Orcas Public Hospital District Candidates’ Statements: Leif

Statement by Leif, Candidate for Orcas Public Hospital District, Position #3

Here is my report as Nurse Advocate on developing an Evidence Based Plan Of Care for the patient: YOU, the Orcas community funding an Urgent Care Service.

First some information: The American Academy of Urgent Care Medicine defines it as:

“outpatient care for the treatment of acute and chronic illness and injury….[for] when [you] are unable to see your usual doctor, timely, or choose not to go to a hospital emergency.”

Hours of operation are usually 8AM-8PM. Most customers are older, are having acute pain, or a downturn in a long-term illness. These services are most common in more wealthy urban areas near Hospital Emergency Depts.

Next, the evidence:
We have none. After months of debate, no one has provided data about how many times a local Doctor has been called in to provide on site, after hours “Urgent Care.” I asked!

But we have estimates of cost! And authoritative statements of unmet need. However we are about to give this patient an expensive, potentially unnecessary treatment for an undiagnosed illness, when they asked for something else entirely. As far as we know.

The essence of patient centered care is:
We Asked .. and we did the research.

This is not my personal opinion. It is my function as Nurse Advocate.
And it is the foundation of collaboration among professionals and others:
to separate personal agendas from patient health,
to consider real needs real costs real benefits.

The reason for a Public Hospital Tax District is to provide for the uninterrupted healthcare of this patient..

Period.

We are here setting an example for how we will operate in the future:

will we prefer expensive wasteful political rumor, or to-the-point professional grade metrics.

If the hospital district is approved, the distribution of funds should take into consideration three factors. All determine What will deliver the best value to Orcas healthcare:

•   First- What is fair. We are heir to a history; ignoring it is an illness that undermines health. For one moment we have the chance to ask the accountants and business people to step aside and consider that this community and its providers are traumatised by the violence done in boardrooms making dysfunction our “norm.”
•   Second- What is fair. We have a long history of accounting too. Numbers were generated under a real life “stress test” and can be taken as a very good approximation of financial need. This should be used as a baseline for future estimation.
•   Third- see definition of successful collaboration below.

Urgent care and after-hours care: “Urgent Care” is an uninformed misnomer revealing the difficulty of oversight in healthcare. Without informed advocates serious misunderstandings develop between professional providers and community debate. eg.: Caring for a sick relative is not qualification as a community healthcare advocate; EMS cannot replace ongoing professional care.  On Orcas we need to be much more careful in our choices about who represents our “needs.” Having popularity or money cannot replace being qualified. Qualifications are verifiable facts and skills.

“After-Hours Medical Care” is for Orcas the test of successful collaboration between our providers including EMS. It is a constant drain on resources, professional and financial, but it is only sparsely remunerated so it becomes largely unrecoverable overhead, like having the heater on all the time.

A successful collaboration between the community, its legitimate local advocates, and the professional team will deliver the best value to Orcas healthcare. We have come to this critical juncture portending the loss of Primary Care on Orcas because of a pattern of complicity giving undue influence to those without sufficient standing, leading to abuses of governance, sapping our limited resources, and destroying confidence in our providers thus rupturing the professional safety net allowing our most vulnerable to fall through.

Financial stresses on the cusp of Boomer senescence has merely exposed this metastatic cancer. No level of management restructuring or financial bailout will substitute for addressing this root cause finally.