Monday, February 25, 2019

Speeding Access to Specialty Health Care in NYC


New Online System Streamlines Process to See a Medical Specialist


HEALTH- Appointments to see an outpatient specialist at NYC Health + Hospitals/Lincoln are expected to be a little quicker and easier to schedule, thanks to a program called eConsult—a system that streamlines the referral process from primary care providers to specialists.


The system also facilitates enhanced communication between the primary care provider and the specialist so sometimes the patient can avoid a visit to a specialist altogether.

The eConsult system has been expanding dramatically in recent months, as more outpatient clinics in the public health system sign on citywide. 

Just this month, Rehabilitation Medicine and Infectious Disease at NYC Health + Hospitals/Lincoln became the 100th and 101st specialty clinics in the city to participate. They join 12 other specialty clinics at Lincoln—including Ear/Nose/Throat, Gastroenterology, Neurology, and Urology—making the hospital one of the most aggressive adopters of eConsult in the public health system.

NYC Health + Hospitals/Jacobi and NYC Health + Hospitals/North Central Bronx are also participating in eConsult, demonstrating the unity of the Bronx hospitals in improving patient access to specialty care.

“Specialists like oncologists, orthopedic surgeons, and ophthalmologists often play a critical role in diagnosing and managing our patients’ illnesses,” said Dave Chokshi, MD, vice president and chief population health officer at NYC Health + Hospitals. “EConsult helps facilitate more rapid access to specialist expertise, which is a priority as we continuously work to improve patient care.”

How does it work?

When a primary care provider’s patient has a health concern that would typically be treated by a specialist, the primary care provider can send a message through the system and get a quick response from the specialist, who can then suggest next steps for the patient, as well as secure a timely appointment for the patient, if needed.

For example, one Bronx resident—we’ll call him Joe—saw his primary care doctor recently, who diagnosed acute pancreatitis. The primary care doctor exchanged messages through eConsult with a gastroenterologist about the best approach for Joe. 

The gastroenterologist gave instructions to the primary care doctor for the tests Joe needed, and an appointment for a visit was scheduled. When Joe went to the gastroenterologist, the diagnosis was already clear, and Joe and the gastroenterologist were able to focus on the plan of care—a much faster path from problem to solution than in the past. Joe couldn’t have been more pleased with the care.

Some lucky patients have it even easier. Depending on the diagnosis, sometimes the guidance from specialists can empower the primary care provider to treat the patient in the primary care setting, avoiding the visit to the specialist completely. 
For example, the specialist might recommend the primary care provider to prescribe a medication, and the patient can do all the follow-up with the primary care provider, always with the support of the specialist if additional guidance is needed.

Measuring success

“By having a significant number of patients managed in the primary care setting and by reducing the number of inefficient first visits to specialists, we have freed up valuable appointment time with our specialists, which makes a huge difference for patients,” said Hannah Byrnes-Enoch, MPH, director of specialty care transformation in the Office of Population Health.

Throughout the public health system, there have already been 79,370 referrals between a primary care provider and a specialist through eConsult, and nearly 8,000 new referrals take place each month. Is it working? When eConsult first started, only 14 specialty clinics participated, but wait times for new patient appointments dropped by 23 percent—a key reason why NYC Health + Hospitals is pushing to expand the program.
  

About NYC Health + Hospitals/Lincoln
NYC Health + Hospitals/Lincoln, located at 234 East 149th Street in the Bronx, is a 362-bed, Acute Care Level 1 Trauma Center with the busiest single site emergency department in the region. Recognized as a “2013 Top Performer on Key Quality Measures” by The Joint Commission, receiving top grades in Leapfrog Scores Safety in 2015 and 2017, and acknowledged with High Performing ranks in U.S. News & World Report in 2017 and 2018, the hospital emphasizes primary care and specialty medicine and uses the latest advances in medical science. It has designations as a Breast Center of Excellence, Breast Imaging Center of Excellence, Diabetes Education Center of Excellence, and others. Lincoln’s Primary Stroke Center has The Joint Commission’s Gold Seal of Approval and the American Heart Association/American Stroke Association’s Gold Plus and Target Plus Honor Elite awards. Its Hemodialysis, Palliative Care and Perinatal Care services are all The Joint Commission certified.

