Struggles in Long-Term Care
BCHIP, in conjunction with the Bucks County Commissioners, Bucks County Health Department, Bucks County Emergency Services, all Bucks County hospitals, and our long-term care facility partners, created the Bucks County Long-Term Care Partnership to create a non-competitive environment in which healthcare facilities and advocates can work together to overcome some of the issues facing long-term care services in Bucks County.
Our goal is to improve the experience for both patients and staff, so that residents feel nurtured, empowered, and respected, and employees feel appreciated, well-compensated, and motivated to come to work every day and provide the very best care.
Staffing
One of the major challenges in long-term care (LTC) revolves around staffing shortages and training.
Many LTC facilities, also called nursing homes, struggle with insufficient staffing and a high staff turnover rate. Certified nursing assistants (CNAs) provide the bulk of care in nursing homes. Fortunately, Pennsylvania ranks highest in the nation for nurse assistant ratio per 1000 jobs in the state (10.96 per 1000), but it is still third-highest in the nation for using contracted staff (17.7%), which means there are many opportunities in PA for steady nursing jobs. Bucks County has a much lower turnover rate than the state and national averages, which is also a sign that our nursing homes are generally seen as good places to work.
Working in a long-term care facility can have unique rewards because RNs, LPNs, and CNAs are able to develop relationships with people in their care. They get to hear about their families and their memories, help them maintain a quality of life and sense of belonging in their final years, and pour a whole lot of compassion on them, which is one of the main reasons for becoming a nurse. However, much needs to be done to retain and attract good nursing staff.
A number of steps are being considered to help us attain this goal, including:
- Increased pay
- Training in geriatric care and other issues specific to elderly, chronically ill, or disabled patients
- Training in patient safety specific to elderly, chronically ill, or disabled patients
- Tuition assistance, reimbursement, or forgiveness
- Developing apprenticeship programs
- Providing benefits such as daycare or daycare reimbursement for nursing staff
Other pressures on staffing are occurring because of the recent strategy of hospitals to send patients to nursing homes when they no longer need hospital care but are not yet well enough to be sent home. This creates another stress on the already strained LTC system.
Some LTC facilities are looking into ways of streamlining tasks that can be automated, such as billing and scheduling, to lighten some of the facility’s financial pressures and staff’s time pressures to allow for more efficient nursing and recordkeeping.
Funding and Regulations
The Long-term Care Partnership of Bucks County is also trying to address the serious issues of funding and regulations that cause additional stress on the system. Changes are necessary at the local, state, and federal levels to support long-term care.
The simple truth is that LTC facilities do not get sufficient funding. Medicare does not cover LTC expenses; Medicaid patients have to be quite poor to receive coverage, and that coverage is not sufficient, so they tend to be in facilities with lower standards that charge less. A patchwork of legislation and funding at county, state, and federal levels creates difficulty in developing sufficient financial stability and efficient facilities management procedures to guarantee the highest quality of care for everyone, even the sickest or most needy patient.
Additionally, in an effort to try to force LTC improvements from the top down, The Centers for Medicare & Medicaid Services (CMS) released minimum staffing requirements for LTC facilities in April 2024. Many nursing homes and long-term care facilities simply cannot meet these stricter staffing mandates; only 6 out of 100 nursing homes currently meet these requirements. This is forcing some LTC facilities to reduce the number of residents to meet the standards, sending many people out of the system and back home with family members who may not be able to give them all they need.
Family Caregivers
Many people prefer to stay home with the support and care of family caregivers. Others are forced to stay in the home, either because they cannot afford LTC or because there is not enough staffing to receive new patients in their local LTC facilities. Either way, this puts tremendous stress on loved ones who are simply not equipped to provide medical care.
Our Long-Term Care Partnership is looking into establishing support for families, including:
- Offering training in geriatric care and other issues specific to the needs of their loved ones
- Providing a system of respite care, to give caregivers a break from constant care and allow them to engage in much-needed self-care
- Developing support groups for family caregivers to provide emotional support and answers to questions they may have about helping their loved ones or helping their families cope
BCHIP is committed to working together with all Bucks County healthcare providers and organizations to ensure the very best care for all Bucks County residents. Our Long-Term Care Partnership is yet another way that we are working to reach our goal.
