Ebola patient walks into Atlanta hospital; wife sees him through glass

By Jason Hanna and Faith Karimi, CNN
updated 10:02 AM EDT, Sun August 3, 2014

http://www.cnn.com/video/data/2.0/video/us/2014/08/02/nr-wsb-american-ebola-patient-arrives-emory.cnn.html

STORY HIGHLIGHTS
Kent Brantly visited with his wife, separated by glass wall, for 45 minutes
Brantly is first known Ebola patient in U.S.
Both Americans infected with Ebola will be treated at Emory University Hospital
Plane will head back to Liberia for the second American patient

Atlanta (CNN) -- A medical plane whisked an American infected with Ebola from Liberia to Georgia on Saturday, the latest leg of a race to save the first known patient with the deadly virus to be treated on U.S. soil.

Shortly after the plane landed, an ambulance rushed Dr. Kent Brantly from Dobbins Air Reserve Base to Atlanta's Emory University Hospital. He's one of two Americans sickened by the deadly viral hemorrhagic fever last month while on the front lines of a major outbreak in West Africa.

Video from Emory showed someone in a white, full-body protective suit helping a similarly clad person emerge from the ambulance and walk into the hospital.

Emory has said it will treat Brantly, 33, and fellow missionary Nancy Writebol in an isolation unit.

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The plane equipped with an isolation unit can only transport one patient at a time. It will now pick up Writebol in Liberia and bring her to Georgia early next week, said Todd Shearer, spokesman for Christian charity Samaritan's Purse, with which both Americans were affiliated.

Brantly's wife, parents and sister cried when they saw him on CNN walking from the ambulance into the hospital, another representative of Samaritan's Purse said on condition of anonymity. His wife, Amber, later said she was relieved that her husband was back in the United States.

"I spoke with him, and he is glad to be back in the U.S.," she said in statement. "I am thankful to God for his safe transport and for giving him the strength to walk into the hospital."

Brantly's wife visited with him from behind a glass wall for about 45 minutes, the Samaritan's Purse representative said. Kent Brantly was described as "in great spirits and so grateful."

Brantly, who has ties to Texas and Indiana, and Writebol, of North Carolina, became sick while caring for Ebola patients in Liberia, one of three West African nations hit by an outbreak.

Treatment in isolation

This will be the first human Ebola test for a U.S. medical facility. The patients will be treated at an isolated unit where precautions are in place to keep such deadly diseases from spreading, unit supervisor Dr. Bruce Ribner said.

Everything that comes in and out of the unit will be controlled, Ribner said, and it will have windows and an intercom for staff to interact with patients without being in the room.

Ebola is not airborne or waterborne, and spreads through contact with organs and bodily fluids such as blood, saliva, urine and other secretions of infected people.

There is no FDA-approved treatment for Ebola, and Emory will use what Ribner calls "supportive care." That means carefully tracking a patient's symptoms, vital signs and organ function and taking measures, such as blood transfusions and dialysis, to keep patients stable.

"We just have to keep the patient alive long enough in order for the body to control this infection," Ribner said.

Writebol was given an experimental serum this week, Samaritan's Purse said, though its purpose and effects weren't immediately publicized.

The Ebola virus causes viral hemorrhagic fever, which refers to a group of viruses that affect multiple organ systems in the body and are often accompanied by bleeding.

Early symptoms include sudden onset of fever, weakness, muscle pain, headaches and a sore throat. They later progress to vomiting, diarrhea, impaired kidney and liver function -- and sometimes internal and external bleeding.

Bruce Johnson, president of SIM USA, a Christian mission organization with which Writebol also is linked, said Saturday that both were seriously ill but stable.

"My last report (on Brantly) was yesterday. ... He was ambulatory, being able to talk, converse, and get up. So that was encouraging," Johnson said Saturday morning.

On Writebol, Johnson said: "She's responsive, and we're encouraged at how she's doing."