#health

Friday, February 15, 2019

Bay Plaza Mall Run Walk to Raise Awareness for Colorectal Cancer


HEALTH- As we close upon Colorectal Cancer Awareness Month, The Mall at Bay Plaza will host the first ever 5K Run/Walk to benefit programs at the American Cancer Society of The Bronx. 

This timed 5k run/walk will travel through the beautiful streets of Bay Plaza and will engage many stores on the property to participate with employees. 

Participants will enjoy snacks, activities, cancer information and live music throughout the morning.

Awards for fastest runners and top fundraisers will also be presented immediately following the run. 

“It is so important to provide a platform where Bronxites can stay active and learn about lifesaving information. Our partnership with the American Cancer Society does just that. We are excited to present this event in conjunction with the community and hope to raise funds for lifesaving research and local programs for in The Bronx,” says Maranda Ashkar, Director of Mall Management. 

“Colorectal Cancer awareness continues to be a priority for The American Cancer Society, partnerships such as this one, allows us to communicate with constituents in our local area to educate them on early detection and screening resources. We are thrilled to be able to do just that with The Mall at Bay Plaza,” said Lizzette Dorado, NYC Community Development Director at American Cancer Society. 

Date: Sunday, March 31, 2019 
Time: 8am registration | 9am kick off  
Location: The Mall at Bay Plaza, 200 Baychester Avenue – JC Penney Lot  
Event Contact: Luis Heredia 212.237.3835 or email luis.heredia@cancer.org  


For more information and to sign up to participate on www.acsdetermination.org/bayplaza5k


#health

Thursday, February 14, 2019

Closing Health Disparities in the Black Community



By Sharon Paul-Sylvestre, RN Visiting Nurse Service of New York

HEALTH- February is American Heart Month—and an excellent time to review heart health risks and guidelines, especially among members of the African American and Latino communities. 


Untreated and longstanding high blood pressure can lead to hypertensive heart disease (HHD), which includes heart failure, coronary artery disease, and other conditions. 

HHD is the leading cause of death associated with high blood pressure for all Americans. High blood pressure also puts people at risk for experiencing a stroke. 
The American Heart Association says African American population is particularly vulnerable to HHD and stroke since roughly 40 percent of African American men and women have high blood pressure, a higher rate than any other racial group in the U.S.

Each year, approximately 100,000 home care patients in the U.S. report a prior stroke, and a recent study at the Visiting Nurse Service of New York Center for Home Care Policy & Research further shows that, at start of care, recurrent stroke risk is high for many patients and in particular, African Americans, due to uncontrolled blood pressure. 

As a registered nurse providing care at home for high-risk patients with chronic heart failure, hypertensive heart disease and post-stroke, I know how important it is to work with these vulnerable patients and their families to help them make lifestyle changes and link them to continuous, responsive hypertension care. 

My colleagues and I at the Visiting Nurse Service of New York are part of a workforce of skilled nurses, rehabilitation therapists and home health aides who work together to provide care coordination and support for more effective chronic care self-management of these health issues. Everyday, we visit at-risk New Yorkers in their homes to help patients and their families understand the persistent hypertension-related disparities that increase the risk for heart disease, stroke, re-hospitalization and even death. Here are a few guidelines for closing hypertensive heart health disparities in the African American community. 

Get Educated
The most powerful weapon we have against hypertensive heart disease and stroke is knowledge. Take every opportunity to learn about your risk for high blood pressure. You can find excellent resources online at the American Heart Association’s www.Heart.org and www.VNSNY.org

Manage Your Diet: this one can be the most challenging especially when your cultural eating habits conflict with healthy eating recommendations. 

It’s important to manage your cholesterol levels by reducing your daily fat intake gradually over time. Talk to your doctor or home health provider about establishing dietary goals that support healthy blood pressure. Even small changes to your diet can make a big difference in your health. Learn how to read food labels and become especially mindful of salt and sodium intake, which can have adverse effects on hypertension and diabetes, respectively. 

Limit or Stop Smoking and Drinking: smoking enhances blood pressure and can cause strokes – try to cut back or stop smoking. Limiting your alcohol consumption is important as alcohol can adversely affect some medications. Each person is different, but moderation is crucial. 

