As It Fights Ebola, Presbyterian Sends Medical Students and Non-Essential Workers Home

Categories: Healthcare

TexasPresbyHospital1.jpg
Emily Mathis
With diverted ER traffic, suspended personnel, and a drop in elective procedures, how much is Texas Presbyterian Hospital business suffering?
As Texas Health Presbyterian Hospital becomes the epicenter of the American Ebola scare, Texas Woman's University announced yesterday that all "non-essential personnel" had been suspended until further notice from the East Dallas hospital. The university referred specifically to the 90 TWU students this decision would effect, but the announcement of the closure touches on just one more way hospital business has taken a hit in the last two weeks.

While the hospital declined to comment on what exactly the removal of these workers entails, the move can be likened to the emergency preparedness plans which remove non-essential personnel from the hospital in the event of a natural or man-made disaster. Not only does the move indicate the hospital's level of concern for further spread within the hospital, the potential for spread is now considered an emergency.

Dr. Forney Fleming, Director of the Healthcare Management Program at UT Dallas, says essential workers who remain at the hospital likely includes anyone involved in direct patient care. "There's a large number of workers who would fall into the non-essential category. So for example there's the IT department, the HR department, the quality improvement department, the students," he says. "Probably they want to take out as many bodies there as they possibly can until they determine how this young lady contracted the virus."

It's the big unknown that clearly has administration at the nonprofit hospital so scared that they're willing to incur revenue losses. And Fleming says in just the two weeks since Duncan fell ill, these losses are likely substantial.

The hospital also diverted emergency room traffic starting Sunday. "No ambulances were being brought there. Now typically that happens when your ER is packed, but by diverting they were trying to keep people away from there," says Fleming.

And this is in addition to the hospital losing elective procedure traffic. "For all those other things, a lot of people will be saying, 'Hey I don't want to go in there for my mammogram right now,'" says Fleming. "So it certainly has to be having an effect on them."

"I think this sends a message of great concern which may be overblown to some extent. There's a lot of communicable diseases that float around, and flu is at the top of the list," he says. "But I think the concern was that the message was being made that the hospital was well prepared to handle this, they could control it. And other than the people that were previously exposed, there was no concern. And then to have a health care worker come down with it, it certainly is going to be concern to the public."

Fleming estimates that non-essential workers will likely remain home for the remainder of the virus incubation period -- at least 21 days for Nurse Pham's case, and additional time for anyone else that may contract the virus in the coming weeks.

"This thing has just snowballed, without question," says Fleming. "On the one hand, there's the cost of the medical care, and then the loss of traffic and revenue because of the people that now are reluctant to use their services for the time being. So both of those are going to show up on the bottom line."

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38 comments
Veritas
Veritas

To Dr. Tom Frieden - Primum non nocere- first, do no harm to Americans. Our health, our economy. Had travel restrictions been in effect, Nina Pham and Amber Vinson would not be ill right now. Stop thinking like a political appointee, and start thinking like a doctor. You owe it to yourself and your fellow citizens.


It is possible to have travel restrictions and help West Africa at the same time.

Ahoy_m8
Ahoy_m8

Are any hospital ER's revenue positive? I thought they've all lost money since EMTALA made treating indigents a condition for Medicare billing. Over 50% ER cases uncompensated. Probably higher in TX. And that's why boutique-y medical centers (e.g. Carrell clinic) hide their ER's. Many hospitals would close their ERs if not required by law. EMTALA is federal, but I think requiring ER services is a state law.

lebowski300
lebowski300

What protocol of managing this situation involves exposing nearly 80 nurses to a highly infectious patient in isolation for less than two weeks? Seems like you'd want to dial it down as much as practical.

Also - it seems to me that if you were one of those nurses and were aware/educated enough to be taking your temperature every day during the incubation period would go hand in hand with not getting on a commercial flight.

It may not spread, but only because we didn't pour *enough * gasoline on its fire.

Once it goes past the tipping point where it is now - all those people are going to scatter. Then the jig will be up.

julzhenderson12
julzhenderson12

The hospital hasn't been a non profit for years, just FYI.

holmantx
holmantx topcommenter

Don't yu wish the guy wandered into Parkland?  I mean, after all, private hospitals have been going tits up for some time.

Seems like the illigit deadman could at least pump the taxpayer on the way our the door.

Remember, this guy fled his country in haste, landed in Dallas and immediately went to the nearest private hospital, infecting everyone along the way.

But of course, lets not bar his entry.

ThePosterFormerlyKnownasPaul
ThePosterFormerlyKnownasPaul topcommenter

Given the downside risk and the lack of knowledge as to how Ms. Pham contracted the disease, I would hardly say that this is overreacting.  It sounds to be extremely prudent to me.

harmonicpies
harmonicpies

Having students present can divert employees' focus from their primary responsibilities as their preceptor must take the time to teach and provide a good learning experience. I expect the hospital needs everyone's undivided attention on their work right now.

