January 16, 2013

Early Flu Season Has Hospitals Gearing Up

Flu season has arrived early this year but it’s not too late to get vaccinated. That’s the advice of Dr. David Herman, Chief of the Section of Infectious Diseases at the University Medical Center at Princeton.

“Nationally there has been a marked increase this year in the number of cases and it has started earlier than usual,” said Mr. Herman in a phone interview, Monday.

Noting the city emergency in Boston and the high levels of flu cases being reported in New York City, Mr. Herman said: “Hospitals in our area are gearing up for it. The number of cases is increasing every week and the best thing to do is to get vaccinated. While it would have been better to have done so earlier than now, it’s not too late,” he added.

One hundred and twenty people received flu shots during the first two hours of a free clinic held on Witherspoon Street this past Sunday. The shots were given out by registered nurses courtesy of Princeton HealthCare System (PHCS) at the Neighborhood Information Center, 281 Witherspoon Street. Nurses commented that even though this amounted to a rate of one influenza shot per minute, they had expected an even greater turn out because most local pharmacies had run out of vaccine.

Prompted by the lack of vaccine in his local pharmacy, one Plainsboro resident had urged his wife to come along. He had received a shot through his place of work and warned his wife that she might suffer a mild headache but that was nothing compared to the flu. Side effects of the vaccine, which takes two weeks to take full effect so that exposure during that period can result in flu in spite of vaccination, can include a sore shoulder, a few aches, a low grade fever. It’s a misconception that the vaccination can give you the flu because the vaccine is not live.

“Stay away from crowds,” said Mary Hays RN as she administered a shot to this reporter.

Commonly called “flu,” influenza is a contagious viral infection affecting the respiratory system. Symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea.

Flu season can last from November to April, with most cases occurring in February, so there’s a good chance of exposure. Princeton’s schools have taken the precautionary measure of informing parents of the signs to watch for.

According to the Centers for Disease Control and Prevention (CDC), the current vaccine is approximately 62 percent effective. In a report released last Friday, January 11, “Early Estimates of Seasonal Influenza Vaccine Effectiveness,” the CDC described the vaccine as “moderately effective.”

Since the flu season of 2004–05, the CDC has been giving out annual estimates of the effectiveness of seasonal influenza vaccine. Data from 1,155 children and adults with acute respiratory illness between December 3, 2012 and January 2, 2013, at five study sites with outpatient medical facilities was used to make the determination.

The CDC report notes that 24 states and New York City were reporting high levels of influenza-like illness, 16 states were reporting moderate levels, five states were reporting low levels, and one state was reporting minimal levels.

The CDC recommends annual vaccination for all persons over 6 months of age. Since influenza activity is likely to continue for several more weeks, it recommends that vaccination efforts should continue.

“The vaccine protects you against most of the strains now circulating,” said Mr. Herman “The pharmaceutical companies seem to have done a good job of matching the vaccine to what is out there, but we won’t know for sure until later in the year. Sometime they guess well, sometimes not, but this year it seems to be good,” he said.

As of January 4, more than 128 million doses of influenza vaccine had been distributed in the United States for the current 2012–13 flu season, from approximately 135 million doses that were anticipated to be available for the U.S. market. At this point some vaccine providers might have exhausted their supplies so if you are looking for a flu shot you many need to call more than one provider (pharmacy, health department, or doctor).

Because the vaccine is not 100 percent effective, some of those vaccinated will become infected with influenza. If you do get the flu, antiviral medications can reduce the duration of the illness as well as complications associated with it. Early antiviral treatment is recommended for individuals with severe or progressive illness (e.g., people in hospital) and those at high risk for complications from influenza. Antiviral treatment should be started as early as possible, preferably within 48 hours after illness onset.

According to CDC reports, this flu season is shaping up to be one of the more difficult the nation has seen in several years. The last week of 2012, saw more than twice the reported number of emergency room visits attributable to influenza as there were during the same week in 2011. In New Jersey, the deaths of two children have been reported: a 14-year-old boy in Ocean County in November, and an 8-month-old boy in Camden County in December. According to Mary O’Dowd, the state’s health commissioner, both boys had underlying medical conditions.

About 24,000 Americans die each flu season, according to the CDC. This winter has been worse because of a new strain of influenza to which few people have built up immunity.

While there’s no reason to panic, there is reason to take precautions such as washing your hands often and staying away from close contact with sick people, said Mr. Herman. And if you get it, you should stay at home. The virus can be spread from a distance of six feet and a day before symptoms become apparent.

Superintendent of Schools Judy Wilson noted that so far Princeton schools had been spared. “We have certainly had students and employees ill but have not had a huge wave of absenteeism as yet and our school nurses have provided parents with additional information on prevention and care,” she said.

