Among more than 71,000 employees, Iowa hospitals have countless examples of amazing people doing outstanding work.  Each year, IHA honors some of those employees as Iowa Hospital Heroes.  In the coming weeks, IHA will share the stories of our 2009 Iowa Hospital Heroes.  Below is our Hero for this week: 

Edra Fouts
Stoddard Care Coordinator
Iowa Methodist Medical Center, Des Moines

At the John Stoddard Cancer Center at Iowa Methodist Medical Center, Registered nurse Edra Fouts makes a difference in the lives of her patients and their families on a daily basis. From the first day she arrived at Stoddard, Edra did everything possible to make sure her breast cancer patients received the best care possible.  She cares for each and every one of them with her whole heart.

Recently, Edra spent several hours at the end of her day with a dying patient to help write cards to the patient’s three children and mother for special events (birthdays, Mother’s Day, graduations). Edra didn’t think twice about spending countless hours with the patient to make sure the cards were finished.

Somehow, Edra still finds time to dedicate herself to a number of other projects, including Pink Saturdays, a free mammogram screening partnership; serving on the Polk Metro Breast Cancer Committee; traveling to Washington, D.C. to lobby for breast cancer implants for her patients; serving as a Komen for the Cure board member for one year; facilitating a multidisciplinary breast cancer conference; and mentoring new Stoddard Care Coordinators. Edra has also made herself available for countless presentation requests on breast cancer, traveling to area businesses, churches and leadership groups to share her knowledge.

Edra is a Hospital Hero because of her endless dedication to her patients and in the fight against breast cancer. Watching patients who have become friends pass away from the disease is not an easy thing to do. But Edra strives to do everything possible to make sure her patients are receiving the best care and support they need to fight cancer. She never thinks twice about giving of herself and is truly an amazing nurse, friend and hero.

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After nearly 14 hours of debate, the U.S. House voted 220-215 to pass H.R. 3962 the Affordable Health Care for America Act.  The final vote took place around 11:30 p.m. Saturday night in the nation’s capital.

The bill required 218 votes to pass and achieved 220 with one Republican, Representative Joseph Cao (R-LA) voting “aye.”  Cao’s vote was unexpected, though does help push forward claims of “bipartisan negotiations” as desired by Democrats as Cao now joins Senator Olympia Snowe (D-ME) as the two Republicans now having voted “yes” on health care reform legislation. 

Cao refused to talk with reporters following the vote, but later released a statement indicating that he had garnered a deal with the White House concerning disaster relief in Louisiana should he vote yes on the measure.  Cao said, “Today, I obtained a commitment from President Obama that he and I will work together to address the critical health care issues of Louisiana including the Federal Medical Assistance Percentage crisis and community disaster loan forgiveness, as well as issues related to Charity and Methodist Hospitals.”

Although 39 Democrats voted no, in Iowa, all Democratic members, Congressmen Dave Loebsack, Leonard Boswell and Bruce Braley voted for the bill while Republicans Tom Latham and Steve King voted no.

Two amendments were considered, one offered by Congressman Bart Stupak (D-MI) which added language to the bill strengthening the section concerning abortion, limiting payment for abortions using federal health reform dollars to only those pregnancies caused by incest, rape or danger to the life of the mother.  This controversial amendment helped garner more votes for the overall package from conservative-leaning Democrats, while infuriating many members including the Democratic Women’s Caucus and other pro-choice Democrats in both chambers.  The amendment now adds an additional roadblock while moving toward final negotiations on the bill.

The other amendment was an “amendment in the nature of a substitute,” containing language that would strike the entire bill and replace its language with the Republican substitute bill.  The measure failed.

The final affirmative vote in the House is certainly a step forward in the health care debate but the process is long from over.  The battle now turns to the Senate where the Democrats are unsure as to whether or not they have the 60 votes needed to pass their bill, as Senator Joe Lieberman (I-CT) has expressed disappointment over the bill and has indicated he would join a Republican filibuster attempt should the bill be brought to the floor as is, leaving Democrats at least one vote shy of passage.

Remaining unresolved are the controversial issues of insurance mandates, tax increases and the public option.