After an Overdose
Substance abuse causes tremendous suffering to both individuals and their families. When you or a loved one experiences an overdose, you need immediate help to recover as well as long-term support to overcome addiction. BCHIP is here to provide that help through a program known as BCARES.
BCARES
BCARES is a collaboration of many healthcare and behavioral health partners throughout Bucks County. These organizations work together to provide assistance to individuals who have survived an opioid overdose. BCARES also provides services to individuals with any substance use disorder who are being treated in a Bucks County hospital.
BCARES stands for Bucks County Connect. Assess. Refer. Engage. Support. Through BCARES, we provide recovery support, education, resources, and direct connection from the ER or hospital to ongoing treatment.
BCARES supports any individual in a Bucks County hospital who has experienced an opioid overdose, regardless of the person’s county of residence or insurance. The Bucks County Drug & Alcohol Commission (BDAC) will fund the first three days of treatment for an opioid overdose survivor, regardless of insurance, while the treatment facility arranges ongoing funding options.
Certified Recovery Specialists
A cornerstone of our program that drives its success is the Certified Recovery Specialist (CRS). These are individuals who are in long-term recovery from substance use and have been trained and certified as support for others struggling with addiction. The CRS meets with each person individually, using his or her lived experience to provide needed emotional support, while coordinating the appropriate next steps for the recovering person’s care. This includes a warm hand-off to the next step of treatment services, including arranging transportation, if necessary. The CRS remains in contact with the person for 30 days, helping him or her succeed in long-term recovery.
If an individual is hospitalized but has not experienced an overdose, hospital staff will still arrange for the person to meet with a CRS to help provide the necessary recovery, support, education, and resources to overcome substance abuse and prevent an overdose.
BCARES Family Connect
Just as we have CRS who have experienced substance abuse to work with individuals fighting addiction, we have Family Connect, led by people whose loved ones have experienced addiction, to work with affected families. Our Family Connect support members share their lived experiences with struggling families and provide them with resources to help them journey to healing and health with their loved ones. Family Connect volunteers are available 24/7, either in hospital ERs, or by telephone, text, or email.
Contact information:
Kimberly S. London, Drug and Alcohol Program Specialist
Bucks County Drug & Alcohol Commission, Inc.
55 E Court Street, 4th Floor
Doylestown PA, 18901
Hours: Mon-Fri 8:30am-4:30pm
Email: kslondon@buckscounty.org
Get Help Now
Bucks County, the state, and the federal government all provide hotlines and websites to help people dealing with addiction as well as mental health crises. Here is a short list of resources:
- Call BCDAC at (215) 444-2700 for local resources and information, M-F 8:30am-4:30pm
- Call PA Get Help NOW Hotline: 1-800-662-4357 (1-800-662-HELP), available 24/7
- Dial 988 for the National Suicide and Crisis Lifeline, which provides 24/7 access to trained personnel who can talk people through their crisis and connect them with local agencies that can provide immediate help.
- Narcan is distributed at various locations throughout the county or it can be ordered online; click here to learn more ways to procure Narcan and receive training.
- For local support for a wide variety of needs, from healthcare to housing to food to legal help, visit www.findhelp.org.
Substance abuse can be overcome with the right support. At BCHIP, we are committed to providing you with that support. You and your loved ones are not alone. Reach out for help.
Myths about Healthcare Advance Directives / Living Wills
At BCHIP, we work to ensure that all residents of Bucks County have access to quality healthcare and accurate healthcare information so that they can make educated decisions regarding their personal health needs. Healthcare advance directives can ensure that your wishes are carried out if you cannot speak for yourself at some point.
Healthcare advance directives are legal documents that provide instructions to medical personnel about the types of treatment you do and do not want to receive. Advance directives should also name your primary healthcare proxy or durable power of attorney – the person who will make medical treatment decisions for you, applying the guidelines you have listed in your advance directive. It is wise to have a couple of alternative names, in case your primary person is unavailable in the case of an emergency.
There are a lot of misconceptions about healthcare advance directives. It’s important to dispel myths so that everyone knows the value of having an advance directive and makes the effort to create a useful document.
Myth: Only the elderly, sick, seriously ill, or those going into surgery need a healthcare directive.
