• An Anton Media Group Special •
HEALTHY LIVING JULY 8 - 14, 2015
Free Standing Emergency Rooms On a recent trip to Texas, while driving on the interstate, I kept seeing neon signs flashing times, “seven minutes to be seen in our emergency room.” Another mile down the road was another sign, “five minutes to ER care.” As I turned down the street, past a drive-through McDonald’s, there was a strip mall with a Quick Lube ten-minute oil change, a drivethrough Starbucks and next door was a stand-alone emergency room. That’s right, an emergency room with no hospital attached to it. Everywhere you go in Texas, these are popping up all over and oftentimes right across the street from urgent care centers. Free standing emergency rooms have been in Texas for almost a decade, with the assistance of state legislation which facilitated their growth. Long Island is now opening its first free-standing Emergency Room on July 1 in Long Beach, which will be affiliated with South Nassau
THE HEART OF THE COMMUNITY
CYNTHIA PAULIS Communities Hospital. Long Island has been in need of these facilities for a very long time and with the closing of many hospitals on the South Shore, some for financial reasons and some because of Superstorm Sandy, many residents are forced to be transported to the North Shore for care, which is not only inconvenient but inefficient. In cardiac and stroke cases, where every minute counts, these facilities can actually be lifesaving. (Full disclosure, I am board certified in emergency medicine with over 20 years’ experience and I have worked in urgent care
centers, emergency rooms both in New York and Texas, and free-standing emergency rooms. Plus I was a medical director of a trauma center so I understand how these work.) A free-standing emergency room is a fully-equipped facility staffed by an experienced board certified emergency room physician, a nurse and two techs. They have their own lab, which can turn around results faster than the medical shows, plus their own CAT scan on premises as well as digital X-ray and ultrasound and X-ray reports that are read by a radiologist off-site within 30 minutes via teleradiology.
Pros The advantage of a free-standing emergency room is the speed at which a patient can be seen compared with a regular emergency room. Oftentimes in a regular emergency room there is a lag time between registration, being brought back to a bed, waiting for labs
to be drawn and the results, waiting for X-rays to be taken and read and, finally, waiting for a disposition. It is not unusual for someone on a good weekend night to wait up to eight hours from start to finish for the process. (Bring a good book like War and Peace when sitting in an emergency room.) This is where the free-standings excel because they are not logjammed with hospital patients taking up ER beds while waiting to be seen by the attending or sent up to a room. In a free-standing ER a patient can be seen, have labs drawn, X-rays taken, plus all results done and a diagnosis made within an hour. If the person needs to be admitted to a hospital, a call is made to the nearby hospital and the patient will be transferred by ambulance, which is on a contract basis with the facility, and transferred. But here is the best part. The patient does not go to the ER of
see ER on page 17A
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HEALTHY LIVING • JULY 8 - 14, 2015
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Here is a list of important urgent medical care centers in Nassau County. • Nassau County Med Science Library 2201 Hempstead Turnpike, East Meadow, 516-572-8742 • Statcare Urgent Care Walk In 412 S Broadway, Hicksville 516-938-1550 • New York Urgent Care Walk In Clinic Services 55 E Old Country Road, Hicksville, 516-605-0120 • Nassau County Employee Assistance 256 W. Old Country Road, Suite D, Hicksville 516-571-7000 • Nassau Immediate Medical Care 465 Willis Ave., Williston Park 516-294-3535 • Winthrop South Nassau Health Systems Huntington Quad Suite 1C14, Melville 631-420-6700 • South Nassau Communities Hospital 3560 Oceanside Road, Oceanside, 516-763-3052 • South Nassau Communities Hospital 2277 Grand Ave., Baldwin 516-377-5000 • South Nassau Communities Hospital 1 Healthy Way, Oceanside 516-632-3000 • South Nassau Walk In MedServices 2710 Long Beach Road, Suite 2, Oceanside 516-558-7858 • South Nassau Family Medicine 196 Merrick Road, Oceanside 516-255-8400 • Nassau-Suffolk Hospital Council 1383 Veterans Highway, Suite 26, Hauppauge 631-435-3000 • Clinic One Urgent Care 111 Hempstead Turnpike, Suite 121, West Hempstead 516-252-0275 • LI Urgent Care 403 Little East Neck Road, West Babylon 631-716-5463
