"Time is Tissue"--The 23 Minute Killer of Lakewoodites.

[Brian Essi]

Something very important is getting lost is the ongoing legal, political and financial debate concerning the hospital:

1. Lakewoodites have already died as a result of the cuts at Lakewood Hospital. That's a fact, not an opinion.

2. More Lakewoodites will die as a result of Lakewood Hospital closing. That's a fact, not an opinion.

So I ask supporters of Summers and his ill-conceived plan, how will you explain your vote to the rest of your family when one of your family members dies at the FHC or in the ambulance on the way to another hospital?



Here is an excerpt from Dr. Terry Kilroy's article from April 14, 2015 that supporters of Summers should consider:

"A number of medical issues revolve around what are called “time is tissue” issues. With these problems, the patients need acute hospital interventions in which any delay leads to increased death and debility. These diagnoses include stroke, heart attack, sepsis, low blood pressure, perforated bowel and cardiopulmonary arrest. Any delay is harmful. As currently envisioned, necessary treatments, such as surgical interventions, specialty support or invasive radiologic procedures will not be available at the free standing emergency room and a stop there will only delay definitive treatment. EMS will need to leave the city to get to the nearest appropriate facility, most likely Fairview or Metro Hospitals. Besides the delay in treatment, this will decrease EMS unit availability because of the prolonged turnaround time estimated to be 23 minutes extra going to Fairview Hospital and even longer to Metro or Main Campus CCF. "

http://lakewoodobserver.com/read/2015/0 ... tal-debate

[Bridget Conant]

According to the Cleveland Clinic, IN AN EMERGENCY SITUATION EVERY SECOND COUNTS.

http://portals.clevelandclinic.org/SpecialtiesServices/EmergencyDepartment/tabid/3324/Default.aspx

34,000 West Siders depend on Lakewood Hospital's Emergency Room.

[scott gilman]

Mr Essi: if you have information about Lakewood residents transported by Lakewood Fire a Department I would like to follow up on this by reviewing the patient care reports with our medical director. Any information you can provide me such as patient name, address and date of incident would be appreciated.
Thank you
Scoot Gilman

[Bridget Conant]

Here is the PD coverage of the Fire Department Chief discussing the impact of the hospital closure on the EMS response time.

http://www.cleveland.com/lakewood/index.ssf/2015/03/lakewood_residents_question_ho.html

Once Lakewood Hospital closes, city ambulances will increase the number of trips to hospitals outside the city from about 469 runs per year to about 2,200, Fire Chief Scott Gilman said.

The city estimates the majority of patients will be taken to the new Lakewood family health center's 24-hour emergency department. However, about 45 percent might need hospital care, and they likely would go to Fairview Hospital or MetroHealth Medical Center, both in Cleveland.

Trips outside Lakewood would increase the time an ambulance crew is tied up on a run from about 45 to 55 minutes to Lakewood Hospital to about 73 minutes to another hospital, Gilman said.

[Lori Allen _]

Scott,

Could you please share with us the name of the Medical Director for the Lakewood Fire Department.

Thanks.

[Bridget Conant]

Guess we can forget that 12 minute performance:

http://lakewoodobserver.com/read/2013/09/05/lakewood-hospital-emergency-department-exceeding-goals-patient-expectations

Lakewood Hospital's Emergency Department was recently recognized for an impressive door to provider time - and for exceeding patient expectations.

What is the definition of door to provider time?

The definition of door to provider time is the median number of time between when the patient arrives to the Emergency Department and the time that it takes for a physician or physician’s assistant to make direct contact with the patient.

Lakewood Hospital door to provider time goals:

Scott Hantz, BSN, RN, EMTP, Nurse Manager along with Lakewood Hospital Emergency Room Medical Director, David A. Levine, MD, in the Lakewood Emergency Department noted that all Cleveland Clinic Hospital Emergency Departments have a goal to door provider time of 14 minutes. Lakewood Hospital Emergency Department averaged 12 minutes in February, 11 minutes in March and has continued through the spring and summer in meeting and exceeding its goal times.

“We have streamlined our process in patient registration and have also decreased the time it takes patients to be given a room. By getting patients into their rooms faster, caregivers are able to get in and do their evaluations in a much timelier manner. It is a rare occurrence that patients are required to wait in our waiting room, which is a significant improvement,” said Hantz.

Lakewood Hospital’s goal is to provide quality and excellent care in a timely fashion. There are many factors that determine how quickly a patient can be seen in the emergency department and there is no guarantee that every patient will be seen in less than 14 minutes. The number of patients arriving at any given moment can fluctuate greatly throughout the course of the day, as can the critical nature of particular patients and the care they demand. Patient experience is very important to the entire team and Lakewood Hospital's Emergency Department works constantly to meet and exceed patient experience on a variety of levels.