TRUTH: Every adult should have an advance directive or living will. While it may seem logical to us that someone who is sick or elderly should prepare in advance in case they cannot speak for themselves, almost everyone knows someone young who has been in a serious accident or became suddenly incapacitated. Who will speak for them? What family member or close loved one will help them, if they don’t have a healthcare directive? Without a healthcare proxy or advance directive, doctors will not know their wishes. Young people out on their own for the first time, especially in a new town, really need an advance directive. They should keep it on their person or in an obvious location on their phone so that someone could find it if needed for an emergency.
Myth: Living wills are complicated and only talk about end-of-life, the refusal of treatment, or the limiting of treatment.
TRUTH: Advance directives inform your medical team about what YOU want, whether that means continuing treatment or limiting treatment under certain circumstances. It is perfectly reasonable for you to have in your advance directive that you do indeed want to continue to receive medical treatment until every resource has been thoroughly exhausted. Or you may ask to be treated until your heart stops twice and you have been resuscitated twice in a row, after which, you can be permitted to die if your heart stops again. With the advice of a trusted doctor or advance directive consultant, you decide what treatments you do and do not want.
Myth: Advance directives are not legally binding unless filed with the court.
TRUTH: Advance healthcare directives are legally recognized documents that need to be witnessed but do not need to be filed in court. You should provide all your doctors with a copy of the document and keep it in several safe places, informing your family of its location. Doctors are given legal immunity if they follow your advance directives, even if in another situation, the doctor might make different decisions. At the same time, doctors may refuse to comply with your advance directive if it is against their conscience or if they are convinced that it is not good medical practice. They are then obligated to transfer you to another healthcare provider.
Myth: It’s too hard and too complicated to create a living will.
FACT: Living wills/advance directives can be easily created, and we can help. Through our Advance Care Planning Program, we provide one-on-one consultations to walk you through the steps so that you address all major issues.
Two-thirds of all American adults have no advance directive or living will. Two-thirds of all American adults are in danger of having their healthcare decisions made at the discretion of their doctor or whatever doctors are caring for them in an emergency situation. Please make the effort to document your wishes now, while you can still speak for yourself.
Jobs in Healthcare
When most people think of jobs in healthcare, they think of doctors and nurses. But there are many other types of jobs, requiring a variety of years of training, for anyone who wants to enter the healthcare field.
Medical services
Many different types of medical personnel are necessary to provide the breadth of services sick or injured people need. If you’re interested in medicine, consider some of these specialties:
- A variety of therapists: massage, respiratory, physical, occupational, speech, and many more
- Dietician/nutritionist
- Orthotics/prosthetics professional
- Phlebotomist
- Surgical technologist
- Ultrasound technician
- Radiology/MRI technician
- Assisted living caregiver
- Home health aide
- Dental assistant
- Sonographer
- Cardiovascular technician
- Paramedic/EMT
- Pharmacy technician
- Medical social worker
Medical social worker
Medical facilities need administrators, just like any business. They need secretaries, accountants, managers, and others to help the organization run smoothly. But medical facilities also require administrative staff that have specialized medical skills, such as:
- Medical scribe
- Medical coder
- Medical transcriptionist
- Medical biller
- Medical manager
Technical services
Hospitals have some of the most advanced technology available. In order to keep it running smoothly, they need experts such as:
- Bio-medical equipment technician
- IT/systems analyst
- Health information technician
Trades
Hospitals need to maintain elaborate electrical and climate control systems, with backup in case of emergency. No hospital can ever afford to lose power. Those in the trades, such as HVAC, plumbing, electrical work, construction, and even painting and janitorial work can provide services to hospitals and other medical facilities and help patients in the process.
Whatever your interest or your skills, if you have a desire to enter the field of medicine, you will find your niche. Bucks County hospitals and medical facilities provide some of the best healthcare services in the country, but we are always in need of more dedicated people to help serve those in need. The Philadelphia area has many educational programs, including universities, community colleges, trade schools, and even certification programs associated with hospitals, that can help you begin your career or pivot an existing career into the healthcare field. If you have any questions about how to find what you’re looking for, contact us. We may be able to help direct you.
Homebound Vaccine Program Has Been Updated
Here at BCHIP, we go to great lengths to ensure that all Bucks County residents have proper healthcare. That commitment includes access to vaccines. After all, vaccines are a cornerstone of our healthcare system and are instrumental in keeping our entire community safe.
