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Arizona to Lose 20 Percent of Family Residencies
John C. Lincoln (JCL) Health Network and Mayo Clinic recently announced that after this year they will no longer accept new residents.
- JCL will close its program at the end of the academic year in June 2009. At that time, the program's four third-year residents will have either completed the program or will continue in the family practice clinic for a few weeks of additional training. The eight remaining residents who are either in their first or second years of training will transition to other programs. JCL will help these residents relocate to other programs, even providing financial assistance to those who must move out of state.
- Mayo Clinic has announced that it will no longer recruit residents for its family medicine residency program. The 16 residents currently enrolled in Mayo's Family Residency program will finish their residencies at Mayo.
JCL and Mayo Clinic both cite lack of funding as a primary reason for discontinuing their respective programs. Arizona’s hospitals receive some state and federal support for their residency programs through the Graduate Medical Education (GME) program. However, these funds support inpatient training and the majority of family medicine training is in the outpatient setting.
“Arizona has historically been successful in recruiting residents to these primary care programs and roughly 60 percent of those trained in Arizona stay in the state to practice,” says Michael Grossman, MD, MACP, associate dean for graduate medical education, University of Arizona College of Medicine, Phoenix Campus, in partnership with Arizona State University. “Losing primary care residents means we ultimately stand to lose primary care physicians.”
Although the number of physicians in Arizona has increased, the supply has not kept pace with the state’s population growth. While the number of practicing physicians in Arizona increased 10 percent from 2004 to 2005, the physicians per 100,000 population ratio increased by only 6 percent to 219 per 100,000 population. This is well below the national average of 293 per 100,000 population.
The JCL and Maoy program closures reduce the number of Arizona family practice residency programs to five.
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Joint Commission Requests Feedback on NPSGs
The Joint Commission is in the process of revising its National Patient Safety Goals (NPSGs). Revisions are scheduled to go into effect January 2010 and will not include any new NPSGs. The objective is to ensure each existing goal is:
- deserving of its status as a NSPG;
- relevant to safety and quality;
- written clearly;
- written in language specific to the field; and
- applicable to the organization seeking accreditation/certification.
Comments are invited from healthcare professionals working in the following categories:
- ambulatory care;
- behavioral healthcare;
- critical access hospital;
- disease-specific care;
- home care;
- hospital;
- laboratory;
- long-term care and Medicare/Medicaid certification-based long-term care; and
- office-based surgery.
To comment, visit: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/.
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EPA Issues Proposed Rule for Incinerators and Pharmaceutical Waste
The Environmental Protection Agency (EPA) has published a proposed rule revising emission standards for hospital, medical and infectious waste incinerators. The proposed standards would require all 57 such incinerators in operation to reduce their emissions. The EPA will accept comments on the proposed rule through Feb. 17, 2009. In addition, the EPA is accepting comments through Feb. 2, 2009 on a proposed rule for hazardous pharmaceutical wastes, which applies to pharmacies, hospitals and other healthcare facilities. The rule would classify hazardous pharmaceutical waste as universal waste, a category which currently includes batteries, mercury-containing equipment, lamps and pesticides.
The EPA’s proposed rule on incinerators is available at http://edocket.access.gpo.gov/2008/pdf/E8-27732.pdf. The proposed rule on hazardous waste may be viewed at http://edocket.access.gpo.gov/2008/pdf/E8-28161.pdf.
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AZ Among States With Highest Rates of Uninsured Children
Arizona is one of five states with more than 15 percent of children who are uninsured—compared to the national median of 9.2 percent. This is according to Left Behind: America’s Uninsured Children, a report issued Nov. 25 by Families USA. The report states that there are 8.6 million uninsured children in the U.S. Of those, 278,000 children in Arizona (16.1 percent)—or one in nine—are uninsured. Other study findings include:
- Uninsured children come from working families. The vast majority of uninsured children (88.2 percent) come from families where at least one parent works and more than two-thirds of uninsured children (68.5 percent) live in households where at least one family member works full-time, year-round.