[Brian Essi]

Ritchie's Letter Terminating Cardio.JPG (85.34 KiB) Viewed 3622 times

ODH-Survey 8-6-14 with plan of correction.pdf

(9.74 MiB) Downloaded 183 times

Chief Gilman,

I understand your sensitivity to the all-important subject that I have raised. Rest assured my post was not directed at the Lakewood Fire Department or any other EMS services transporting to Lakewood. You guys are the heroes in this unfolding tragedy.

I was actually addressing what Bridget later referred to above—the “door to provider” time—that doesn’t start until after your job is done (unless of course you are asked to re-transport and transfer patients to other CCF facilities). Mayor Summers, CCF and LHA as our Lakewood Hospital leadership have put your department and other EMS squads in a jackpot due to changing circumstances and unnecessary cuts that are affecting the door to provider times. Self-serving leadership is to blame for otherwise avoidable death in the hospital.

I look forward to meeting with you (with or without your medical director) at any time you are available.

Just One Example of Death’s Doorstep.

Here is just one example of action by hospital leadership that results in death and debility in Lakewood. Faced with deficiencies brought about their own mismanagement, intentional acts and cost cutting measures, hospital leadership issued a “Plan of Correction” to the Ohio Department of Health (ODH) on February 4, 2015 (see attached) that essentially did 2 things:

1. Voluntarily and intentionally closed a vital life-saving cardiac intervention program.

2. They said they would notify EMS of the closure of the program.

The abandonment of that program did result in death and also cost millions of dollars of revenue to the hospital when the cost of correcting the deficiencies and working with ODH were relatively minor. ODH officials were surprised at leadership’s abandonment of the program under those circumstances.

To make matters worse, their execution of the “Plan of Correction” was so grossly negligent that patients continued to arrive at the Lakewood ER and could not be treated due to the lack of that vital program. Team Health, the outsourced subcontractor that is staffing and operating Lakewood’s ER, apparently was initially given no plan or an extremely poor plan for what to do with the patients arriving in need of acute care. So some patients have been left in the ER essentially untreated waiting until the “transfer” process to other hospitals to be worked out. The “transfer” process continues to result in unacceptable and dangerous delays in care, especially when Main Campus and Fairview are full or would not take the patients.

On May 13, 2015, I attended an LHA Board meeting where Shannon Ritchie and others said that the two major causes for hospital financial losses up until that time were:

1. They claimed ODH terminated the cardio program referred to above (a blatant lie).

2. They claimed the “general announcement” that the hospital was closing had resulted in “misinformation” in the “media” and “confusion” among EMS squads and the public—so the squads weren’t bringing as many patients to Lakewood. The allegation that the “confusion” and “misinformation” was caused by the “media” was another blatant lie---according to the Plan of Correction Lakewood Hospital leadership was to notify EMS of the loss of that program, i.e. it was to tell them not to come to Lakewood.

So Ritchie, et al at the May meeting were essentially throwing our excellent Fire Department (and other area EMS squads) under the bus for a fiasco they had intentionally created to achieve their greed based goals, i.e. They lied and blamed others for being “confused” when it was something they manufactured all on their own.

The cardiac intervention program is only one example of hospital leadership cuts that has led to death.

Hospital leadership has systematically stripped vital personnel and programs under the auspices of “cost-cutting” while they simultaneously cite the resulting loss of revenue as an excuse to cut more to achieve their sinister financial goals and the ultimate closure of the hospital.

The “door to provider” times in Fairview have also been negatively affected by what has happened at Lakewood—there have been reports of log jams and extended wait times at Fairview.

Healthcare is certainly changing in Lakewood….and in Fairview for Lakewood patients.

Indeed, healthcare is changing in a very bad direction for the health of Lakewoodites.

Summers and Lakewood Hospital leadership have chosen monetary goals over human lives---that is a fact, not an opinion. Ken Haber recently told City Council and the pubic that LHA determined “there was a better use for the money”---which of the LHA trustees will explain that “better use” to the families of the wrongful death victims?

Hopefully, Lakewood voters have an opportunity to make a different choice as to how healthcare will change in Lakewood. But our corrupt Mayor, his cronies and his huge corporate partner are working feverishly to prevent the democratic process from deciding our future.

Please recall that Summers’ and hospital leadership’s motto in a top-secret document was: “We don’t anticipate the future, we create it.”

[Brian Essi]

See above, history is repeating itself:

Perhaps this is a good occasion to revisit this thread, which involved some of the same issues.