A while back, we learned that our homebound residents often find it difficult to receive routine medical care like vaccines. This makes sense, as they are often juggling other pressing healthcare needs. It is no wonder that keeping up to date on one’s vaccinations can easily slip through the cracks given those other priorities.
This is why we created a vaccine program for homebound residents in Bucks County.
While many vaccines are only given to children and adolescents, some vaccines are very important for senior citizens or persons with certain health conditions.
Our homebound vaccine program covers the common adult vaccines including influenza, COVID-19, shingles, RSV, and the pneumonia vaccine, which is a recent addition to our homebound vaccines program.
The CDC provides immunization schedules by age and medical condition. Review the tables with your medical provider to determine if any of the vaccines available for adults are right for you:
- Vaccines in the Adult Immunization Schedule by Age
- Vaccines in the Adult Immunization Schedule by Medical Condition
BCHIP has partnered with Eric’s RX Shoppe to provide you or your homebound loved one with friendly, compassionate, and efficient homebound vaccine service. They are available to work around your schedule.
Once you have determined your vaccination needs, contact us to schedule your appointment at 267-291-7882 or email rconnor@bchip.org. Insurance is required for home vaccine appointments. If you are unsure whether you are covered, contact your insurance company. If you need access to affordable health insurance, please contact the Bucks County Hub.
BCHIP stands for Bucks County Health Improvement Partnership. We are an association of healthcare and government organizations working together to improve the health of all Bucks County residents. BCHIP member organizations include the Bucks County Department of Health, the Bucks County Medical Society, and the six major Bucks County hospitals: Doylestown Health, Grand View Health, Jefferson Bucks Hospital, Lower Bucks Hospital, St. Luke’s University Upper Bucks Campus, and St. Mary Medical Center.
How Do Vaccines Work?
When you get sick, your body fights off the illness through your immune system. In the process of fighting off the disease or illness, the immune system develops antibodies, which are Y-shaped proteins specific to that virus, bacteria, or other pathogen that will help you fight off the disease the next time it enters your body. In many cases, the antibodies will prevent you from getting sick again. We call this “immunity.”
Immunization can happen naturally, as described above, or it can occur through inoculation by a vaccine. There are different types of vaccines that work somewhat differently, but the goal of every vaccine is to stimulate your immune system to recognize a pathogen and develop antibodies against it.
Some illnesses create complete immunity in the body – you only catch it once. Others, such as the flu, can be caught repeatedly because they mutate. While you may have immunity to one particular strain, you could catch another strain of the flu. But your body will have developed some antibodies that should lessen the severity of a future bout of the flu.
The same is true for vaccines. Many vaccines, especially those against childhood disease, give complete immunity. Others may require booster shots to maintain immunity or to provide protection against additional strains of the illness. This is why detailed immunization schedules have been developed by the CDC for both children and adults, to guide doctors and patients in determining what vaccines may be advisable.
Types of vaccines
Most people are familiar with the concept of “live” and “inactivated” vaccines because these are the oldest forms of vaccine. The first vaccines were inactive vaccines, casually referred to as “dead” vaccines. The virus or bacterium is grown in a lab and then treated with heat or chemicals to inactivate it before putting it in a vaccine. These vaccines cause few side effects but may provide less robust immunity and may require boosters, such as the polio vaccine.
Live attenuated vaccines involve growing the pathogen in a lab, then selecting the weakest strain and growing another culture from it, repeating this process until a very weak live pathogen is produced. This provides a much stronger immunity, though it can cause more side effects, and those with compromised immune systems should talk to their doctor before taking them. These vaccines include MMR, chickenpox, and rotavirus vaccines.
More recent forms of vaccines include subunit vaccines, such as whooping cough, shingles, hepatitis B, meningitis, and HPV vaccines. These use a portion of the germ rather than the entire germ to stimulate an immune response. The mRNA vaccine, such as the two-dose COVID vaccine, introduces an agent that mimics a portion of the pathogen (but is not a natural part of the pathogen) to stimulate an immune response.