Be on the Lookout for Depression
Patients with heart disease and stroke survivors are at high risk for experiencing depression. 

Adapting to a new lifestyle and temporary or permanent limitations to mobility, speech or cognitive function can present significant challenges. 

Frustration and depression are especially common in the winter months. Talk with your health care provider about the signs and symptoms of depression and online or community resources that may be available easily accessible for you.

Move a Little: just 15 to 30 minutes of light physical activity three to five days a week can help reduce your risk for stroke and heart disease. 

Small steps can lead to big progress if you just add a little activity to your life: walk to the mailbox or the corner bodega every day, get off one stop early and walk a few extra blocks if you ride the bus or subway, do stretches and “hall laps” at home if you need to in order to get started.

Manage Your Stress: sometimes stress is unavoidable, but most of the time we can take a few minutes to separate from the typical tensions that we all face in a busy day. This is especially important when recovering from any heart-related health issue. 

Give yourself 10-minute de-stressing breaks to listen to music, visit with a friend, meditate, practice gentle yoga or take care of a pet to help reduce your risk for hypertension. 

Keep a Health Journal: take the time to write down all of your medications and any changes your doctor makes to each prescription. Don’t forget to write down over-the-counter medications you take too, from baby aspirin to vitamins. 
Note how you feel each day, especially on days when you feel a little groggy, tired, sad or confused. This way you have a record of your health so every health professional on your care team can understand your full medical history at any time.

American Heart Month is a great time to begin implementing heart healthy habits for everyone, but it is especially important for those with high risk for hypertension to stay in communication with their physicians and be mindful of high blood pressure and related health risks. As always, it is important to consult your health provider before making significant changes in your diet or fitness routine. 


#health

Thursday, February 7, 2019

$7.5M Allocated for Drug Prevention and Treatment


HEALTH- Governor Andrew M. Cuomo announced more than $7.5 million in funding is available to enhance addiction prevention, treatment and recovery services in New York State. 




The funding will be awarded through a series of Requests for Applications issued by the New York State Office of Alcoholism and Substance Abuse Services. 

"We are committed to fighting addiction and ensuring all New Yorkers have the resources and support they need for recovery," Governor Cuomo said. "As we build on the progress we have made to combat this disease across the state, we will continue to fund these ongoing initiatives to promote a stronger and healthier New York State."

"This funding for recovery, treatment, and support services for those struggling with addiction continues our aggressive efforts to combat the opioid epidemic in New York State," said Lieutenant Governor Kathy Hochul, co-chair of the NYS Heroin and Opioid Abuse Task Force, who made today's announcement at an opioid forum in Suffolk County. "The opioid crisis continues to claim the lives of too many New Yorkers, and we're committed to investing in programs that will help end these tragedies once and for all."

The following funding opportunities are available through this initiative.


$3,500,000 to Establish Medication Assisted Treatment (MAT) Services in Federally Qualified Health Centers in Partnership with OASAS Certified Treatment Programs: OASAS will issue up to 10 awards of up to $350,000 each to Federally Qualified Health Centers (FQHCs). This funding will help enable FQHCs to establish opioid use disorder services, including increasing prescriber capacity, counseling, behavioral therapies, and recovery supports. Staff will be trained on the utilization of all three FDA-approved medications used in the treatment of Opioid Use Disorder. One award will be issued to a FQHC in each of the 10 Empire State Development Regions. FQHCs must partner with at least one OASAS-certified provider to receive funding.

$1,750,000 to Facilitate the Process of Buprenorphine Induction in Hospital Emergency Departments and Linkage to Community Based Treatment using Peers: Up to five awards of $350,000 each will be issued to expand the availability of buprenorphine to treat addiction in emergency departments. The funding will be used to train staff in hospital emergency departments on Medication Assisted Treatment, how to screen for and respond to instances of opioid misuse, and the implementation of protocols to link patients with peers and community-based treatment providers. OASAS identified applicants in areas of high unmet need for this service. Eligible applicants are emergency departments in the following counties: Allegheny, Bronx, Brooklyn, Cattaraugus, Chautauqua, Chenango, Delaware, Essex, Hamilton, Nassau, Richmond, Suffolk, Sullivan, Ulster, and Warren. Emergency departments must partner with an OASAS-certified outpatient program to receive funding, with a maximum amount of $350,000 per partnership ($200,000 for emergency department and $150,000 for provider).


