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Blood Alcohol Content Testing Protocol for Pennsylvania Hospitals

Blood Alcohol Content Testing Protocol for Pennsylvania Hospitals. Cheri Rinehart Vice President, Integrated Delivery Systems Robert Wood Johnson Executive Nurse Fellow The Hospital & Healthsystem Association of Pennsylvania.

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Blood Alcohol Content Testing Protocol for Pennsylvania Hospitals

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  1. Blood Alcohol Content Testing Protocol for PennsylvaniaHospitals Cheri Rinehart Vice President, Integrated Delivery Systems Robert Wood Johnson Executive Nurse Fellow The Hospital & Healthsystem Association of Pennsylvania 15th Annual Sobriety Checkpoint Conference, Days Inn Penn State May 18, 2006

  2. Pennsylvania’s Hospitals & Health Systems: • Admit nearly 1.8 million people. • Treat more than 33 million people in an outpatient setting. • Provide 5 million ED visits. • Provide $979 million in uncompensated care. • Directly employ more than 259,000 people. • Provide $17.5 billion in direct total spending, and $33 billion with indirect total spending.

  3. The Number of Licensed Pennsylvania Hospitals Source: Pennsylvania Department of Health

  4. Workforce Challenges and Opportunities During the next 15 years, hospitals and health systems are facing two critical problems related to the health care workforce: • There will not be enough workers. • Those who are available will not have the skills needed in the health care system that is emerging. Source: AHA, ACHE, Futurescan, Healthcare Trends & Implications, 2005-2006

  5. In Pennsylvania: RN Supply vs. Demand In 2000, the supply of RNs was estimated at 104,000 while the demand was nearly 110,000 (5% shortage). By 2020, the shortage will grow to 30% or 40,381 RNs. Demand Supply Source: Health Resources & Services Administration (HRSA), Projected Supply, Demand, and Shortages of Registered Nurses 2000-2020, July 2002

  6. Percent of Total Population Without Health Insurance Coverage Source: U.S. Census Bureau, HHS Division

  7. Percent (%) of Pennsylvania General Acute Care Hospitals with Negative Total Margins Source: FY 2002 from HAP analysis of PHC4 data, FY 2003 from HAP FY 2003 Financial Survey

  8. Areas of Medical Underservice • 22% of the state’s population lives in a federally designated shortage area • Areas of 55 of 67 counties have shortage designations

  9. Blood Alcohol—An Intersection of Many Worlds • Confrontation • Finger pointing • Frustration • Anger • Defeatism • Failed convictions

  10. Stakeholders Were Fighting One Another Rather than the Problem Partners in Development of the Protocol

  11. Issues for Hospitals • 1st Priority: Patients • EMTALA • HIPAA • Liability • Court appearances • Consents • Legal responsibilities • Payment • Crowded EDs

  12. Issues for Police • Timeliness • Preservation of evidence • Conviction • Return to duty

  13. Issues for District Attorneys • Chain of evidence • Timeliness • Conviction

  14. Shared Issues • Wanted to keep drunk drivers off the road • Recidivism • Streamlining process • Wanted shared understanding • Wanted to be partners, not adversaries

  15. What the Protocol Addresses • Consent • Probable cause • Right of refusal—individual & hospital • Release of results • Minors

  16. What the Q&A Addresses • Notification of police • Informed consent • Avoiding subpoena • Release of results • Payment

  17. What the Q&A Addresses • EMTALA • HIPAA • Testing kits • Medical v. legal blood alcohol • Unconscious patients

  18. What the Q&A Addresses • Court appearances • Probable cause • Qualifications of blood drawers • Minors • Breath v. blood testing • Patient refusal

  19. House Bill 601 • Signed into law by the Governor • Takes effect in July • Addresses cost of testing

  20. Where Do We Go from Here? • Need to update protocol • Need to identify issues requiring regulatory or legislative action • Need to understand one another’s worlds

  21. “Imagining something may be the first step in making it happen…

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