Moving forward, the Senate will now attempt to pass its stand alone bill, following its action, both bills will need to be “reconciled” in Conference Committee with members appointed by Majority party leadership in both chambers.  However, Congressional leaders have also been working on methods aimed at skipping the conference committee process and working together to craft one bill between both chambers that would to go to the president.  The Senate is expected to move forward in the coming weeks, with hopes of sending a final bill to President Obama before the Congressional holiday break.

IHA is moving forward cautiously with health care reform, and continues to work with Iowa’s Congressional Delegation to ensure hospital concerns remain top priority in continuing discussions.

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Featuring hospital and health care headlines from the media and Web from October 31-November 6.

Iowa Headlines

Hospice workers get life out of caring for dying
Joyce  Hutchison continues to use her passion and years of experience to educate others about the benefits of hospice. Part of that is overcoming fear. Going to hospice won’t make patients die any sooner, she said.  (November 4, Des Moines Register)

Genesis will demonstrate da Vinci surgery system
Da Vinci offers a precise, minimally invasive procedure for hysterectomies and prostatectomies. Patients benefit with a faster recovery time, shorter hospital stay, less pain, less scarring and quicker return to normal activities.  (November 5, Quad-City Times)

Harkin asks big insurers to explain rate practices
Sen. Tom Harkin said this week he was launching an investigation into health insurance pricing, asking four major insurers to justify their pricing practices.  An industry spokesman called the move unfair and misguided.  (November 4, Des Moines Register)

U.S.  Headlines

Costs at urban hospitals may get extra scrutiny in health bill
As Congress struggles to rein in health care costs as part of its sweeping reform efforts, hospitals in New York City and other urban areas that provide some of the most expensive care are among the primary targets.  (November 2, New York Times)

Health bills aim a light on doctors’ conflicts
As part of the health care overhaul under consideration by Congress, lawmakers have included so-called sunshine provisions intended to shed light on the financial relationships between the medical industry and doctors.  (November 3, New York Times)

Program will monitor Maryland doctors’ hand-washing
State officials said this week they’re creating teams of staff members at hospitals around the state to secretly monitor their colleagues’ hand-washing habits as part of a first-of-its-kind program. The monitors will contribute to a systemwide report on hand-washing, using $100,000 in federal stimulus money.  (November 3, Associated Press)

Texas lawmakers try to give doctor-owned hospitals a dose of help
Texas House members are mounting a late effort to delay new limits on physician-owned hospitals, putting them at odds with Democratic leaders who think the facilities drive up health care costs.  (November 5, Dallas Morning News)

Nurses union reaches deal on H1N1 safety in U.S.
The H1N1 pact, announced on Monday as part of a contract settlement between the California Nurses Association and Catholic Healthcare West, averted a one-day strike threatened by thousands of registered nurses at more than 30 hospitals.  (November 2, Reuters)

Hospitals make slow progress in harnessing the ‘social’ aspects of social media
Hospitals’ current social media activties can be classified across to five major areas: brand management, real-time public relations, volume generation, non-marketing functions and community building. But only a small amount of hospital activity in the social media space could be described as “social.”  Rather, the majority of these efforts are either one-way “monologues” or bounded two-way conversations with little staying power.   (October 31, iHealthBeat)

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The issue of geographic payment disparity in the Medicare program is once again in the headlines, and it’s good news for Iowa that this fight continues to be fought. 

As many Iowans know, our state’s hospitals spend far less (and receive far less) Medicare funds than most other states.  The Dartmouth Atlas of Health Care has documented that higher-spending hospitals and states are not providing any better care and, in fact, much of that extra spending is simply wasted.  The White House and much of Congress is in agreement, and this is making some high-spending hospitals nervous, the New York Times reports: 

The issue pits hospitals in more rural states like Iowa and Minnesota, where spending tends to be lower, against those in areas like New York City and Los Angeles, and revolves around a question that has bedeviled the medical establishment for decades: how much money do hospitals need to provide adequate care for patients…

Urban hospitals are countering that they serve poorer, sicker patients.  But that does not explain why similar hospitals – such as highly regarded academic medical centers in urban areas – have extraordinary differences.  Take a look at the table below (this information all pertains to Medicare patient averages during the last two years of life): 

