Becker's ASC Review

February Issue of Beckers ASC Review

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44 HEALTHCARE NEWS Judge says Texas hospital can end life support for infant By Gabrielle Massoon A judge ruled Jan. 2 that Fort Worth, Texas-based Cook Children's Medical Center could end life-saving treatment for an 11-month-old infant, ac- cording to e New York Times. Tinslee Lewis was born at Cook Children's with a rare heart defect called Ebstein anomaly, chronic lung disease and severe chronic pulmonary hypertension. She requires full respiratory and cardiac support, along with deep sedation to keep her medi- cally paralyzed. Cook Children's has also said the infant is suffering from severe sepsis, the NYT reports. e hospital attempted to invoke Texas' "10-day rule," in November, which gives a family 10 days to transfer a patient aer a hospital decides to end life-sustaining treat- ment. A judge ordered the infant be kept on life support until Dec. 10 and later extended the injunction into the new year. However, on Jan. 2, Tinslee's family's request for an injunction stopping the hospital from ending treatment was denied. e family's lawyer, Joseph Nixon, told the NYT that he filed a notice of appeal and would file a motion for emergency relief ursday aernoon. e hospital agreed not to end life support for a week, allowing Mr. Nixon time to file the motions. Mr. Nixon added that a team is still working to find another medical facility to care for Tinslee. Cook Children's said it contacted over 20 facilities and specialists about continuing Tinslee's care, but none would accept the infant, according to the NYT. Sixteen Texas lawmakers cited Tinslee's case in a December letter to Republican Gov. Greg Abbott, asking him to call lawmakers into session to repeal the 10-day rule. In November, Ken Paxton, the state's attorney general, filed a friend-of-the-court brief that said allowing the hospital to end life support violates the constitutional right to life. n How UMass Memorial cut executive payroll in half By Emily Rappleye U Mass Memorial Health Care led the pack of healthcare organizations in central Massachusetts that cut executive payroll in recent years, ac- cording to a report from the Worcester Business Journal. The Worcester-based health system reduced executive payroll by nearly $15 million, or 52.5 percent, over a period of five years, spanning from 2013-17, according to the report. The report notes that cuts didn't necessarily come from executive paychecks — UMass Memorial President and CEO Eric Dick- son earned almost $2.3 million in 2017. Instead, the health system reduced executive payroll by attrition and eliminating redundant positions. "We wanted a slimmer organization at the top," Sergio Melgar, UMass Memo- rial CFO, told the Worcester Business Journal. "It was very hard to promote anyone to a [vice president] in the organization during this timeframe. If we lost a VP, they were generally not replaced." UMass Memorial made the cuts in response to declining patient discharge counts and other financial pressures like lower Medicaid reimbursement and increasing employee salary and retirement costs. Other healthcare organiza- tions in the region used a similar strategy over the same time period, though UMass Memorial made the largest reductions. The health system does not have more cuts planned for 2020, according to the report. n What millennials' lunch breaks reveal about their expectations for medical appointments By Andrea Park T he ultra-efficient workday lunch break is nothing new, but millenni- als have taken this efficiency to ever more "joyless, ruthless" levels, CityLab reports, highlighting the generation's tendency toward total optimization at the expense of human interaction. Patient experience officers and other hospital and health system leaders can learn quite a bit from the way that millennials have largely phased out the long, luxurious "power lunch" in favor of a 15-minute roundtrip to pick up a pricey, assembly line-made salad that they pre-ordered online and which they will eat while working at their desks. The cohort not only demands ef- ficiency in all unavoidable encounters — eating lunch, undergoing an annual physical — but takes no issue with doing so with minimal human interaction, nor with having to pay a premium for the convenience. It would seem, then, that the ideal medical appointment for millennials would involve online scheduling, check-in at a faceless kiosk, a straightfor- ward and bare-bones clinical interaction and, finally, the ability to pay online, ideally through a specialized app — and all of this in 20 minutes or less. This attitude toward relentless optimization may eliminate "the delicious vaga- ries of consumer choice," per CityLab, but it leaves millennials with more time to spend on the activities they value most and, by fitting around their existing schedules and values, does more than traditional healthcare delivery methods to ensure they continuously and regularly engage with their health. n

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