Nurse coordinator Holly Javick noted that an information sheet had been distributed to parents warning them that the flu is highly contagious and though it’s often confused with the common cold, its symptoms are usually more severe than the typical sneezing and stuffiness of a cold. The information sheet suggests reducing the spread of the virus by keeping students with influenza-like symptoms at home for at least 24 hours after they no longer have a fever (100 degrees Fahrenheit or 37.8 degrees Celsius, measured by mouth) or signs of a fever (chills, feeling very warm, flushed appearance, or sweating) without the use of fever-reducing medicine.

More information for Princeton parents is provided on the website at: www.cdc.gov/flu/pdf/freeresources/updated/a_flu_guide_for_parents.pdf.

November 28, 2012

Hospital Responds To Arrest of Worker

Edher Osrio of Princeton, an emergency room worker at the University Medical Center of Princeton at Plainsboro, has been accused of forcing a female patient to improperly touch him and, in a separate incident, of sexually assaulting another female patient. The alleged contact happened on November 23 with a 60-year-old female patient, while the alleged assault occurred with a 36-year-old female patient in June 2012.

The following statements from Princeton HealthCare System (PHCS) are in response to questions about the ongoing investigation involving PHCS employee, Edher Osorio, and about Mr. Osorio’s return to work after he was the subject of a criminal investigation that was conducted earlier this year. We are providing these statements in response to those inquiries. In June of 2012, a patient complained that a PHCS employee had inappropriate sexual contact with her. The Plainsboro police and the Middlesex County Sex Crimes Unit conducted a thorough investigation and did not find a reason to charge the employee with a crime. The employee was an employee in good standing at that time. As is our practice, we had conducted a thorough pre-employment reference check and criminal background check, and he had passed both. At the time of the investigation, the employee had no record of criminal conduct or of patient complaints and had not been charged with a crime. He was allowed to return to work when the investigation was completed. PHCS is fully cooperating with the police investigation, and are unable to comment on the case.

Mr. Osorio is being held at the Middlesex County Adult Correction Center in North Brunswick in lieu of $200,000 bail.

Anyone with information that may be relevant is asked to call Investigator Terpanick of the Middlesex County Prosecutor’s Office at (732) 745-3600, or Detective McElrath of the Plainsboro Police Department at (609) 799-2333.

July 18, 2012

Rabner: “Recent Improvements” Offset Consumer Reports Hospital Ranking

The University Medical Center at Princeton scored 39th among the 62 New Jersey hospitals listed in Consumer Reports’ (CR) recent (August 2012) “Ratings of Hospital Safety” (consumerreports.org).

“Hospitals should be places you go to get better, but too often the opposite happens,” begins the CR report, a sobering fact that appears to have played out in the recent death of 12-year-old Rory Staunton from septic shock in a New York City hospital.

“We believe it is important to give consumers access to information they need to make informed choices about their healthcare, so we support efforts such as the recent Consumer Reports (CR) safety rankings,” said Princeton Healthcare System President and CEO Barry S. Rabner in an email.К“Unfortunately, the rankings relied on some older data and failed to reflect recent improvements.”

Mr. Rabner did not mention the hospital’s move on May 22 to a larger, improved facility, but noted that “our hospital has madeКsignificant improvements over the past few years related to several items factored into the rankings, including infection control, communication with patients regarding their medications, and communication prior to discharge.

“In fact, within the past 10 months, two independent organizations whose purpose is to evaluate the safety and quality of healthcare have given our hospital care their highest marks,” he added.

In a web-based list of “Quick Facts,” the hospital, now known as the University Medical Center of Princeton at Plainsboro, notes that the new facility includes “231 single patient rooms with welcoming décor and amenities that reduce stress and anxiety, while minimizing hospital-acquired infections, improving patient safety, enhancing privacy, improving communications and confidentiality, and speeding recovery.”

The hospital safety rating was a first for CR, which reported “using the most current data available to us at the time of our analysis.” This included information from government and independent sources on 1,159 hospitals in 44 states. They also reportedly interviewed patients, physicians, hospital administrators, and safety experts; reviewed medical literature; and looked at hospital inspections and investigations.

A hospital’s “safety score,” according to Consumer Reports, results when six categories of hospital safety are combined into a score between 1 and 100.

Four measures of safety were actually cited in the list, which was arranged by state. Out of five scores, with five being the best and one the worst, Princeton scored two for infections; two for readmissions; one for communication; and four for scanning. The highest-scoring hospital in the state was Deborah Heart and Lung Center in Browns Mills, followed by Newton Medical Center in Newton. The lowest score went to Kimball Medical Center in Lakewood, followed by JFK Medical Center in Edison.


May 23, 2012

Hospital Sold Out Greater Princeton After Being Given $100M to Relocate

To the Editor:

A matter of civic dismay: Princeton Hospital has left, but hospital leadership has not explained to the community why it has selected AvalonBay to develop the old hospital site with plans that violate Borough Code and the 2006 Master Plan. Why has the hospital sold out greater Princeton, which gave it $100M to relocate?

On May 7, 2012, Princeton Citizens for Sustainable Neighborhoods / Witherspoon raised these issues in a letter sent to Barry Rabner, President and CEO of the University Medical Center at Princeton (UMCP) and to all trustees. To date, no response has been received.

