restorARTively

Deep within the 117 page 2009 annual report of the Pennsylvania Patient Safety Authority is a sliver of light into what neonatal hospitalized patients face. A study from 2006 at St Christopher's Hospital in Philadelphia on ventilator-associated pneumonias (VAP) is shared. VAPs are a preventable medical error. At St. Christopher's in 2006 after noticing an increased rate of VAPs that were significantly above the national average, the hospital proactively initiated a literature review and collaborated with other pediatric hospitals. Per the report, this "multidisciplinary team implemented a series of revisions to an existing pediatric ventilator bundle to better serve the neonate population." The changes that were implemented addressed standards for oral hygiene of neonates depending on their gestational age at birth, "securing endotracheal tubes using standard procedures, discarding all tubing and circuits from standby ventilators, altering the frequency of vent...

A recent news story highlighted the plight of a newborn boy, Houston, born with a congenital heart defect. The child's defect is known as transposition of the great arteries. For a full term infant with no other anomalies, the typical treatment is a surgical repair in the child's first month of life. It is often rarely diagnosed prenatally. Houston's parent's insurance company designated his birth defect as a preexisting condition. On those terms, it denied the child health insurance coverage the day after the president signed the new health care bill into law. Read the full story here. There are a number of issues and concerns that this story brings up for me. To be able to fully understand my own discomfort for this reality is to figure out what questions I have. I will focus on one now and perhaps share more later. The First Query: Without promoting one side or the other - I am surprised that the pro choice movement would let this slip or that the pro life movement h...

"These are very complex issues, but it is really all about relationships." ~Madeline Albright , first female United States Secretary of State Whether international relations, law building or health care delivery it is all about the relationships. Not only the relationships between insurance companies and the insured, but also between insurance companies and the uninsured, between physicians, between physicians and nurses, between risk managers and the patients who walk through the door. Some of these entities never cross paths in person but they have a direct impact on each other's choices an decisions in medical care. My youngest son spent a full week in the NICU before coming home. The twenty four hour access to their new babies that parents are offered on 8 Ravdin at The University of Pennsylvania NICU allows relationships to be built. Relationships are built between parents and the clinicians, parents and other parents, and especially between parents and their n...