to the friend who hadaccompanied her and received her firststanding hug in more than two months.
“It felt real good,” Johnson said.
Step by step
On March 1, Johnson returned to herjob as a social worker with the KansasCity Missouri School District.
Johnson shares her story with herstudents, reminding them how fleetinglife can be. She works with MADD(Mothers Against Drunk Driving). Andshe’s planning a prayer vigil at the site ofthe crash—a site she drives by every day—to celebrate the fact that she’s alive.
“I am so grateful to the Saint Luke’strauma team and to my family and friendsfor helping me survive,” she said. +
Last year, a car crash threatened Tracy Johnson’s life. Today, nothing slows her down,
thanks to trauma and surgical specialists at Saint Luke’s Hospital
On Sept. 2, 2006, Tracy Johnson was driving down Meyer
Boulevard. She was three minutes from her Kansas City home when an oncoming vehicle sped over the median and crashed
into her car. The impact smashed Johnson’s vehicle into another car.
89
Beating the odds Tracy Johnson
sustained massive internal injuries in a car crash,
including a torn aortic artery. Thanks to special-
ists at Saint Luke’s Hospital, she’s back to
work—and back to living.
ADeath-DefyingRecovery
S A I N T L U K E ’ S H O S P I T A L
is a Level I Trauma Center—the highest
level—serving as a referral center for a
four-state region. It offers around-the-clock
specialized emergency care, including
cardiac, neurological, and orthopaedic.
Fewer than 700 critical care surgeons
practice throughout the world—three of
them at Saint Luke’s Hospital. They work
with a team of specially trained nurses,
anesthesiologists, radiologists, and other
critical care staff. +
Care MostCritical
This scenario is common in emergencyrooms nationwide. (See sidebar.) Uninsuredpatients and those with minor ailmentsstrain urban hospitals like Saint Luke’s.Routine care cases create EmergencyDepartment bottlenecks: Overcrowdingincreases patient wait time, and beds areoften scarce for critical patients.
“Largely because of our cardiac andstroke programs, our admission rate isnearly double the rest of the country andour patients are more acute,” said Dr.Scholes. “We need to focus on those whorequire true emergency care.”
She may get her wish, thanks to a newSaint Luke’s Hospital and Swope HealthServices partnership. They recentlyopened a priority care clinic within SaintLuke’s Emergency Department to treatmedical issues that aren’t urgent.
Select care
Designated as a Federally QualifiedHealth Center, Swope Health Servicescares for underserved people regardless of their ability to pay. Swope physicianassistants and nurse practitioners staff the clinic, Swope Health Plaza. It operatesfrom 10 a.m. to 10 p.m., seven days a week.
“Forty percent of patients in theEmergency Department don’t have emer-gency conditions, and a disproportionatenumber are underinsured,” said MarkMcPhee, M.D., Senior Vice President andChief Operating Officer of Saint Luke’sHospital. “This will provide a safety netand integrate them into a system forimmediate and ongoing care.”
Now patients whose ailments aren’turgent will be encouraged to visit theclinic. It will serve the uninsured as well as those with private insurance.
“It allows us to provide the quickest,most appropriate care for everybody,” saidDenise Mogg, R.N., M.S.N., Director of
Emergency Services. “We can bring theminto a community where they’ll receivefollow-up care for eye, dental, and wellwoman exams. Many patients don’t knowwhat’s available.”
Fulfilling a need
Urban areas’ lack of health care fuelsthis crisis: Urgent care is scarce after-hours;many uninsured patients lack access.
“A person suffering strep throat whomakes $5 an hour can’t afford to take offwork,” said Dr. Scholes. “So he ends up inour Emergency Department where we’rerequired to care for him. Many patientsare willing to wait hours for care.”
However, patient surveys show longwaits frustrate patients. Dr. McPhee hopes the clinic will change that.
Before launching Swope Health Plaza,Saint Luke’s tested an urgent care clinicfor six months. It decreased patients’wait times.
“It’s like air traffic control,” he said.“We want to manage the traffic and getpatients moving quickly.” +
10 11
A new partnership gives patients priority care and helps the Emergency Department focus on emergencies
Anoninsured family visits the Emergency Department
seeking care for colds. They ask the doctor to also check a skin rash and refill prescriptions. “Most patients don’t know the
difference between an ER doctor and general practitioner,” said Alie Scholes, M.D., Medical Director of Emergency Services.
“I should be focused on patients with emergencies and life-threatening conditions.”
Urgent ActionCritical caretaker Physicians like Alie Scholes, M.D., hope Saint Luke’s Emergency Department
reform will allow them to focus on the care of the emergency patient.