TheRealFJM
TheRealFJM

Wondering if this is paid or unpaid "leave?"

mavdog
mavdog topcommenter

they have to stanch the losses of an under utilized hospital...how many people have either postponed an elective procedure or moved to another facility since Duncan went to THR Presby? and shutting down the emergency room reduces the number of new admissions.

wonder what will restore the public's confidence?

roo_ster
roo_ster

Now, envision one Liberian Ebola Guy at every major hospital in the DFW area.


How many LEGs would it take to cripple our metro area's health system?

everlastingphelps
everlastingphelps topcommenter

Don't worry, it's so hard to catch you have to make a least one mistake in your PPE protocol to get it.  


Maybe.

TheRuddSki
TheRuddSki topcommenter

This isn't good news:

World Health Organization researchers issued a dire new forecast for the Ebola epidemic Tuesday, one that sees 20,000 cases by November, much sooner than previous estimates. And 70 percent of patients are dying.

ScottsMerkin
ScottsMerkin topcommenter

Is it time to panic yet?  Shutze, what do you think?

LovingPerson
LovingPerson

@Ahoy_m8 if ERs weren't profitable there wouldn't be 100's of ER only business springing up everywhere and hospitals wouldn't spend millions of dollars getting trauma, stroke and PCI designations. Hospitals will try to entice ambulance workers to bring patients there with free food and other goodies. They have billboards everywhere that try to convince people that their ER is the fastest or the best. The ER is the gateway for getting all serious patients into the hospital and putting all the surgeons to work. but even beyond that it's apparently profitable by itself as is apparent by stand alone for profit ERs

obrown11
obrown11

@holmantx So I am curious have you seen his plane ticket? Because clearly you must know what his travel arrangements were prior to coming to America to visit his girlfriend? He assisted aid to a pregnant woman, he did not know had the virus, now he is a villain.. Maybe if there wasn't a blind eye being turned to the thousand of mothers, fathers, and children been killed by this virus, and if it had been contained months ago, there would be nothing to be worried about. But hey who gives a damn as long as it is not happening to me right? 

roo_ster
roo_ster

@holmantx 

Hell, folk from Mexico with expensive to treat conditions fly into DFW and call 911 after they land so they can get treated for free at Parkland.  Why should Liberians be any different?

MissMacy
MissMacy

@mavdog The virus is no longer contagious after 21 days, so I'd say three weeks from now if there have been no new cases reported at Presbyterian it would end the quarantine.

Greg820
Greg820

@roo_ster Presby will be the staging area for North Texas until this is cleared up. 

RTGolden1
RTGolden1 topcommenter

@ScottsMerkin doesn't matter.  The cowboys are on a streak.  Everyone knows, no matter what, you don't fuck with a winning streak.

holmantx
holmantx topcommenter

@obrown11

1. His passport was stamped at every airport he deplaned at and passed through their customs.  It also shows which country he originated from.

2. He lied on his entry information form

3. He lied on his Liberian exit form, according to the Liberian President and a warrant was issued for his arrest.

http://www.cnn.com/2014/10/02/health/ebola-us/

so America had it coming, eh?

mavdog
mavdog topcommenter

@tPFKAP

One, that info is out there for people to find

Two, if you believe the public will actually go and read the info, you have too high an expectation.

ScottsMerkin
ScottsMerkin topcommenter

@Greg820 @roo_ster Presby has 3 isolation rooms, of which as of this morning 2 are now in use.  Other hospitals will be taking on Ebola by the end of the week I suspect

roo_ster
roo_ster

@Greg820 @roo_ster 

Tell that to the latest ebola guy fearing for his life who walks into Parkland's or Baylor's or John Peter Smith's ER.  I'm sure he'll alter his travel plans in accordance to bureaucratic diktat.

JFPO
JFPO

Don't throw logic at rooster. It overheats the coils in his brain.

wcvemail
wcvemail

@Greg820 @roo_ster

Right answer to a different Q, Greg. The answer is three to cripple, five to paralyze.

How many people just stepped off a plane/Greyhound, or drove up from Houston's airport, feeling fine except for a new sniffle?

JFPO
JFPO

With Cowboys getting arrested again, this should be a great year.

mavdog
mavdog topcommenter

@holmantx

holman, to be accurate you should say "I believe he lied..."

it's been discussed many, many times on this board, nobody can say for certain Duncan knew he had been infected.

except for Duncan himself. and he can't tell us.

he didn't "leave his country in haste', he applied for the visa about a year prior to leaving to come and marry the mother of his chld.

he also did not go "immediately to the nearest private hospital", it was almost a week after he arrived that he went to the hospital for the first time.

Greg820
Greg820

@ScottsMerkin @Greg820 @roo_ster Maybe you have more facts than I , but I find it hard to believe that a facility of that size has only three isolation rooms in the entire hospital.  Maybe you are thinking only about the ICU.

everlastingphelps
everlastingphelps topcommenter

@ScottsMerkin @Greg820 @roo_ster And honestly, those are likely cramped quarters.  The facility is Nebraska, for example, has 8 nominal rooms, but they are really only equipped to handle 2 comfortably.  Having all 8 rooms would be stretching everything to the limit.


I suspect it is the same at Presby.

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