The Cook County North Shore Hospital might be adding a new level of expertise to its roster of services – paramedics providing advanced life support on ambulances. On Thursday, February 18, 2010, the hospital board authorized Administrator Diane Pearson to apply for an advanced life support license.
Sometimes a patient needing to be transported by ambulance to Duluth needs a higher level of care than can be provided by the EMTs (emergency medical technicians) who currently staff the ambulance service. Finding a nurse—or sometimes a doctor— available to accompany the patient can be very difficult.
In a January 11 letter highlighting the problem, Sawtooth Mountain Clinic physician Michael Sampson appealed to the hospital board to support the creation of an on-call transport team for critically ill patients.
“At this time we have no consistent and immediately available transport team to ship these critically ill patients,” Sampson wrote. “Our current system at best raises a level of anxiety in every transport situation and at worst can negatively impact the quality of care to our patients here in Cook County.”
Sampson gave a recent example in which a pregnant woman came to the hospital needing immediate transport to Duluth. Both the mother and the baby were “at high risk for severe problems,” Sampson wrote. “We frantically called around trying to find nurses to come in to cover.” This took time away from caring for the woman and increased the stress in an already stressful situation, according to Sampson. Fortunately, one nurse came in and took over for a nurse already on duty, who traveled to Duluth with the patient.
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“I do not think we want to rely on a system that depends on the goodwill of a few nurses,” Sampson wrote. “I believe we need a more comprehensive system in place so that we do not have to repeatedly try to patch things together in emergent situations.”
Sampson’s suggestion to implement a more reliable system was consistent with a suggestion Administrator Pearson had made previously to consider having paramedics on-call for such emergencies. This could potentially reduce the need for helicopter transports and could bring extra income into the hospital.
Pearson will be applying for an “intermittent” advanced life support license that would allow the hospital to provide advanced life support on ambulances as needed while providing basic life support at other times. An “intermittent” license would preclude the hospital from having a paramedic on call 24 hours a day. The hospital is considering keeping paramedics on-call during peak periods when they have historically had more ambulance calls.
According to Director of Nursing Bridget Sobieck, one person in the community is a paramedic and another is pursuing certification.
Thehospital sometimes calls Gold Cross ambulance service if its crew is busy on other runs. Gold Cross has a mobile ground unit ready to go at all times and provides a higher level of care than the North Shore Hospital ambulance can provide right now.
It’s painful to see a patient waiting here for hours, ambulance service director Darrell Smith said, while the hospital waits to see if Gold Cross is going to send an ambulance up.
Critically ill patients, such as those with heart emergencies, are taken by helicopter, which is faster than an ambulance even though the helicopters come from well outside the county. They can get to the hospital in an hour or less, Sobieck said, and are sometimes there by the time an ambulance returns from picking up a patient. Helicopters are also called for patients with neck fractures because they provide a smoother ride than the one down Highway 61.
Even airplanes transfer patients sometimes if the weather is too dangerous for helicopters or if a patient is headed to a Mayo Clinic hospital.
Once Administrator Pearson submits an advanced life support license application, Medical Director Paul Terrill will review ambulance service policies and procedures for compatibility with the licensure.
An advanced life support license would allow the hospital to bill at a rate not authorized for providing basic life support services. One of the hospital’s goals is to be able to provide better service, but it also hopes to be compensated adequately for the services it provides.
» In other news, the board
approved a new three-year agreement with Olympus, the company that has been providing the hospital’s colonoscopy equipment. The previous lease was $2,800 a month but the new lease will go down to $860 since the equipment is now three years old.
“Dr. Terrill believes the current equipment is still very adequate for our needs,” Diane Pearson wrote in a February memo to the board. “It is also his intent to continue offering
this service for the foreseeable
future.”
» The hospital renewed an
annual agreement with Cook County Public Health and Human Services (PHHS) to provide home health care on a sliding scale to patients referred by the county. PHHS will pay $43,086 as it did last year, although the hospital’s actual expense exceeded that amount by $20,000.
“We’re serving more people than county dollars can support,” Pearson said. The hospital is contributing the
unfunded amount as an act of
“charity,” Pearson said.
» Radiology Supervisor Ron
Benrud is retiring March 31 after 25 years with the hospital. Administrator Pearson said the plan is to have whoever replaces him look into upgrading to digital mammography equipment, which will provide radiologists tools to read mammograms more accurately.
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