Vaccine safety
According to the U.S. Department of Health and Human Services (HHS), vaccines go through testing and evaluation before being licensed by the Food and Drug Administration (FDA) and recommended for use by the Centers for Disease Control and Prevention (CDC). Once released for use, safety is tracked through the Vaccine Adverse Event Reporting System (VAERS). While serious side effects from vaccines are rare, it is still critical to follow up when such events are reported, in order to determine if they are in any way associated with the vaccine. This information can help the FDA and CDC make any necessary dosage changes or take other precautions.
At BCHIP, our goal is to ensure that every resident of Bucks County has access to quality medical care, including vaccination. Visit our Bucks County Immunization Coalition page for vaccine resources and information about our at-home vaccines for the homebound.
Vaccine Safety
Vaccines have saved millions of lives, especially the lives of children, who used to die in great numbers or be seriously debilitated due to many childhood diseases, such as measles and polio. Very few children have reactions from childhood vaccines, and most are minor, such as a mild fever or redness around the area of the vaccination. It is nonetheless very important to track any potential very rare and serious side effects. For this, the CDC has developed the Vaccine Adverse Event Reporting System (VAERS).
VAERS was established in 1990 through a collaborative effort between the Centers for Disease Control (CDC) and the U.S. Food and Drug Administration (FDA). VAERS allows healthcare providers, vaccine manufacturers, and members of the public to submit reports of adverse events that follow vaccination. Correlation does not automatically prove causation – an event that follows a vaccine may have nothing to do with the vaccine. However, by collecting this information, the CDC and FDA are able to monitor adverse events (AE) and determine if there are any red flags that indicate the need for further research.
Reported AE can range from redness and fatigue to the five serious adverse outcomes that trigger immediate investigation:
- Death
- Life-threatening AE
- Inpatient hospitalization or extension of existing hospitalization
- Persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions
- Congenital anomaly/birth defect
Reports of serious AE are followed up within five days. VAERS investigators generally contact the health facilities (at times the individuals, as well) for more detail related to the report. Often, reports are incomplete, and further information is necessary to carefully analyze the event. Experts will use additional safety systems, such as the CDC’s Vaccine Safety Datalink and Clinical Immunization Safety Assessment Project, or the FDA’s Biologics Effectiveness and Safety system and data obtained in collaboration with the Centers for Medicare & Medicaid Services. The occurrence of the AE will also be compared with the occurrence of the same condition in people who have not had the vaccine. Deeper analysis will determine if the event occurs more or less often in certain populations, depending on male or female, age, race, location, and frequency or timing of dosage.
Discovery of any risks related to a vaccine in any particular population may lead to a pause or an adjustment in recommendations regarding the administration of the vaccine.
BCHIP is a collaboration between medical facilities and health agencies in Bucks County, and we take our responsibility for your health and well-being very seriously. If you have any concerns about your health or the health of your child following a vaccine, even if the event occurs several weeks following the vaccine, contact your medical health provider immediately. He or she will be able to evaluate you, provide you with any medical help or advice you need, and determine whether or not to report your event to VAERS. You may also report to VAERS yourself, at https://vaers.hhs.gov/reportevent.html
If You Live in Bucks County and Do Not Have Health Insurance
There are many reasons why you may not have health insurance. Perhaps you recently lost your job, work part-time, or work at a job that does not provide adequate coverage. Perhaps your spouse, who carried the insurance, died, or you are going through a divorce. Perhaps you simply can’t afford the copay on the employer-provided insurance.
Whatever the reason, you do not need to live without insurance coverage. Bucks County provides many opportunities for you to get the medical help you need.
Pennie Insurance
Pennie is a program sponsored by the PA Department of Human Services, linking Pennsylvanians to various support services throughout the state. Pennie Insurance, PA’s official health insurance marketplace, is available during Open Enrollment, typically between November 1 and January 15 of the following year. You may be able to enroll at other times if you have had a qualifying life event (moved, lost income, etc.) or are at or below 150% of the Federal Poverty Level. Visit their website at pennie.com.