$1,815,000 to Implement PAX Good Behavior Game in Classrooms to Prevent Opioid Use Disorder: OASAS will issue up to 11 awards, with a maximum amount of $165,000 each, to expand the use of the PAX Good Behavior Game, an evidence-based prevention program. This initiative uses a classroom-wide game format with teams and reinforcement to equip students with the skills necessary for self-regulation. Research has shown this reduces aggression and disruptive behavior, which are risk factors for adolescent and adult illicit drug use. Funding will help train prevention staff in the PAX Good Behavior Game, who will partner with teachers to implement the program. These providers must have existing formal relationships with school districts, or individual schools, or must establish them for this project.

$410,000 to Deliver Strengthening Families Program (SFP) to families residing in Upstate New York Permanent Supportive Housing (PSH) in Erie, Albany and Schenectady counties: Two awards of up to $205,000 each will be issued to support the expanded use of the Strengthening Families Program, an evidence-based prevention program, which is designed to help families maintain stability, and reduce the likelihood of substance use disorders. Under this initiative, prevention program staff will be trained in this program, and will deliver it to families in OASAS Permanent Supportive Housing programs in Erie, Albany, & Schenectady Counties.

$100,000 to Create Peer-driven Recovery Networks for Youth and Young Adults: OASAS will issue up to 10 awards, with a maximum amount of $10,000 each, to support in-person or virtual networking among youth and young adults in recovery from substance use disorders, as well as activities that promote recovery. Successful applicants will participate in the New York State Alumni Network and collaborate with Youth Voices Matter, a statewide network of youth and young adults in recovery.

"Our efforts to fight addiction in New York State are working, and this new funding will continue the great work initiated by Governor Cuomo to increase the availability of services in every part of the state," New York State Office of Alcoholism and Substance Abuse Services (OASAS) Commissioner Arlene González-Sánchez said. "We look forward to these expansions and enhancements, which will give more New Yorkers the ability to access services closer to where they live."

Senator Pete Harckham, 40th Senate District, Chairman of the Senate Alcoholism and Substance Abuse Committee said, "Substance abuse and addiction can be found in every city, town and county in New York State, in every age group and in every socio-economic group. This new, important funding announced by Governor Cuomo will make critical treatment programs available to more addicted individuals and help New York's communities and families better deal with the deadly scourge of addiction that is ending way too many lives."

The full RFAs for each of these initiatives can be viewed here.

Since taking office, Governor Cuomo has instituted an aggressive, multi-pronged approach to addressing the opioid epidemic, and created a nation-leading continuum of addiction care with full prevention, treatment, and recovery services. To combat this epidemic, the Governor has worked to expand access to traditional services, including crisis services, inpatient, outpatient, and residential treatment programs, as well as medication assisted treatment, and mobile treatment and transportation services.

In 2016, Governor Cuomo's Heroin Task Force recommended new, non-traditional services, including recovery centers, youth clubhouses, expanded peer services, and 24/7 open access centers, which provide immediate assessments and referrals to care. These services have since been established in numerous communities around the state, and have helped people in need access care closer to where they live.

The Governor has advanced legislative and regulatory reform to enable people to get treatment faster by eliminating many insurance restrictions, as well as legislation to reduce most opioid prescriptions from 30 days to seven days, and legislation to increase training and education for prescribers. Governor Cuomo has also taken action to combat patient brokering and fraudulent addiction treatment services.

The Governor has also worked to increase training and availability of naloxone, resulting in more than 300,000 individuals in New York State being trained and equipped with the opioid overdose reversal medication. Through Governor Cuomo's actions, pharmacies around New York State are now able to provide naloxone without a prescription.


New Yorkers struggling with an addiction, or whose loved ones are struggling, can find help and hope by calling the state's toll-free, 24-hour, 7-day-a-week HOPEline at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369). 

Available addiction treatment including crisis/detox, inpatient, community residence, or outpatient care can be found using the NYS OASAS Treatment Availability Dashboard at FindAddictionTreatment.ny.gov
 or through the NYS OASAS websiteVisit CombatAddiction.ny.gov to learn more about the warning signs of addiction, review information on how to get help, and access resources on how to facilitate conversations with loved ones and communities about addiction. For tools to use in talking to a young person about preventing alcohol or drug use, visit the state's Talk2Prevent website. 