Emory's isolation unit was created with the Centers for Disease Control and Prevention, based down the road. It aims to optimize care for those with highly infectious diseases and is one of four U.S. institutions capable of providing such treatment.

The World Health Organization reports that the outbreak in Liberia, Sierra Leone and Guinea is believed to have infected 1,323 people and killed more than 729 this year, as of July 27.

Fear, conspiracy theories

As officials worked to bring the two Americans home, the idea of intentionally bringing Ebola into the United States has rattled many nerves.

"The road to hell was paved with good intentions," wrote one person, using the hashtag #EbolaOutbreak. "What do we say to our kids When they get sick& die?"

On the website of conspiracy talker Alex Jones, who has long purported the CDC could unleash a pandemic and the government would react by instituting authoritarian rule, the news was a feast of fodder.

"Feds would exercise draconian emergency powers if Ebola hits U.S.," a headline read on infowars.com.

Ribner repeatedly downplayed the risk for anyone who will be in contact with Brantly or Writebol.

"We have two individuals who are critically ill, and we feel that we owe them the right to receive the best medical care," Ribner said.

The fight against Ebola

All concerns about the United States pale in comparison to the harsh reality in the hardest-hit areas.

Even in the best-case scenario, it could take three to six months to stem the epidemic in West Africa, said Dr. Thomas Frieden, director of the CDC.

There's no vaccine, though one is in the works.

There's no standardized treatment for the disease, either; the most common approach is to support organ functions and keep up bodily fluids such as blood and water long enough for the body to fight off the infection.

The National Institutes of Health plans to begin testing an experimental Ebola vaccine in people as early as September. Tests on primates have been successful.

So far, the outbreak is confined to West Africa. Although infections are dropping in Guinea, they are on the rise in Liberia and Sierra Leone.

In the 1990s, an Ebola strain tied to monkeys -- Ebola-Reston -- was found in the United States, but no humans got sick from it, according to the CDC.

Experts: U.S. health care system well-prepared for Ebola

CNN's Chelsea J. Carter, Greg Botelho, Deanna Hackney, John Branch, Danielle Dellorto, Barbara Starr, MaryLynn Ryan and Ben Brumfield contributed to this report.
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EAH MAKES GA HOSPITAL ASSOCIATION’S PRESIDENTIAL HONOR ROLL

6/29/2009

(Smyrna, GA, June 29, 2009)—Emory-Adventist Hospital at Smyrna has been named as one of only 38 hospitals in the state to the Georgia Hospital Association’s (GHA) Partnership for Health and Accountability (PHA) Presidential Honor Roll.

The honor roll is based on clinical data provided by the federal Centers for Medicaid & Medicare Services (CMS), which administers the nation’s Medicare and Medicaid programs. The data was collected from January 2008 through December 2008. To qualify as a Presidential Honor Roll hospital, EAH maintained a score of 93% or higher in its Appropriate Care Measures (ACM) during that time period.

The CMS data details how well a hospital’s caregivers adhere to a list of Appropriate Care Measures (ACM) which are the clinical processes of care that are known to be the most effective methods of treatment for patients who have suffered heart attacks, heart failure or pneumonia. For instance, a recommended treatment to help prevent a heart attack is to take aspirin either before or upon arrival at the hospital. A hospital’s adherence to these recommended clinical practices usually leads to better outcomes.

"Congratulations to Emory-Adventist Hospital at Smyrna for its outstanding performance," said Joseph Parker, president of GHA. "We are proud of this accomplishment," said Ed Moyer, COO of the Hospital. "It is our mission to ensure that each of our patients receives the right care at the right time, and this recognition validates this."

Emory-Adventist Hospital at Smyrna is operated by Adventist Health System (AHS) as a joint venture with Emory Healthcare. AHS operates the largest not-for-profit Protestant healthcare system in the nation, with 38 hospitals in 11 states, as well as extended-care, home health and hospice facilities. Emory Healthcare is one of the nation's leading health systems and is affiliated with the world-renowned Emory University School of Medicine and Emory University Hospital.