- More than half (60.4 percent) of the nation's uninsured children come from low-income families (families with incomes below twice the poverty level, or $35,200 for a family of three in 2008) who are likely eligible for Medicaid or the Children’s Health Insurance Program (CHIP).
- Besides Arizona, the four other states with the highest rates of uninsured children are Texas, Florida, New Mexico and Nevada.
- The five states with the largest number of uninsured children are Texas, California, Florida, New York and Georgia. Together, the uninsured children in these five states account for nearly half of all uninsured children in the country (48.3 percent). Arizona ranks eighth on this list.
The report is available at http://www.familiesusa.org/assets/pdfs/uninsured-kids-2008/national-report.pdf.
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Joint Commission Reports Gains in Hospital Care Quality
Hospitals have steadily improved the quality of care provided to patients over the past six years, according to a report issued recently by The Joint Commission on Nov. 24. Improving America’s Hospitals: The Joint Commission’s Report on Quality and Safety 2008 tracks how consistently Commission-accredited hospitals perform certain recommended treatments based on quality measures reported by the Hospital Quality Alliance. Between 2002 and 2007, hospitals’ overall performance on the measures rose to:
- 96 percent from 86.9 percent for heart attack care;
- 88 percent from 59.7 percent for heart failure care;
- 89 percent from 72.3 percent for pneumonia care.
In addition, the hospitals showed continual progress on the surgical measures and most of the hospitals consistently complied with The Joint Commission’s 2007 National Patient Safety Goal requirements.
Graphs on each specific performance measure, by state, are available at http://www.jointcommissionreport.org/safetyperformance/qualityandsafetyperformancedetail.aspx. The full report may be found at http://www.jointcommissionreport.org/.
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JCL Receives State Quality Award
The Arizona Quality Alliance announced on Friday, Dec. 5 that John C. Lincoln Deer Valley Hospital has received the 2008 Pioneer Award for Quality. This recognition honors organizations that have established and deployed fundamental quality systems within their operations, attaining high levels of performance excellence service. The annual Arizona State Quality Awards Program recognizes Arizona organizations for performance excellence. The program criteria, modeled after the Malcolm Baldridge Award, provides not only an opportunity for recognition, but also valuable feedback on an organization’s position on the quality continuum.
The awards will be presented on Tuesday, Feb. 10, 2009 at the Chaparral Suites Resort in Scottsdale. Applications for the 2009 program will be available in Feb. 2009. For more information, visit www.arizona-excellence.com.
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ASU College of Nursing Receives IHS Grant
The Indian Health Services (IHS) has awarded a $1.7 million, five-year grant to the Arizona State University (ASU) College of Nursing & Healthcare Innovation to continue the American Indian Students United for Nursing (ASUN) Project. IHS awarded the initial ASUN grant in 1990 when ASU was the only college of nursing to be awarded a grant for a baccalaureate program.
ASUN is designed to support students, as well as to focus on American Indian health issues through both the nursing program curriculum and clinical opportunities. Post-graduate service with IHS is required for all recipients. IHS projects the shortage of American Indian nurses in the United States to increase dramatically from its current 19 percent, in part due to the median age of 47 for American Indian RNs.
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Project C.U.R.E. Seeks Donations for Belize
Project C.U.R.E. (Commission on Urgent Relief and Equipment) has committed to donate $1.6 million (wholesale) in medical supplies and equipment to assist Belize’s families and children. Project C.U.R.E. is requesting consumable supplies and working medical equipment, both new and used, and will send volunteers to pick up these items at hospitals able to donate. Project C.U.R.E. needs:
- OB/GYN: cribs/bassinets, birthing beds and infant incubators, warmers and ventilators;
- Operating Room (OR): anesthesia machines, OR tables and lights; electrosurgical units; adult and infant ventilators, bedside monitors (all types), pulse oximeters and surgical microscopes (basic units);
- Diagnostics: ultrasound machines, standard and portable x-ray units (including c-arm x-rays) and EKG machines;
- Laboratories: analyzers (all kinds – major and minor chemistry, blood, etc.), centrifuges (hematocrit and laboratory), microscopes; lab incubators and scales, CD 4 machines for AIDS testing; and
- Surgical Instruments: scalpel handles and blades; retractors (large and small), scissors (Mayo and Metzenbaum), needle holders (medium and large) and kocher clamps.