#health

Wednesday, February 6, 2019

New Program to Encourage Children to Pursue Health Careers



HEALTH— New York City hospitals announced a new program to introduce elementary and middle school students (ages 9 to 13) to careers in the health care field. 

The four-week Saturday program series will allow students to learn about human anatomy, physiology, pathology, and biomedical careers in a fun and interactive format.

Shaped in partnership with the national non-profit Mentoring in Medicine, the Youth Academy will launch its first series on Saturday, March 2. 

On four successive Saturdays, the program will run from 9:00 a.m. to 1:00 p.m. Tailored to each age group, the curriculum will cover health science topics through hands-on activities. Course content will focus on the musculoskeletal and cardiovascular systems, with an emphasis on anatomy, physiology, and pathology, as well as related health interventions. An expected byproduct of the program is the strengthening of the participants’ English language arts and math skills.

“Inspiring children from diverse backgrounds to pursue careers in health care will not only open an exciting professional life for them, but also help reduce racial and ethnic disparities in the field,” said Cristina Contreras, executive director of NYC Health + Hospitals/North Central Bronx. “We want the children in our program to meet and learn from a range of health professionals, including some who look, sound, and act like they do—so they learn that they are not just welcome but also belong in the health care field.”

“I am excited to hear that NYC Health + Hospitals/North Central Bronx will be offering opportunities for kids in the Northwest Bronx to explore potential future medical careers,” said Assemblyman Jeffrey Dinowitz. “All kids should grow up with the mentality that they can accomplish any career they set their mind to, and having firsthand hospital experience is a terrific way to cement this dream. Thank you to Mentoring in Medicine and NYC Health + Hospitals/North Central Bronx for their partnership on behalf of our neighborhood kids.”

“This is not just a program,” said New York City Council Member Andrew Cohen. “This is an investment in the next generation of healthcare professionals—and it is happening right here in the Bronx! I am thrilled that children from all backgrounds will have the opportunity to get an in-depth look at the health care field. It is important that we support, engage, invest in, and challenge our youth with interesting subjects and diverse programing, so I am sincerely thankful to NYC Health + Hospitals/North Central Bronx for creating this Youth Academy and for valuing diversity and inclusivity in the healthcare industry.”

Fifty slots are open for the introductory series. The children will be divided into five teams, each led by its own instructor. There are no academic requirements to enter, but children are expected to attend an orientation session and abide by a code of conduct.

Among the highlights of the first series, children will learn about the structure of the heart, explore the anatomy of a cow’s heart, handle medical instruments, create a public health campaign to raise awareness of diseases of the heart, and learn elements of first aid.

Each session will culminate in students delivering a capstone project on lessons learned and receiving a certificate of completion.

“Engaging with children in the community is a true pleasure and a huge source of personal and professional satisfaction,” said Chinyere Anyaogu, MD, deputy chief medical officer at NYC Health + Hospitals/North Central Bronx, who will be one of the staff members teaching. “Our greatest investment in the future is our youth, and it is an honor to be able to help a child decide to enter the medical field.”

Subsequent four-week sessions will focus on different parts of the body. Additional content may be developed to focus on health informatics, mobile app development, and data science, as well as introductions to biomedical research and public health. Sufficient variety in course content is planned for students to participate in sessions over multiple years and always cover different content. Each session is designed to stand alone, so there will be no expectations that a student will have taken a previous session.

“As the co-founder and president of Mentoring in Medicine, I’m delighted to launch our Youth Academy in partnership with NYC Health + Hospitals/North Central Bronx,” said Lynne Holden, MD, professor of Emergency Medicine at the Albert Einstein Medical School. “We look forward to bringing our ten years of successful in-school programs to a hospital. Our goal is to help develop the next generation of health care leaders dedicated to serving our neediest communities. We will provide academic enrichment, leadership development, college readiness, biomedical career exposure, and mentoring targeting elementary and middle school students.”