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Source: http://www.emoryadventist.org/News/NewsArticle/tabid/4625/ItemID/2891/srcmid/21550/Default.aspx
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Emory’s name doesn't ensure its high standards

Metro Atlanta / State News 8:50 p.m.

Friday, November 6, 2009

Emory’s name doesn't ensure its high standards
Medicare data reveals some partner hospitals’ shortcomings

By Carrie Teegardin
The Atlanta Journal-Constitution

Patients who arrive for care at Emory-Adventist Hospital might reasonably assume that the Cobb County facility is run by Emory University

Those turning to Emory Eastside Medical Center in Snellville and Emory Johns Creek Hospital in North Fulton might also believe they are entrusting their care to the folks who operate the highly regarded teaching hospital on the Emory campus.

But Emory’s name on the sign out front does not mean Emory is completely in charge. And it doesn’t ensure that high quality standards are always met.

Medicare statistics measuring the quality of care at the nation’s hospitals reflect shortcomings at two hospitals using the Emory name, according to an Atlanta Journal-Constitution study.

Of the five metro Atlanta hospitals in the Emory Healthcare system, Emory University exclusively manages just two: Emory University Hospital on Clifton Road and Emory University Hospital Midtown on Peachtree Street.

The other three Emory hospitals are joint ventures with other hospitals chains. In each case, Emory helps oversee operations but leaves much of the day-to-day management to its partners.

Academic hospitals such as Emory’s Clifton Road and Midtown facilities partner with community hospitals to extend their reach into suburban areas. Some jointly run the hospitals. Others team up to create a specialty unit within a hospital, said Dr. Joanne Conroy, chief health care officer at the Association of American Medical Colleges.

Conroy said quality control is key for the academic hospitals.

“When their brand is out there, they want to make sure that patients have an expectation and receive the same level of services they would receive at the mother ship,” she said.

Emory Eastside, a joint venture between Emory and the health care company HCA Inc., posted a high death rate among pneumonia patients admitted between 2005 and 2008. Emory-Adventist, which is co-owned by Emory and Florida-based Adventist Health System, earned some of the worst marks in the state on 2008 patient satisfaction data compiled by Medicare. The numbers are the most current statistics available to the public.

John T. Fox, Emory Healthcare’s chief executive officer, said Emory sets quality standards and demands good results. Emory doctors serve on each hospital’s board of directors and also work at each facility monitoring quality statistics. He said Emory has closely worked with its partner to address problems highlighted in the Medicare reports.

“We would not enter into a joint venture with anyone who had a lower standard of commitment on quality,” Fox said. “We obviously take our name and our reputation very seriously and we are careful with how we use the brand.”

Fox said Emory staff constantly monitor a range of statistics measuring outcomes and satisfaction.

“Whenever we see a number that is below our expectations, and we see it long before it ever gets published, we go to work on it,” Fox said. “That’s independent of whether it’s a joint venture or a 100 percent Emory-owned hospital.”

As one of its many measures of hospital quality, Medicare surveys the nation’s patients after a hospital stay.

On seven of the 10 patient satisfaction questions, Emory-Adventist posted scores that ranked it no better than third-worst in the state, according to an AJC analysis of the data covering overnight admissions in 2008.

Only two Georgia hospitals scored worse than Emory-Adventist on overall satisfaction and only one scored worse on the percentage of patients who said they would not recommend the hospital. Only one Georgia hospital scored worse on the measure of how well doctors communicated with patients and only two hospitals scored worse than Emory-Adventist on communication with patients by nurses.

No hospital had a more negative rating than Emory-Adventist on how well pain was controlled and only two had higher negatives on whether patients received help quickly when they called for assistance.

Emory owns 35 percent of the 88-bed Emory-Adventist through a 1995 joint venture. Adventist Health System, a nonprofit chain with 37 hospitals nationwide, owns the majority stake of Emory-Adventist and handles most day-to-day operations.

The facility gets more than 80 percent of its admissions through its emergency room, the hospital said.

