DiversityNursing Blog

Sandee LaMotte

"Our data raise questions about the current recommendations," said Mayo pulmonologist, Dr. David E. Midthun, one of the study authors. "We do not have the best tool to identify who is at risk for lung cancer."

Current U.S. Preventive Services Task Force guidelines recommend annual low-dose CT screening for adults age 55 to 80 who have smoked 30 pack-years (one pack a day for 30 years), and who currently smoke or have stopped smoking within the last 15 years. This criteria is used by doctors and insurance companies to recommend and pay for scans.

According to the researchers, the percentage of lung cancer patients who smoked at least 30 pack-years declined over the study period while the proportion of cancer patients who had quit for more than 15 years rose. 

"As smokers quit earlier and stay off cigarettes longer, fewer are eligible for CT screening, which has been proven effective in saving lives," said epidemiologist Dr. Ping Yang in a statement released by the Mayo Clinic Cancer Center. "Patients who do eventually develop lung cancer are diagnosed at a later stage when treatment can no longer result in a cure."

Over the study period the percentage of lung cancer patients who would have been eligible for CT screening under current guidelines fell dramatically: from 56.8% in 1984-1990 to 43.3% in 2005-2011. The proportion of men who would have been eligible decreased from 60% to 49.7%, while the percentage of women dropped from 52.3% to 36.6%. 

Researchers worry about the trend. "We don't want to disincentive patients to stop smoking," Midthun told CNN in a phone interview. "When I told one of my patients about the study, his first question was, 'If I stop smoking will I have to stop screening?'"

"We want people to stop smoking, and we don't want them to lie or continue smoking just so they can be screened," added Midthun. "We need better tools to make risk calculations for those who should be screened."

The Mayo study did not take into account other risk factors for lung cancer, such as personal and family history for lung cancer or Chronic Obstructive Pulmonary Disease (COPD) because they are not in the current guidelines for reimbursement. For example, COPD "raises a person's risk for lung cancer by four to six times," said Midthun, yet "only age and pack year history are in the guidelines."

"There's nothing magical in 30-year pack history," added Midthun. He told CNN that age is an equally important factor. "For example, if a person stops smoking at age 55, his risk of lung cancer at age 70 is higher than it was at age 55 when he quit."

The study was published in the February 24, 2015 issue of JAMA, the journal of the American Medical Association. It was funded by the Mayo Clinic and grants from the National Institutes of Health and the National Institute on Aging.

Source: www.cnn.com

By Elizabeth Baier

Anyone who has spent much time in Minnesota's "Med City" can't help but notice that wheelchairs are everywhere.

From city parking ramps and downtown sidewalks to park trails and the local mall, the chairs have an inescapable presence.

More than likely that has do to with the fact that Rochester is home to Mayo Clinic, visited by thousands of patients every day. Many of them use wheelchairs to get around. So it's not surprising that they exist in big numbers.

The big curiosity is how they end up all over the city with their users nowhere in sight — a fact that some local residents can be oblivious to.

Denny and Carol Scanlan say empty wheelchairs are just part of the Rochester landscape.

"I never even thought of it until just now," Denny Scanlan says over a drink at American Legion Post 92, where he is a member. "Well, I see them kind of everywhere we go, I guess — where you least expect them."

"Yes," says his wife, with a laugh. "At the mall. In a restaurant. " She adds, "We're so used to it that I don't even notice it."

But some people do notice the big blue chairs.

At the Blue Water Salon on the skyway level of the Doubletree Hotel, owner Shelly Joseph often sees them just outside her door, in a public stairwell largely used by hotel staff.

"I don't know why they're in here, but randomly they're in this stairwell," she says. "It's a fire exit, basically."

At the Starbucks across the hall, manager Dawn Lee-Britt sees wheelchairs outside the employee entrance at the back of the coffee shop at least a couple of times a week.

"Sometimes we can't get out," she says. "I'm getting used to it because we see them so often." She adds: "It's like they don't need it anymore or it's time to go.

Mayo Clinic has 1,180 wheelchairs in its Rochester fleet, largely for patient transport. It loses up to 150 chairs each year, says general services manager Ralph Marquez, who oversees patient equipment.

At $550 each, that could be as much as $82,500 a year.

"Yes, it's a financial burden to us from that standpoint, but it's also a service we provide," Marquez says. "And if the patient, you know, truly comes first, sometimes that's the expense of the business."

Because the clinic does not want to keep patients from leaving the campus, the clinic's courier service rounds up wheelchairs weekly, mostly from hotels and other places that alert them.

But the chairs can travel much farther than that.

"We've gotten calls from Orlando Airport. Goodwill up in Duluth had one of our chairs and luckily we were able to retrieve that one. We've had them in Denver, out east in a few airports," Marquez says. "They get back to us dirty and needing to be cleaned. People may take them home for a while. They wind up everywhere."

That includes the Rochester Public Library, where communications manager John Hunziker considers wheelchairs normal.

"I'm sure if you aren't used to Rochester, seeing somebody going down the skyway, you know, pushing an IV on a rolling stand looks kind of weird," he says. "But it's just part of living in Rochester."

And on some days, part of Hunziker's job is to let the Mayo Clinic know there's a blue chair to pick up in the lobby.

Source: www.npr.org

By Debby Scheinholtz and Shane Nelson

As the Affordable Care Act phases in, up to32 million individuals—mostly lower-income Blacks and Latinos—should have first-time access to health insurance by the beginning of next year.

The link between culturally competent patient care and hospitals’ increasing commitment to diversity management is escalating dramatically, evidenced by a doubling of the number of hospitals participating in the DiversityInc Top 50 competition this year. With more hospitals doing this well, we were able to expand our Top Hospital Systems list from five to 10.

