From combating the HIN1 flu to protecting drinking water, dozens of health services in Macomb County will be compromised after commissioners today cut $2.1 million from the Health Department.
Beginning in January, the cuts will reduce or eliminate water sampling, immunization clinics, hazardous waste pickups, restaurant inspections and subsidized health care for seniors and lower-income residents, among other services.
Lines at health clinics will grow, and the county’s response to health emergencies, such as an H1N1 pandemic, will be slower and less efficient.
The cuts “are an unreasonable expectation to ask of us,” Health Department Director Thomas Kalkofen told commissioners. “It really puts us in an awkward and untenable position. We have lost the ability to provide services.”
Commissioners, who supported the cuts 22 to four, said the decision was tough but necessary to erase next year’s $15.7-million deficit.
The cuts represent 8% of the Health Department’s budget.
“In the future this is going to get worse, not better,” Commissioner Ed Bruley, D-Mt. Clemens, warned of the county’s growing budget problems.
The four defectors said cuts to public health services were too deep.
“I’m having a hard time with this cut,” Doherty, D-Warren, said. “I’m extremely concerned about public health issues.”
Blue Cross Blue Shield of Michigan has decided to provide a second $6 million grant to the Michigan Health and Hospital Association for research to improve health care quality and patient safety, and to reduce costs.
The Blues made an initial $6 million grant in 2004.
The funding will go to MHA’s Keystone Center for Patient Safety and Quality.
“The MHA Keystone Center projects have already delivered a phenomenal return in improving safety and quality,” said Blue Cross CEO Dan Loepp in a statement.
Most of Michigan’s 144 hospitals have participated in the center’s projects – that include reducing hospital-acquired infections, improving care for mothers and newborns and increasing patient flow in emergency departments.
The Center's projects include reducing hospital-acquired infections, improving care for mothers and newborns and increasing patient flow in emergency departments.
For example, improving quality in hospital intensive care units the past four years have saved 1,800 lives, cut 129,000 hospital days and saved $247 million in unnecessary costs, Blue Cross said.
Hospitals also have saved more than $10 million by reducing urinary tract infections acquired from hospital catheters.
Spencer Johnson, MHA president, said patient lives have been saved by following best practices discovered through the research.
“The Michigan hospitals that participate in the MHA Keystone Center programs have achieved significant, measurable patient safety improvements – errors have been reduced and lives have been saved,” said Johnson in a statement.
What do women want? Henry Ford Health System thinks it knows.
When the new $360-million Henry Ford West Bloomfield Hospital opens next month, it will debut a 16-bed unit for female patients only, hoping to study whether gender-specific floors improve patient care, or at least, make women more comfortable during their hospital stays.
"That's really one of the things we want to test," said Christine Zambricki, the hospital's chief operating and nursing officer. "Is this an unspoken wish and need of our patients right now?"
The all-women's unit is one of many innovations revealed Wednesday by Detroit-based Henry Ford at a preview of its new Oakland County hospital, an expansive 300-bed structure set to open March 15. The stone and brick building is attached to the existing medical center Henry Ford opened in 1975. The new hospital has a ground-floor retail area with small-town style storefronts and a look more in line with the feel of a northern Michigan lodge than a sterile medical building.
Along with its cozy resort-style look and all-private patient rooms, the hospital will have robot-assisted surgery, a one-stop care center to treat seniors with neurological illnesses, and a wellness center with day spa services and personal health coaches.
The female-only unit for Michigan women's health -- a ground-breaker in Metro Detroit, according to Henry Ford officials -- is on the hospital's third floor beside pediatrics and maternity. It will differ from a typical women's health center, where hospitals tend to group women's services, such as maternity and OB/GYN, because it will accommodate women with more generalized medical needs, such as recovering from surgery, Zambricki said.
"We may find women are more comfortable getting out of bed, walking, sitting in a day room" with just other women around, Zambricki said.
Studies show post-surgical patients heal better when they're able to stretch their legs and walk around, she added.
"We may find it's a healthier environment," she said.
While not necessarily a new concept, female-only areas aren't common because most hospitals group their admitted patients according to their illness or medical needs, such as cardiac care or oncology units.
"I haven't heard of any, but that doesn't mean they aren't out there," said Matt Fenwick, a spokesman for the American Hospital Association.
Genders separate until '60s
Gender-specific wings used to be the norm, though, and it wasn't until the 1960s that hospitals integrated their inpatient floors -- placing women alongside men, said Dr. Dee Fenner, director of gynecology at the U-M Health System in Ann Arbor.
Before, men and women were kept separate because hospital beds were arranged in open halls with little privacy. But with the advent of private and semi-private rooms, hospitals began grouping patients according to their illness or complexity of the care to ensure medical expertise is concentrated in one area, Fenner said.
Stays in Henry Ford's female-only unit are optional and won't cost more, hospital officials said. And while the majority of the unit's staff also will be women, men aren't banished from the unit's corridors, where the walls are deep blue with nothing distinguishing the unit as something for women only. Male doctors and visitors will be permitted to see patients there.
In the 1990s, the idea of an all-women's unit -- or so-called "women's pavilion" -- resurfaced after market research showed the majority of family decisions regarding hospitals were made by women, said Dr. Janice Werbinski, a founding president of the American College of Women's Health Physicians and a doctor of obstetrics and gynecology in Kalamazoo.
"Usually if you are able to get the loyalty of the women, the rest of the family will follow," Werbinski said, noting that Borgess Women's Health in Kalamazoo, where she works, is considering an all-women's unit.
But the idea fell largely out of favor by the decade's end as many hospitals realized that having all-women sections wasn't as profitable as anticipated, especially with insurers reimbursing less for medical services. The logistics were also a challenge, because many nurses and hospital staff are trained to specialize in certain medical areas, not to provide general care.
As for any health benefits of women's wards, Werbinski isn't so sure. There haven't been enough women's hospitals or pavilions for researchers to determine their effects, Werbinski said, although, she added, any benefits would likely be minimal.
"I do think it's nice, but I call it sort of window dressing," she said.
Experiment may be tweaked
Hospital officials say they are well-aware of the challenges in grouping different medical needs on one floor but the practice is becoming more common.
And not all female patients who request the women-only unit will be admitted, because doctors may determine they would be better served in another department, Zambricki said.
Rather, she said, the hospital is looking to experiment with the concept and tweak it as needed.
"It's not the 1990s," she said. "We know a lot more about integrated medicine. We know that women respond differently to disease than men."
And does Henry Ford know what men want?
"We are going to start with women," Zambricki said, and depending on how that goes, "we may expand it to men."
