Hospital administrators in Connecticut who have been involved in the unprecedented streak of mergers and consolidations often tout the financial benefits and efficiencies of such moves. But as the number of independent hospitals in the state dwindles – with more than half of the 29 acute-care hospitals now operating in networks with other hospitals or out-of-state partners – experts and advocates worry that the consolidations will reduce competition in the market and give hospitals more leverage to raise prices. Adding to their concerns is a proposal by a private company to convert four non-profit hospitals to for-profit entities. Several studies, as well as data from the federal Medicare program, suggest that mergers and for-profit conversions may lead to higher prices. But the state has yet to study the impact of mergers on patient pricing, and has no requirement that hospitals try to hold patient charges steady after a merger or conversion. The state also has no comprehensive blueprint guiding hospital configuration or limiting the number of takeovers or networks it will allow.
Four nursing homes have been fined more than $1,000 each in connection with several incidents that included a resident drug overdose and two residents suffering broken bones. Cambridge Manor of Fairfield was fined $1,380 on July 31, in connection with two incidents at the home, according to a citation by the state Department of Public Health. In the first incident, on July 3, a resident was admitted to a hospital as unresponsive and suffering an overdose of opiates, the citation states. A DPH investigation determined that the resident had been given morphine and thyroid medicine by mistake, according to the citation. William Gerrish, DPH’s spokesman, said the resident recovered and returned to Cambridge Manor. In the second incident, on July 12, a resident with anxiety and dementia was left unattended in a wheelchair in the lobby, the citation said.
Major changes are underway at the state Medical Examining Board, in an attempt to reduce long delays in disciplining doctors. The state legislature recently expanded the board from 15 to 21 members to be able to hold hearings more quickly when complaints are filed against doctors. Two board members are now involved earlier in investigations, and physicians now must respond to investigations earlier in the process, said William Gerrish, spokesman for the state Department of Public Health (DPH). Also, the DPH plans to hire a consultant by the fall to conduct a full review of the way complaints against doctors are investigated and adjudicated, Gerrish said. Most visibly, Gov. Dannel P. Malloy has also installed a new chairperson on the board, replacing Anne C. Doremus, a Manchester Republican, with Kathryn Emmett, a prominent Democrat and lawyer in Stamford who worked on Malloy’s transition team in 2010.
When Said Nedlouf’s wife, Mary, was terminally ill with metastatic breast cancer in late 2006, Nedlouf was willing to do anything to save her. He found Dr. Jarir Nakouzi in Bridgeport, a homeopathic doctor who said he could cure Mary’s cancer. During Nakouzi’s treatment of Mary, her husband racked up over $40,000 in charges. The treatment — which involved a variety of pills and supplements and “bioresonance” therapy, a technique that measures electrical activity at the skin—failed. In early 2007, Mary passed away at the age of 42. When he sought Nakouzi’s help, Nedlouf’s wife was “in and out of consciousness,” he said in a recent interview. Desperate for a cure at the time, he “didn’t think much.
Last summer, the state Department of Public Health fined a Danielson nursing home $580 after a resident whose feet were not properly secured to a wheelchair suffered a hip fracture. This January, a Waterbury nursing home was fined double that amount — $1,160 — after an incident in which a resident sustained a cut on the forehead during a fall, while being transferred to a toilet without proper precautions. Similarly, the Lutheran Home of Southbury paid a $615 state fine last spring, after a resident who was supposed to be served a “soft diet” was instead served a meal of ham and carrots and choked to death. Then more recently, in February, the state fined the Paradigm Healthcare Center of Norwalk double that amount — $1,230 — in connection with the death of a resident who choked on food that had been left on a tray at a nursing station. Why the differences in penalties?
At Bridgeport Hospital, “talking bed rails” programmed to speak to patients in the geriatric psychiatric unit are helping to reduce the number of alarms that sound when a patient at risk for falling tries to get out of bed. At the Hospital of Central Connecticut in New Britain, health care professionals are adopting techniques from aviation safety experts to reduce the chances of a catastrophic event happening before a clinical alarm goes off. These are among the many ways Connecticut hospitals are tackling a phenomenon known industry-wide as alarm fatigue. Health care experts worry that medical devices with built-in alarms – such as heart monitors, infusion pumps and ventilators – designed to alert caregivers that patients are in danger could potentially put patients at risk because caregivers are desensitized by the sheer number of alerts and false alarms and fail to respond in a timely fashion. Research shows alarms in intensive care units are accurate less than 10 percent of the time, and 90 percent are false alarms.
Solutions for combating alarm fatigue range from alarm integration technology that sends alerts to a caregiver’s telephone to the development of a new generation of “smart alarms,” including ones designed to monitor multiple vital signs.