The DiversityInc Top 10 Hospital Systems list is based on the same criteria as the DiversityInc Top 50. Here are some facts about why this top 10 is so outstanding and some examples of individual excellence:

CEO Commitment

• Eighty percent of Top 10 Hospital Systems CEOs meet regularly with resource groups—up from 67 percent last year.
• Massachusetts General Hospital President Dr. Peter Slavin serves as chief diversity officer. He holds department heads accountable through individual diversity plans, and he started the Multicultural Affairs Office Advisory Board to create an inclusive work environment and recruit and retain physicians underrepresented in medicine.

Cultural Competency

• At University Hospitals, all residents participate in a two-week training rotation that includes a cultural competency module. Topics cover what to do when patients’ religious beliefs prevent them from following doctors’ orders, or how to respond to cultural concerns regarding food/nutrition recommendations or restrictions.

Addressing Health Disparities

• Henry Ford Health System’s Institute on Multicultural Health conducts research on health disparities, develops community-based programs aimed at improving the health of underrepresented populations, and provides cultural-competency training to researchers and healthcare providers.

Disability Initiatives

• Rush University Medical Center has an ADA Task Force that oversees extensive efforts to make the medical center and university more accessible. Some of the hospital’s efforts include the Hospital-to-Home Program, designed to keep people from being readmitted to the hospital; a buddy program for patients with intellectual disabilities; and the Thonar Award, given annually since 1991 to recognize Rush individuals whose efforts “turn a disability into a possibility.”

Ensuring a More Diverse Pipeline for Medical Professionals

• The North Shore-LIJ Health System’s Hofstra School of Medicine’s Medical Scholars Pipeline Program prepares students from traditionally underrepresented groups for college and medical school. The five-year summer academic program gives students support to become physicians or other health professionals.

Patient-Focused Resource Groups

• Mayo Clinic’s 13 resource groups, known as MERGs (Mayo Employee Resource Groups), work to improve cultural competency and patient engagement. MERGs at Mayo’s Rochester, Minn., location have helped initiate its Destination Medical Community initiative, a joint effort between Mayo and the City of Rochester to welcome patients and families who travel to use Mayo’s services.

• Cleveland Clinic has 10 resource groups, each focused on employee development and patient experience. For example, ClinicPride, Cleveland Clinic’s Gay & Lesbian Resource Group, provides a network that supports the recruitment, professional development and retention of LGBT employees, and provides insight on gay and lesbian patient-health and -wellness issues.

Patient-Focused Diversity Council:

• University of New Mexico Hospitals’ Office of Diversity, Equity & Inclusion has a steering committee and four taskforces, focusing on patient care, cultural competence, community and compliance. The community taskforce includes several representatives from New Mexico’s Native American community—11 percent of the hospital system’s patients are Native American.

Mentoring Programs:

• Continuum Health Partners’ Diversity Mentoring Program is cross-functional. As it moves into its fourth round, it will include more clinicians and middle managers to pair with senior leaders.
• More than half of the managers at SSM Healthcare participate in formal mentoring, an effort that started in 2000 with the development of the pilot Diversity Mentoring Program, designed to increase the number of people of color, of different ethnicities or with disabilities in SSM’s management ranks.

Supplier Diversity:

• University Hospitals was on pace to meet construction supplier-diversity goals of 15 percent MBE and 5 percent WBE spend in 2012.
• Henry Ford Health System is recognized locally and nationally for its supplier-diversity initiative and is considered “best practice” among the healthcare industry. Ten percent of its prime contractors are Minority Business Enterprises.

By AL STRAIN

OWATONNA — A new program is now in place at Owatonna Hospital to help people who have been victims of sexual assault.

The hospital has instituted the Sexual Assault Nurse Examiner program after identifying a need for a sexual assault program to serve Owatonna and surrounding areas.

“There wasn’t a program like this nearby,” said Jody Kaiser, RN, assistant manager for the Emergency Department at Owatonna Hospital, in a news release. “For assault victims, whether physical or emotional, there just wasn’t the option for a trained nurse examiner.”

Four nurses in Owatonna went through a five-day, 40-hour training course through the Sexual Assault Response Service.

“While we don’t see the number of patients the metro area does, it’s important to have a program in place locally,” said Kimberly Glasgow, RN, a trained nurse examiner, in the release. “This program offers patients comfort after a traumatic situation.”

According to Lori Pfeifer, the sexual assault program coordinator for the Crisis Resource Center of Steele County, one in six people will be the victim of a sexual assault at some point.

“That’s Owatonna. That’s Blooming Prairie. That’s everywhere in our vicinity, and that’s men, women, old people, young people and everybody,” Pfeifer said. “(The program) is going to help with gathering evidence for prosecution. It’s going to help with follow-through for victims.”

Pfeifer said the program is very beneficial for the community, and thought it could make a difference for victims to see a medical professional who is trained to handle a sexual assault situation, which may not have always happened in the past.

“Any time someone is in the unfortunate position of being sexually assaulted, they need to be able to go into an ER that’s full of understanding and empathy, and that’s exactly what the nurses are trained to do,” Pfeifer said.

The nurses trained in performing exams with Obstetrics and Gynecology staff and nurse practitioners at Mayo Clinic Health System — Owatonna. The program also received funding from the Owatonna Hospital Auxiliary, which donated $2,500. Thrivent Financial in Owatonna also contributed $500.

The program will receive a digital camera and memory card to document evidence, along with toiletries, underwear, sweat pants and hooded sweatshirts that will be given to victims.

“They don’t have to leave the hospital in a hospital gown,” Pfeifer said. “To be able to give them back something of warmth ... you want to give people their dignity and their privacy back.”

The program is available to anyone over the age of 12. Younger victims are referred to Children’s Hospital and Clinics of Minnesota in St. Paul.