• Bay Shore Urgent Care Services 40 Bay Shore Ave., Bay Shore 631-969-8700 • Premier Care 1919 Hempstead Turnpike, East Meadow 888-373-8955 • Premier Care 358 Jericho Turnpike, Syosset 888-846-9609 • Premier Care 3276 Hempstead Turnpike, Levittown 888-216-2044 • Premier Care 415 Northern Blvd., Great Neck 888-309-3856 • Clinic One Urgent Care 111 Hempstead Turnpike, Suite 121, West Hempstead 516-252-0275 • Premier Care 235 Glen Cove Road, Carle Place 888-373-8952 • Premier Care 1989 Merrick Road, Merrick 888-309-3852 • Premier Care 656 Wellwood Ave., Lindenhurst 888-846-9611 • Premier CareRockville Centre 560 Merrick Road, Rockville Centre 888-532-8992 • Premier Care 4410 Sunrise Highway, Massapequa 888-373-8940 • City MD 904 W Beech St., Long Beach 888-373-8949 • City MD 1995 Nesconset Highway, Lake Grove 888-309-3858 • Premier Care 585 Merrick Road, Lynbrook 888-309-3855 • Premier Care 6500 Jericho Turnpike, Commack 888-309-3854 • Premier Care 2459 Merrick Road, Bellmore 516-826-2273 • Premier Care 292 Herricks Road, Mineola 888-287-8825
HEALTHY LIVING • JULY 8 - 14, 2015
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ER from page 15A the hospital, but is transferred directly to a room and will be seen by the attending. Fast and efficient, like the drive-through at McDonald’s. Long Beach will also transfer the patient by their own ambulance directly to a room in the hospital. If a patient is having a heart attack or stroke, meds can be administered on site and the stroke team can be alerted or the cardiologist and the patient can be transferred directly to the cath lab. Free standing emergency rooms are open 24/7 and are staffed by only board certified emergency room physicians, not physician assistants or nurse practitioners. Cons Most of the for profit free-standing emergency rooms will not accept Medicare or Medicaid and will only take credit card, cash and some insurance. Of course, if this is a true emergency you will be seen regardless and billed later. According to my sources, the new facility at Long Beach is a nonprofit free-standing emergency room and will accept Medicare and Medicaid. If you have a simple laceration or a cold, you are much better off going to an urgent care center because the cost is going to be cheaper than it would be going
to a free-standing emergency room. Urgent cares have been terrific in handling minor emergency problems, getting the patient in and out in a timely fashion. The problem with urgent care centers is that they are limited in what they can do, they are often staffed with physician assistants and they are not open 24 hours. LIJ recently opened two urgent care centers on Fire Island; they are only open 9 to 11 a.m. and 4 to 6 p.m. Many urgent care centers on Long Island are only open eight hours and
none are open through the night. Two years ago, the Village of Massapequa Park wanted to open a free-standing emergency room on Sunrise Highway. The town hall was packed with residents complaining that these facilities would bring in drug addicts and more traffic, while not being essential. Most of the protests were led by a nearby hospital which recently renovated its emergency room and didn’t want the competition. Many of the community members did not understand the
concept of the facilities. The proposal was shot down and residents still rely on urgent care centers or travel a distance to a hospital on the North Shore for care. Once a community understands how valuable these free-standing emergency rooms are, we will hopefully see more of them on Long Island. Who knows: you may be able to get some fries, an oil change and a Frappuccino while waiting to see the doctor, the way you can in Texas.