Project C.U.R.E. also needs volunteers to help sort, pack and ship medical supplies and equipment.
More than 30 Arizona hospitals have contributed medical equipment and supplies that would otherwise have been discarded to Project C.U.R.E.—a nonprofit humanitarian relief organization that collects and donates medical supplies as well as equipment to clinics in need of medical relief. C.U.R.E. Clinics operate in Bolivia, China, Ghana, Guatemala, Kenya, Rwanda, Togo and other developing countries throughout the world.
For more information about Project C.U.R.E., contact Michael Medoro at 480-262-7328 or michaelmedoro@projectcure.org or visit www.projectcure.org.
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Webinar: IRS Form 990
The Internal Revenue Service (IRS) has proposed sweeping changes to the Form 990, which is filed by almost all tax-exempt organizations, including hospitals. Due to these changes, hospitals may need to modify information gathering procedures and corporate policies. To help hospitals navigate these changes, the Arizona Hospital and Healthcare Association (AzHHA) is hosting a Webinar—Redesigned IRS Form 990: What Your Organization Needs to Know—from 9 to 10:30 am on Wednesday, Dec. 17.
The Webinar is geared toward CEOs, CFOs, business office directors and audit committee members. Faculty members are from the Exempt Organization Tax Services group in Ernst & Young LLP’s National Tax Department. Registration is $200 per connection for AzHHA members. This includes one telephone and Internet connection. Numerous people at a single site—with one computer and one Internet connection—may participate with a single registration. However, if participants at a site require more than one computer and telephone connection, additional registrations are required. For those who register, but have team members who are unable to attend, CD recordings will be available for purchase for an additional $50.
To register, visit www.azhha.org/educational_services and click on Education Events. Questions? Call 602-445-4356 or e-mail edservices@azhha.org.
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West Valley Hospital Names New CEO
Abrazo Health Care has appointed Jo Adkins as CEO of West Valley Hospital in Goodyear. Adkins most recently served as CEO of Sun Health Del E. Webb Hospital in Sun City West. Prior to that she was senior vice president and chief operating officer for Memorial Medical Center in Springfield, Ill. and at St. Joseph’s Mercy Hospitals and Health Services in Clinton Township, Mich. Adkins has a master’s of science degree in nursing from Indiana University and a bachelor of science degree in nursing from Eastern Kentucky University. In addition, she completed a post-graduate fellowship at the J & J Wharton Fellowship in Nursing Program.
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MIHS Names New Chairman and Elects New Vice Chairman
Bil Bruno has been named chairman of Maricopa Integrated Health System’s (MIHS’s) governing board, which oversees Maricopa County’s public health system. Bruno, an insurance professional, will lead the five-member board. He has served on the MIHS board since Maricopa County created a special healthcare district for Maricopa Medical Center in 2003. Bruno has served on AzHHA’s Patient Safety Steering Committee since 2006.
Susan Gerard, former director, Arizona Department of Health Services, has also been elected as MIHS’s vice chairman.
Three new members also were sworn into the MIHS board:
- Greg Patterson, Scottsdale;
- Elbert “Bick” Bicknell, Wickenburg; and
- Alice Lara, Phoenix.
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Weekly to Become Insider
Look for AzHHA’s new publication, the AzHHA Insider, beginning in 2009. This newsletter will replace the Weekly and will still include the same timely information and articles, but will be issued every other Friday, as opposed to every Friday. A series of telephone interviews and a readership survey of Weekly recipients revealed that members value the publication, but they recognize there are other AzHHA communications vehicles, such as the daily publication, Health-E-News, that keep them informed of healthcare news. Look for your first edition of the AzHHA Insider on Friday, Jan. 9, 2009!
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