The cost for the four-week series is $297. (A discounted cost of $199 is offered to children of NYC Health + Hospitals employees.) To register, please visit https://www.eventbrite.com/e/nyc-health-hospitals-north-central-bronx-youth-academy-tickets-55271569753. For questions about the program, please email andrew@medicalmentor.org.

#health

Tuesday, February 5, 2019

New York to Invest $204 M in Health Care Projects




#health

Taking Steps to Reduce Blood Clots


Efforts Hailed in Clot Reductions

HEALTH- Protocols undertaken by NYC Health + Hospitals/Jacobi in October 2016 to identify and reduce the threat of deep vein blood clots, or venous thromboembolism, have resulted in dramatic improvements.




HEALTH- Protocols undertaken by NYC Health + Hospitals/Jacobi in October 2016 to identify and reduce the threat of deep vein blood clots, or venous thromboembolism, have resulted in dramatic improvements.

In the first year following the protocols’ implementation, the number of cases of deep vein blood clots following surgery declined 53 percent, from 13 cases (baseline, November 2015 to October 2016) to 6 cases (November 2016 to November 2017), according to hospital-wide data. 

In the second year (December 2017 to December 2018), the number of cases declined to 4—an additional 15 percent decline from the baseline—demonstrating sustainability. Patient safety satisfaction scores also improved by 83 percent in the first year, according to Press Ganey data.

Venous thromboembolism refers to a blood clot that starts in a vein. A clot that develops in a deep vein, most often in the legs, is referred to as deep vein thrombosis. When such a clot breaks free from a vein wall and travels to the lungs—especially dangerous because it can block some or all of the blood supply—that is known as a pulmonary embolism.

The federal Centers for Disease Control and Prevention estimates that between 60,000 to 100,000 Americans die from venous thromboembolism every year. 

Patients recovering from surgery are at an increased risk for the condition. Other risk factors include age (starting at about age 40 and increasing over time), obesity, and cancer.

Clinicians at NYC Health + Hospitals/Jacobi sought to improve post-surgical safety by instituting a risk assessment scale to identify the patients at highest risk and introduce special monitoring and new preventive measures into their care. Among the interventions are:

· Introduction of an intermittent pneumatic compression device or stockings to allow for compression of blood veins to stabilize blood flow, used both before anesthesia (pre-surgery) and after surgery.
·Proper pharmaceutical prophylaxis, including the use of drugs like heparin only after applying the risk assessment scale.
· One-on-one consultations with all at-risk patients, addressing education about risk factors and warning signs. 

Follow-up with patients occurs at three days, two weeks, and one month post-operatively to screen for warning signs and reconfirm medication regimens.

"Between 60,000 and 100,000 Americans die every year from deep vein blood clots, according to the CDC,” said New York State Senator Luis Sepulveda. “I applaud NYC Health + Hospitals/Jacobi for dramatically improving the identification and reduction of the threat from deep vein blood clots. Lives will be saved through this medical innovation."

“The joint effort undertaken by the medical team at NYC Health + Hospitals/Jacobi is nothing short of astounding,” said Assemblywoman Nathalia Fernandez. “To see the number of cases of venous thromboembolism, which has been fatal to so many, taken down from 13 three years ago to 4 cases last year is an amazing accomplishment. I would like to extend my most sincere thank you to the team for limiting the number of fatal incidents post-surgery and for continuing to help the people in our communities.”

The article “NSQIP Impacts Patient Experience,” published in the December issue of the peer-reviewed Journal of Patient Experience, provides additional data and detail, focusing on implementation and related metrics in the hospital’s General Surgery service. (Unlike the article, today’s reported numbers reflect hospital-wide data. The sets of data, while different, reflect similar improvement.)

The article was written by Maria Castaldi, MD, former Director of Breast Health Service at NYC Health + Hospitals/Jacobi; Geena George, MPH, of Westchester Medical Center; Pamela O. Turner, MSN, Director of Nursing for Perioperative Services at NYC Health + Hospitals/Jacobi; and John McNelis, MD, Chairman of Surgery at NYC Health + Hospitals/Jacobi. The authors from NYC Health + Hospitals/Jacobi are also those who led the implementation of the protocols.