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HEALTHY LIVING • JULY 8 - 14, 2015
LIJ Receives Highest Nursing Credential
designation with its performance in nursing quality indicators, particularly in low infection rates, falls and pressure ulcer rates, and high RN and patient satisfaction scores. Magnet facilities outperform other hospitals in both recruiting and retaining nursing professionals. “We are already an employer of choice,” said Margaret Murphy, chief nursing officer. As a Magnet facility, LIJMC can promote its high retention and low vacancy rates. Achieving Magnet recognition “is not a destination,” Ms. Murphy added. The rigorous, lengthy process
requires “many years, hard work, staff engagement and having the right people in the right structure to build to where you are ready to even apply for Magnet status.” The current LIJ CNO credited her predecessor, Kerri Scanlon, RN, CNO at North Shore University Hospital and deputy nurse executive for the North ShoreLIJ Health System, for “creating a culture of excellence. That doesn’t happen overnight, it requires a strong commitment and support from the executive leadership team also.” —Submitted by LIJ Medical Center
For men, staying in shape means exercise. But exercise does not have to be grueling and a grind to be effective. Fun and fitness go hand in hand with a little imagination and a willingness to try something new. Does just the thought of exercise make your muscles sore? If so, consider a few fun tips to make your workout more invigorating. • Include circuit training for a fast-moving, goal-oriented workout. • Incorporate “beat the clock” challenges to tap into your competitive drive. For example, challenge how many push-ups you can do in your first set of 20 seconds; then beat that number in set two. • “It Takes Two” obstacle course— Set up an obstacle course with a workout partner (see below); partner #1 starts the course at the beginning; partner #2 starts at the end of the course. Set timer and go. Partner #1 has to chase down #2 while #2 has to catch up to #1. • Change it up and then change it again. Use a range of training
see FITNESS on page 19A
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LIJ Medical Center has been recognized by the American Nurses Credentialing Center (ANCC) with a Magnet Recognition Program designation. The credential recognizes healthcare organizations for quality patient care, nursing excellence and innovations in professional nursing practice. In the nursing profession, Magnet recognition is considered the gold standard of quality, safety and improvement; intradisciplinary and interdisciplinary teamwork; knowledge of evidence-based practice and research; and formal nursing education. U.S. News & World Report uses Magnet designation as a criterion when it determines “America’s Best Hospitals.” Of more than 6,000 hospitals in the nation, only 7 percent have achieved Magnet status. LIJ became the 22nd Magnet facility in New York State and is distinguished as the first tertiary hospital and third facility in the North Shore-LIJ Health System to achieve Magnet status—along with Huntington Hospital and Northern Westchester Hospital in Mount Kisco. LIJ clinched the four-year
Fitness Can Be Fun
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HEALTHY LIVING • JULY 8 - 14, 2015
Growing Number Of Elderly In ERs
FITNESS from page 18A
BY MARIA CARNEY, MD
EDITORIAL@ANTONMEDIAGROUP.COM
modalities from dumbbells, kettle bells, barbells and bodybars to resistance tubes, medicine balls, stability balls and air ropes. • Game on. If you think games are just for kids, consider Ultimate Frisbee, Flag Football or a pickup game of basketball. Choose fast moving games that foster team camaraderie and fun competition. • Freshen up your workout playlist with upbeat music that inspires you to move. • Splurge once in a while on new workout gear that accentuates your progress. • If you usually walk alone, consider gathering a group of friends for a challenging hike. • Sign up for a local road race and run for a cause. Needless to say, events on Long Island provide many opportunities for such a road race.
I recently walked through the emergency room on my way to see a patient. What I noticed was that the majority of the people on stretchers were older adults, some confused, agitated, frightened and suffering. As a geriatrician who specializes in aging populations and end-of-life care, one of my greatest challenges is protecting my frailest patients from the stress of hospitalization and emergency room stays. Today, more than 60 percent of people age 75 years and over are admitted to emergency departments (ED) each year in this country. These numbers will grow as life expectancies continue to rise. Elderly patients in the ED comprise a highly vulnerable patient population—a finding well-supported in medical literature. These older individuals frequently present with complex conditions and multiple medical diagnoses, including cognitive impairments from dementia or stroke that complicate the ability to assess, diagnosis and treat individuals. They are at an increased risk of return visits
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admissions and ease the burden on caregivers. To find out more about healthy aging initiatives, call the North ShoreLIJ Department of Medicine’s Division of Geriatric and Palliative Medicine at 718-470-7270. Maria Carney, MD, is chief of geriatrics and palliative medicine at North Shore University Hospital and LIJ Medical Center.
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to the ED, unneeded and/or repeat hospitalization, prolonged pain and suffering, and death. Most ED physicians are not equipped to comprehensively address the needs of the expanding complex geriatric population in the setting of a busy ED, which is designed to stabilize acute conditions for discharge or hospital admission. The result? Often it is a missed opportunity to avoid unnecessary complications of hospitalization, recognize and treat delirium, and eliminate repeat ED visits and preventable hospitalizations. In fact, those 65 and older account for 43 percent of all hospital admissions that come through the ED. At Long Island Jewish (LIJ) Medical Center’s ED, the Lillian Rose Program founded by Denise Silverberg, is providing additional resources focused on this vulnerable patient population, creating a geriatric and palliative emergency department. By providing a specialized team, focused training for all ED staff and a modified ED environment, we have implemented “geriatric friendly” changes that provide better care coordination, reduce ED utilization, prevent avoidable hospital
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