Some of the other services you can find on their website, pennie.com/learn/other-programs, include:
- COMPASS: An online tool to apply for and manage benefit information with many health and human services programs, including Medical Assistance (Medicaid), CHIP, Cash Assistance, Child Care Works Program, SNAP, and more
- Medical Assistance (Medicaid or MA): Offers Medicaid, CHIP, and Medicaid for Former Foster Youth
- Medicare: Federal Health Insurance program for older Americans (or permanent residents) and those who have a qualifying disability or illness
- WIC: Supplemental nutrition program for women, infants, and children
- SNAP: Supplemental Nutrition Assistance Program
- Mental Health Resources: Includes 988 hotline (A direct suicide prevention service, by phone or text) and other mental health resources
- Local Food Banks
Bucks County HUB
The vision of the Bucks Human Services Connect Hub is for Bucks County residents, their families, and those who support them to be aware of and have access to human services resources in person and virtually through a person-centered, supportive, integrated experience.
Bucks County offers a wide variety of support services, including health care, food assistance, housing, substance abuse, employment, suicide prevention, and other critical needs in our community. Visit their website at buckscounty.gov/1299/find-help.
For a list of hotlines, including suicide prevention, elder abuse, domestic abuse, poison control, veterans crises, Children and Youth After Hours Emergency, and more, visit buckscounty.gov/1363/hotlines-and-crisis-services.
You can also contact the Hub at (215) 348-6201 or thehub@buckscounty.org.
Suicide prevention
If you are feeling emotionally overwhelmed or suicidal, please do not suffer alone! Contact:
- Suicide Prevention Lifeline: call or text 988 any time, 24/7
- Bucks County Crisis Center at Lenape Valley Foundation: call (800) 499-7455 any time, 24/7 – includes dispatching crisis teams or medical assistance
- National Alliance on Mental Illness: text NAMI to 741741 any time, 24/7 or call the NAMI Bucks County Helpline: 1-866-399-NAMI (6264) from 10am-10pm
Other mental health hotlines available HERE
Substance abuse
- Drug and alcohol addiction services are available to help those in need. If you have a loved one with a drug problem, you can also get Narcan, an over-the-counter opioid overdose treatment that is considered an “opioid antagonist medication” – that is, it reverses the effect of an opioid overdose and can save lives, if administered early enough.
- The Bucks County Drug and Alcohol Commission (BCDAC) offers many ways to obtain Narcan, which you can find on their website, bcdac.org/resources/naloxone_narcan.php. The website also explains how to obtain Narcan by mail or at a local pharmacy.
- The PA Get Help Now Hotline, staffed by professionals trained in crisis management, is available 24/7, and will provide a warm handoff to the agency or organization that can provide the next step in care. That Hotline number is 1-800-662-4357 (1-800-662-HELP).
- BCHIP offers a free Quit Smoking Program both virtually and in person that has helped thousands of people successfully quit smoking.
Don’t get overwhelmed. There are many services available to help you live your life well in Bucks County. Contact the services you need today.
Violence in the Workplace – Healthcare
Healthcare is one of the most rewarding professions. As a healthcare worker, you help people in their time of greatest need, providing them with the medical care and often the emotional support that they require on their journey toward health and wholeness. However, because patients are in a vulnerable position, emotions can run high, and sometimes physical or verbal attacks can occur. Government data shows healthcare workers are five times more likely to experience workplace violence than other workers.
Millions of people are helped every day in hospitals, therapy centers, doctors’ offices, home health agencies, and other medical facilities across the country. Amid that great volume of need, it is not surprising that some people act badly. Many non-fatal injuries occur from healthcare workplace violence, most of which is perpetrated by the patients themselves. Distraught family or friends can cause a small percentage of those incidents. Common abuses may include pushing, kicking, biting, spitting, or verbal abuse. More serious attacks are very rare, but the risks should be taken very seriously, and any abuse can cause physical and emotional harm to the victim.
BCHIP is partnering with NOVA and the DA’s office to address these issues. A task force is in place in coordination with our partner institutions to study the problem, determine root causes, and implement policies, procedures, and consequences for violence in the workplace.
Some causes or risk factors of workplace violence seem to include:
- The emotional state of the patient, family, and/or friends
- Shortage of staff, causing long waits at healthcare facilities such as emergency rooms
- Overworked inpatient staff, with too many patients per nurse
- Healthcare staff who are not trained in conflict resolution to de-escalate volatile situations
- Environmental factors that cause patient or family frustration: inflexible visiting hours, overcrowding, lack of information, language or cultural barriers
- No clear consequences for patients or family members who engage in physical or verbal abuse
While most patients greatly appreciate the help of healthcare workers, a few unpleasant experiences can cause nurses and other staff to feel vulnerable, demoralized, and overly cautious with other patients, which can have an adverse effect on the quality of care a nurse or healthcare provider offers. It is critically important for nurses and all staff working in medical settings to feel safe and to know that, if violence does occur, those who commit the assault will experience consequences for their behavior.
