sacramento bee

Case study: Nurses offer cross-language care

Mon, 09 Jul 2007 20:01:35 -0400

Virtually every hospital faces at least some issues in working with immigrants who don't speak English. That's particularly true in states that face a particularly large flow of new immigrants, like California. Hospitals there are responding with new programs to meet the steadily increasing demand.

At UC Davis Medical Center, for example, they're handling the problem by establishing a special program designed to connect bilingual nurses with patients who need them. Under the center's Transcultural Linguistic Care Nurse Program (known as TLC), bilingual nurses conduct admissions interviews, interpret for physicians and work with patients. These nurses add to the medical center's existing capabilities, which include use of hired interpreters, translating phone services and the use of non-clinical bilingual staff members. To date, only five nurses have been assigned to the program, but hospital executives hope to add more.

To learn more about these programs:
- read this piece from the Sacramento Bee

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Calif. nursing shortage looms

Wed, 30 May 2007 20:01:34 -0400

It's hardly surprising, but still sobering. According to new state projections, California could see a shortfall of 12,000 full-time registered nurses over the next seven years if things don't change. This is, in part, because there are far fewer slots in nursing schools than there are interested applicants. Last year, only 11,000 out of 28,410 applicants were accepted into the state's nursing programs. What's more, those that enter the programs often drop out. In fact, a full 25 percent of community college students don't graduate.

To avoid the coming crisis, the state's universities and community college must bring in more nursing students and slash dropout rates, according to a new report. The report recommends that the state offer bonuses to schools where student graduation rates improve. It also suggests that the state boost the number of grants it offers to students who go on to join nursing faculties. The state, which has 230,000 registered nurses, will need 40,000 more full-time nurses by 2014 to meet the state's growing needs.

To find out more about the projected shortage:
- read this Sacramento Bee piece

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Lawmakers question California Medicare audits

Tue, 22 May 2007 20:01:37 -0400

A Medicare auditing firm part-owned by the husband of a U.S. Senator has come under intense scrutiny by the California state legislature, dogged by claims that it's rejecting claims unfairly just to make profits for itself. The company, PRG-Schultz International, is contracted with CMS to examine reimbursements and identify inappropriate payouts. PRG-Schultz gets 30 percent of any overcharges it finds. The California Hospital Association has said that PRG-Schultz is on a rampage, rejecting nearly all of the claims rehab hospitals made for post-knee and hip-rehab care since 2002. What makes this a bit more controversial is that the investment firm owned by the husband of Sen. Dianne Feinstein (D) has a substantial financial stake in the company. Members of California's House of Representatives plan to issue a letter asking CMS to investigate PRG-Schultz's activities in the state. Feinstein has already issued a similar letter. CMS officials, meanwhile, have already come out to defend PRG-Schultz, which they say is simply enforcing neglected regulations.

To find out more about the controversy:
- read this piece in The Sacramento Bee (reg. req.)

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With donations, Sutter bonds get final approval

Mon, 02 Apr 2007 20:01:37 -0400

After months of negotiations, northern California's Sutter Health has gotten final state approval for a $910 million bond issue, but only after the health system agreed to substantial donations to rural hospitals and clinics. Sutter will use $750 million for facility upgrades and new construction, including major expansion of its Sutter Roseville Medical Center and Sutter Amador Hospital. The remaining $160 million will go to refinancing long-term debt at more favorable interest rates. However, to get the approval of the California Health Facilities Financing Authority (CHFFA), Sutter had to agree to sweeten the pot by committing $4 million over the next six years to rural hospitals and $750,000 a year to rural clinics. State authorities now say that they're likely to impose similar conditions on future bond issuers. Sutter had hoped to complete the process last year. However, CHFFA withheld its approval for months more, in part due to urging from unions, who pressed the authority to make sure Sutter passed some of the bond benefits back to the community.

To learn more about the financing deal:
- read this item in the Sacramento Bee

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EMRs not right for healthcare?

Mon, 22 Jan 2007 19:01:35 -0500

In the Sacramento Bee, Dr. Michael Wilkes argues that EMRs won't prove to be as useful as many in the healthcare industry assume they'll be. The primary problem, he says, is that medicine won't benefit from computerization the same way other industries will. "In medicine, our fundamental activity is not stocking warehouse shelves or ordering merchandise from vendors. Medicine involves one human listening to, talking with and examining another."