Hospital	Physician visits	Medicare spending	Days in the hospital
Barnes-Jewish Hospital (St. Louis)	61	$63,281	27
Cleveland Clinic	63	$55,333	24
Hospital of the University of Pennsylvania	72	$80,727	31
Johns Hopkins Hospital	57	$85,729	29
Massachusetts General Hospital	75	$78,666	29
New York-Presbyterian Hospital	83	$91,113	39
UCLA Medical Center	101	$93,842	32
UCSF Medical Center	63	$78,046	22

 

These hospitals all happen to appear at the top of U.S. News & World Report’s “Best Hospitals” list and they all serve very urban populations.  Yet the differences are stark and raise many questions.  Why, for example, are patients spending 10 more days at UCLA Medical Center then its sister institution in San Francisco?  Why are 26 more physician visits needed at New York-Presbyterian than Johns Hopkins? 

Now, just for perspective, here are the numbers for Iowa’s major medical centers, along with the overall U.S. average: 

Hospital	Physician visits	Medicare spending	Days in the hospital
Alegent Health Mercy Hospital	58	$40,831	20
Allen Memorial Hospital	47	$39,386	18
Covenant Medical Center	57	$41,998	18
Finley Hospital	56	$38,696	19
Genesis Medical Center	58	$39,964	25
Iowa Methodist Medical Center	66	$44,068	25
Jennie Edmundson Memorial Hospital	65	$40,357	22
Mercy Hospital	47	$31,229	20
Mercy Medical Center-Cedar Rapids	52	$36,590	20
Mercy Medical Center-Des Moines	73	$42,091	24
Mercy Medical Center-Dubuque	47	$32,403	16
Mercy Medical Center-Mason City	43	$37,920	14
Mercy Medical Center-Sioux City	57	$42,272	22
St. Luke’s Hospital	50	$37,263	20
St. Luke’s Regional Medical Center	59	$37,581	19
University of Iowa Hospitals & Clinics	51	$48,427	24
U.S. Average	70	$52,838	25

 

One last thing:  Though it’s convenient from a media perspective, this is not necessarily an urban vs. rural issue.  There are, as the tables above show, urban hospitals that are providing value to the Medicare and there are rural facilities that are extreme outliers when it comes to Medicare spending.  The point is it is time for Medicare, as a health care consumer, to seek out and reward value – wherever it is found.

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Among more than 71,000 employees, Iowa hospitals have countless examples of amazing people doing outstanding work.  Each year, IHA honors some of those employees as Iowa Hospital Heroes.  In the coming weeks, IHA will share the stories of our 2009 Iowa Hospital Heroes.  Below is our Hero for this week: 

Sharon Ferguson
Registered Nurse
Mahaska Health Partnership, Oskaloosa 

Sharon Ferguson has been employed at Mahaska Health Partnership (MHP) in Oskaloosa for a little more than a year, but she has already made a tremendous impact.  Sharon has been a nurse for 36 years, working in many different arenas before landing her current position as Diabetes Educator for MHP Community Health.

Sharon spent many hours of her own time learning everything she could about the diabetes disease process. In a short amount of time, she has established great partnerships with many professionals and her relationship building efforts have allowed her to offer free blood glucose screenings at the local Hy-Vee pharmacy on two different occasions, screening more than 150 people and providing valuable information regarding diabetes maintenance and follow-up care.

Sharon started a free monthly diabetes support group in January and already has an average of 20 people attending. She organized and offered Diabetes Wellness in

Self-Management Education (WISE) classes, which currently boasts 39 participates completing the 10-hour classes. Thanks to her leadership and persistence, the Diabetes WISE program recently received certification from the American Diabetes Association.

Many patients and community members have benefited from Sharon’s wealth of knowledge and the compassionate care she gives to every individual, treating each person like family. Sharon has integrity, always placing her patients’ needs first.  Recently, she heard about a co-worker’s elderly neighbor who was traveling 30 miles to receive free diabetes supplies and offered to make a home visit to see how she could assist him.

Sharon whole heartedly deserves this award for exemplifying honesty, integrity, humanity, courage and commitment. She has worked through many obstacles throughout her endeavors and continues to persevere in her personal mission to educate the community about diabetes and help prevent some of the devastating complications it can cause when left unchecked. She has used her talents and expertise to improve our organization and the health and well being of our community. She truly is a living hero.

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