Possible solutions could include:
- Clearly established policies regarding violence against healthcare workers, including serious consequences that can include pressing charges
- Training in de-escalation and conflict resolution
- A reporting system that documents all incidents of abuse
- A culture of support for victims of abuse and encouragement of thorough reporting
- Sufficient security systems, security personnel, alarms, and emergency response teams
Certainly, one can have compassion for the patient who, in an unhealthy state, reacts with anger or aggression, but compassion cannot justify overlooking the behavior and the harm done to the victim. Even unwell people should be held accountable for their behavior. The goal is to find a balance that ensures that our Bucks County healthcare workers are at all times respected and protected, while they continue to provide the care that patients need.
Data shows that when a measurable, enforceable workplace violence prevention program is in place, the quality of care increases, incidents of violence decrease, and staff is more comfortable and confident. At BCHIP, we are working with our partners, healthcare workers, and other stakeholders to make Bucks County one of the safest counties in the country for healthcare workers and their patients.
Overcoming Inequity in Healthcare
BCHIP is a coalition of Bucks County hospitals, health service organizations, and the Bucks County Department of Health working in collaboration to overcome healthcare inequities in our county and improve overall health in our community.
The causes of inequity in healthcare are many and diverse. They include socioeconomic status, race, ethnicity, location, education, health insurance, social isolation, ethnic medical diversity, and community traditions. Institutional disparities also exist, such as location and availability of health services. These are also referred to as social determinants of health. With so many factors causing healthcare inequity, a multipronged approach is needed.
Awareness is the first step to overcoming this problem. Many doctors and medical professionals are unaware of the level of disparity in our community. And many members of the community who receive unequal medical care are unaware of their need for help or they are unwilling to seek out help. Both populations need to be educated so that disparity can be overcome.
Educating healthcare providers
Healthcare providers need to be aware of the data demonstrating disparity so that they are more likely to recognize and combat it. Subconscious and unintended stereotyping or bias can contribute to healthcare disparity, which providers need help to recognize and overcome.
Sometimes a patient may refuse necessary treatment. A medical provider should ask appropriate questions to determine the reason for the refusal, which could be due to a lack of healthcare insurance, a fear of losing time off from work, a poor understanding of the seriousness of the condition, or a general suspicion of medical care. With knowledge of the reasons, the provider can help the patient overcome these concerns.
Thorough intake questionnaires should include all known disparity risks and social determinants of health. Training in proper evaluation of these questionnaires will help healthcare providers notice red flags warning of increased risk of health disparity and take necessary steps to overcome them before serious illnesses develop, such as these sobering statistics:
- Stroke risk is 50% higher among individuals with three or more known disparity risks, even after adjusting for stroke risk factors
- The infant mortality rate for college-educated black women is higher than that of white women with similar education
- African American children are hospitalized for asthma at a rate 4-5 times greater than white children
In addition, the percentage of uninsured Americans varies by race:
- 36% Latinos
- 33% Native Americans
- 22% African Americans
- 17% Asian and Pacific Islanders
- 13% Whites
Uninsured adults are less likely to visit a doctor, less likely to have a private physician, and less likely to engage in necessary medical treatment.
Educating the public
It’s important to raise public awareness of these disparities, especially among the underserved. Education should include linguistically and culturally sensitive information; education in healthier lifestyle options; awareness of medical resources; and awareness of agencies and organizations that provide financial and other types of support for medical needs.
Developing outreach in partnership with community stakeholders will help us ensure that our message reaches the most vulnerable populations.
Providing more access to healthcare
The BCHIP partnership is looking at ways to make healthcare more easily accessible to underserved communities by providing more clinic access and more medical practitioners in their areas. Increasing the number of minority medical providers is also an important part of the outreach strategy. Convenient access to both physical and mental health services is being evaluated to ensure that no one in Bucks County is without the help he or she needs.