For more:
- check out this editorial

PLUS: Manoj Jain, M.D. discusses the importance of the doctor-patient relationship. Article

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Sutter officials must pay staff for lockout

Wed, 11 Oct 2006 20:01:37 -0400

The National Labor Relations Board has found that Sutter Roseville Medical Center must pay workers back wages interest after locking them out for four days in 2002. The ruling upholds the decision made by an administrative law judge in 2004. The NLRB finding will affect about 450 workers, each of whom should get an average of $444, for a total payout of about $200,000, according to The Sacramento Bee. Workers, including nurses and operating room techs, had staged a one-day walkout over staffing ratio issues, pay and benefits. After that day, workers were ready to return to their jobs but the hospital kept replacement workers on site for an additional four days. The strike had been backed by SEIU-United Healthcare Workers-West, which has worked to organize workers within Sutter Roseville parent Sutter Health for several years. The move has won praise from nursing organizations, which were extremely critical of the NLRB's recent decision broadening the definition of "supervisor" within health organizations.

For additional info on the dispute here:
- read this article in The Sacramento Bee
- check out the union's press release

UC Davis mulls pharma freebies ban

Mon, 02 Oct 2006 20:01:36 -0400

Jumping on a trend that seems to be gathering momentum, the UC Davis Health System may be the next medical center to strictly limit how much pharma company swag doctors are allowed to accept. Interestingly, the initiative is being driven by Garen Wintemute, an emergency doctor and UC Davis professor, rather than a bioethics think tank or executive board looking to polish its reputation. The effort is also endorsed by many UC Davis medical students.

While the restrictions are only at the proposal stage, the medical center's Pharmacy and Therapeutics committee has recommended that the center:

Ban all gifts, free meals, travel reimbursements or other payback from medical device or pharma companies for attending meetings, or payment for taking part in online medical education.
Stop accepting free drug samples from pharma sales reps, using a voucher system instead to help indigent patients get the medications they need.
Exclude providers with ties to pharma or medical device makers from hospital or medical group committees that buy drugs or devices.

The new restrictions are being considered by the medical center's executive committee. If the executive committee approves the recommendations, UC Davis would be joining Stanford University, Yale University and the University of Pennsylvania, which have already adopted similar policies.

Learn more about the medical freebies issue at UC Davis:
- read this article in The Sacramento Bee

Related Article
As you might expect, MDs reading FierceHealthcare disagree strongly as to whether accepting drug/device freebies is unethical. Letters

UCDMC missed $2.2M in taxes

Thu, 20 Jul 2006 20:01:34 -0400

In an internal review of its finances, UC Davis Medical Center has found $2.2 million in physician benefits that weren't properly taxed dating back to 1994. About 200 doctors never received W-2 forms for such things as continuing-education payroll deductions, insurance coverage and retirement buyouts. The center will have to pay $220,000 in overdue taxes and some docs will owe back taxes, though the three-year statute of limitations has ran out on many of the personal income tax returns.

The tax problems were discovered as UC Davis is in the process of overcoming accusations about improper employee compensation. The center has been accused of not fully disclosing certain perks used to attract top faculty to the public system. UC Davis has reworked its compensation plan and is focusing on greater disclosure of employee pay.

- check out this article from The Sacramento Bee for more

Hospitals challenge retrofitting requirements

Tue, 23 May 2006 20:01:37 -0400

The Hospital industry is running a full court press in California to convince Sacramento that tough seismic retrofitting rules aren't really necessary. Industry lobbyists are arguing that a computer simulation developed by FEMA is a more effective way of predicting possible seismic risks than simple inspections. FEMA's program takes into account variables such as soil conditions, proximity to earthquake faults and the area's history of seismic activity. If the move succeeds, many hospitals in the state will have until 2030 to make changes. Under the current rules, hospitals considered at risk of collapse must be replaced by 2008. California healthcare unions are decrying the proposal, calling it an attempt to "cry wolf."

- see this article from the Sacramento Bee

Poll: Californians support physician-assisted suicide

Tue, 14 Mar 2006 19:01:39 -0500

A new Field Poll finds that the majority of Californians support a bill that would allow terminally-ill patients to end their own lives with a lethal prescription. The bill, drafted by Patty Berg (D) and Lloyd Levine (D), would allow a doctor to prescribe a lethal prescription if a person is found legally competent and declared terminally ill by two physicians. Supporters believe the recent Supreme Court Decision upholding Oregon's physician-assisted suicide law will help attract support for the measure. Many analysts have predicted a wave of such laws around the country in months to come.

- see this article from The Sacramento Bee