The article notes the dramatic change underscoring the improvement in patient satisfaction. Before the new interventions, only four patients of 109 who were surveyed recalled having a conversation with their doctor before surgery about the risk of blood
clots during surgery, the need for screening and prophylaxis to reduce the risk, and patient safety being a top priority. After the intervention, 145 of 147 patients surveyed reported that the indications, risks, and benefits of screening and prophylaxis were explained well or very well.

“This was truly a multi-disciplinary approach among members of our medical team,” said Dr. McNelis. “Surgeons, nurses, physician assistants, and anesthesiologists worked together to identify the risks to our patients and reduced them dramatically, and more important, the results have been sustainable.”

These protocols are just one component of the hospital’s ongoing efforts to make surgical care as safe as possible.


#health

Monday, February 4, 2019

NY Hospitals Try to Prevent Legionnaires’ Disease


HEALTH- NYC Health + Hospitals/Lincoln announced today the completed installation of state-of-the-art antimicrobial cooling towers. The towers not only support the heating, ventilation, and air conditioning system but also include antimicrobial features that significantly reduce the risk of harmful bacteria that sometimes grow in less advanced cooling towers. 


The modern towers are also expected to reduce energy consumption by about 40 percent, according to engineers.

The new cooling towers replace ones that had reached their expected end of life. While the old ones never contributed to any health concerns in the community, leaders at the hospital nevertheless saw an opportunity to increase protections. Following research of replacements models, the cooling tower model selected was chosen because of several innovations.

Enhanced safety to the community was a significant factor. The model selected has features that prevent or impede the potential growth of bacteria, including Legionella, which can cause a type of pneumonia commonly known as Legionnaires’ disease. The shells within the towers that hold the water are infused with an antimicrobial resin—wide-spectrum additives that operate on a cellular level to continuously disrupt and prevent uncontrolled growth of microorganisms and biofilm. In addition, while traditional metal cooling towers are vulnerable to corrosion from salt air and industrial gasses, the new towers’ high-density polyethylene design is resistant to such corrosion. Moreover, it is also resistant to the harsh chemicals required for use in treating the recirculating water and cleaning the towers.

In addition the shells that hold the water have a rounded shape, as opposed to the boxy shape of traditional shells, with corners in which water moves less and bacterial growth can flourish. The rounded shapes do not allow water to become dangerously stagnant in spots.

Another major appeal of the model was the promise of energy savings. To meet the city’s mandate to save on energy, NYC Health + Hospitals teamed up with the New York Power Authority, a state power organization dedicated to innovative and energy-efficient infrastructure.

“We worked with New York Power Authority to ensure that the new cooling towers would be as energy-efficient as possible,” said Louis Iglhaut, associate executive director at NYC Health + Hospitals, who led the team responsible for selecting and installing the new cooling towers. “Our old towers used large, 48-horsepower fans on each unit, which required the use of a lot of electric power. The new modular units are equipped with smaller 5-horsepower, 18-inch fans, so the energy consumption is far less.” He adds that they also installed variable-frequency drives, which increase energy savings. The hospital is expected to yield energy savings of 40 percent compared to the operational costs of the retired system.

“New York City’s public health officials have worked proactively to curb outbreaks of Legionnaires’ disease in the five boroughs,” said Assembly Health Committee Chair Richard N. Gottfried.  “But Legionnaires’ is unpredictable and difficult to eradicate.  By installing this state-of-the-art technology, Health + Hospitals is continuing to act with vigilance and prudence to protect the people of New York City.”

The cooling towers were manufactured by Delta Cooling Towers. “We are very pleased that Lincoln was the first medical facility in the greater New York City area to adopt the anti-microbial tower, and while it is increasingly being selected as the cooling tower for a number of industries including health care, Lincoln was just the 6th facility nationwide to have it installed,” says John Flaherty, CEO of Delta Cooling Towers.

The installation was handled without any disruption to hospital operations. Because of the modular nature of the towers, with each component smaller and lighter than the components of the old system, the installation team was able to use a small crane to lift the towers into position.

“Sometimes I think people like engineers should be judged by things that don’t happen in the hospital,” said Milton Nuñez, chief executive officer of NYC Health + Hospitals/Lincoln. “In this case, the cooling towers went in seamlessly without interruptions to any patient areas. It was up and running with zero downtime. I commend our team for an excellent job, from the product selection through the installation. It’s a strong message to our community that we care about their safety.” 

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