Why will hospital leadership not explain why it has reneged on commitments it made? Mr. Rabner was himself a primary participant in Health Care Task Force discussions, and his team negotiated a very high housing density (280 units) in exchange for specific commitments to large public plazas, bike/pathways crossing the site, compliance with LEED-certification, and building-heights in scale with the neighborhood.

Not one of these commitments is being honored by AvalonBay, the contract-buyer.

Hospital leadership has an obligation to fulfill its commitments. The burden of desperately poor urban planning with which Princeton is otherwise left is too heavy to be borne; AvalonBay plans a “gated community” (prohibited by the Master Plan), and that will drag down all of Witherspoon Street, together with the idea of what Princeton stands for.

It’s time for the hospital to exercise pressure. Contract negotiations are not yet settled. Indeed, the “word on the street” is that there are disputes between the hospital and AvalonBay, and that Barry Rabner will no longer engage in discussions with AvalonBay’s representative, Ron Ladell—“One of last year’s most polarizing top 10 picks — you either think he’s a joke or a rock star” (NJBIZ, Real Estate, 2011).

And it’s time for the hospital to honor its commitments. How can the hospital’s CEO step away from formal agreements in which he participated? Barry Rabner gained the hospital a decent selling price; he’s been leading tours of the new hospital for weeks.

It’s high time he and the hospital trustees rededicated themselves to the Princeton they’ve left in the lurch. We want a written response. And we want action: a better developer who will honor Borough Code at the insistence of hospital leadership. Anything less is betrayal.

Miki Mendelsohn

Hickory Court

UMCP Facility Marks a New Era in Healthcare

Like a proud father, Barry Rabner beamed and shook a lot of hands Tuesday morning. The CEO of the University Medical Center at Princeton had barely slept the night before, as final preparations were made to move the hospital’s staff and patients from the old building on Witherspoon Street to its gleaming new home in Plainsboro, three miles away.

But Mr. Rabner showed no signs of fatigue as he welcomed patients to the $522.7 million medical complex that took four years to build. Transported by ambulance, the patients on stretchers began arriving about 7:30 a.m. Some smiled and took in their new surroundings. Others, in more serious condition and accompanied by their doctors, appeared to sleep through the momentous occasion.

Some 110 patients were being transferred from the old hospital in Princeton Borough to the new one across Route 1. The process, mapped and choreographed to the minute, was projected to take about six hours. A sign outside the entrance to the emergency room of the old hospital was in place by early morning, directing people to the new building and instructing them to call 911 if they needed emergency transportation.

“How cool is this?” said Mr. Rabner, who strolled up and down the light-filled lobby hallway of the new building, surveying the action. “What’s really great is seeing all the nurses with their noses pressed against the windows. Everyone is talking about it С and not just about the place itself. They are so excited, because they want to change the way care is delivered. It’s all been about taking care of the patients in a new way.”

The 636,000-square-foot hospital is the centerpiece of a 171-acre site that, when completed, will include a nursing home, age-restricted housing, a research building, a day care center, a park, and additional facilities. Merwick Rehabilitation Center is already located on the property. The hospital was designed to take advantage of green technology and sited to maximize natural light. All of the 231 single-patient rooms have large windows and expansive views.

Dr. Daniel Farber, an emergency room physician at the hospital, paused in the hallway to shake Mr. Rabner’s hand. “It’s a wonderful thing,” he said. Numerous people have been offering their congratulations, Mr. Rabner said, from the doctors to the housekeeping staff. “Even the volunteers, and we have over a thousand of them, are just as jazzed up as the people who are paid to be here,” he said.

Smita Shah, a hospice volunteer, was among those on hand to help new patients and their families on opening day. Ms. Shah, who lives in East Windsor, has been a hospital volunteer for years. “How could I miss out on this unique event?” she said. “I think this is an excellent facility and it will be a great service to so many people.”

Up on the maternity floor, Nicole Williams was bonding with baby Atticus, born Monday at the old hospital and the first baby to be transported to the new building the following day. Settled into her room, Ms. Williams marveled at the color-coordinated sheets and the view from her picture window. “It’s really open. You can see a lot more, and I think that makes you feel better,” she said.

Nurse and lactation consultant Dee Vandegrift, proud to be the first in the hospital to handle a baby, described the opening day as “an overwhelming feeling of excitement.” Ms. Vandergrift worked in the old building for 15 years. “The techniques we use will be so much more advanced here,” she said. “Medicine is changing, and this hospital will allow for that change.”

The hospital has been a fixture in Princeton Borough for the past 93 years. Leaving the Witherspoon Street location was emotional for some. A few weeks ago, a farewell ceremony was held in front of the building. On Tuesday at 5:15 a.m., staff members involved in the move gathered in the old hospital for the last time.

“It was very sad,” said Mr. Rabner. “The hallways are empty. All the pictures are taken down. There are people who have worked in that building for decades, like Hettie Dean — she’s been there for 56 years. One family has 26 members working there. It’s a huge tradition for them.”