Emory appoints four of the facility’s 10 board members, one of whom is the chief quality officer at Emory Hospital Midtown.

Insurance companies and government regulators are paying close attention to customer feedback. “Patient satisfaction is clearly an important component of quality,” said William S. Custer, a Georgia State University professor who is an expert in health care and insurance.

Custer said if he were a consultant to Emory-Adventist, he would study emergency room operations since the vast majority of patients start there.

“What this shows is that they need to change the culture to have their employees communicate with patients better at every step,” Custer said.

Emory Eastside and Emory Johns Creek are joint ventures with HCA Inc., a Tennessee-based health care company that operates hospitals nationwide.

At both Eastside and Johns Creek, an Emory doctor monitors quality statistics. Fox said Emory doctors are also assigned to serve as “hospitalists” at the facilities — internal medicine specialists available to nursing staff around the clock. Emory doctors serve on each hospital’s board of directors.

HCA, however, oversees most day-to-day details.

Emory Johns Creek earns strong marks on patient satisfaction surveys and quality measures.

Emory Eastside’s patient ratings were better than Emory-Adventist’s, but below state averages on most questions.

Emory Eastside scored poorly on Medicare’s pneumonia mortality rate, in spite of earning high scores from Medicare for following protocols designed to prevent pneumonia deaths. The hospital is among 14 across Georgia that Medicare highlighted for posting high 30-day death rates among patients admitted with a pneumonia diagnosis over a three-year period, the latest data available.

The Atlanta Journal-Constitution published an in-depth story in October about Georgia hospitals’ poor performance on Medicare’s measurements of clinical outcomes.

Larry Kloess, president of HCA’s division that includes Georgia, said the foundation of HCA’s partnership with Emory is a “shared commitment” to delivering the highest quality care possible.

In a prepared statement, Kloess also said it’s important for consumers to realize that some publicly reported data lags months behind current performance. Medicare does reach back to 2005 to calculate its current pneumonia death rates.

Emory Eastside said it is making a special effort to work with patients suffering from chronic conditions after they leave the hospital to try to improve results. Emory Eastside’s Web site prominently displays its affiliation with Emory Healthcare, but not with HCA.

Dr. John Santa, director of the health ratings center for Consumer Reports magazine, said many patients would assume Emory alone runs a facility that bears its name.

“If they find out differently, doesn’t that kind of sound like a bait-and-switch?” he said.

Some patients might want to know, Santa said, they are going to a hospital where a for-profit company is involved in management. Santa described Emory as a “very impressive brand.”

“I would assume that Emory has business reasons for being willing to share their brand,” he said. “How that involves quality and performance is a good question.”

Administrators at Emory-Adventist are working furiously to improve patient satisfaction ratings, including making changes to assure feedback is accurate.

Ed Moyer, the hospital’s chief operating officer, said the changes include phones instead of call lights, message boards displaying key staff names and a “turn-down” service offering patients a clean gown or fresh sheets.

The hospital’s most recent internal data show significant improvements in satisfaction ratings for patients admitted this year.

Adventist Health System is affiliated with the Seventh-day Adventist Church. “We take seriously our mission to extend the healing ministries of Christ,” Moyer said.

Fox, the Emory Healthcare chief, said he is very comfortable with the quality of care being delivered at all hospitals in the system. But he said he wants to see improvements at each facility, including the highly regarded hospital on the Emory campus that does ground-breaking work every day.

“I want perfection,” he said. “That does not exist in the Milky Way in terms of health care.”


Online rankings


Patient opinions about their experiences in a hospital have historically been limited to what friends and neighbors share. Today, Medicare’s “Hospital Compare” Web site allows consumers access to detailed patient survey data collected in a scientific manner and made available for almost every hospital in the country.

Many consumers have grown accustomed to checking online reviews before making a purchase. Medicare’s data is backed by hundreds of responses, not just the feedback of patients who happened to post comments on a Web site.

To review detailed quality and satisfaction data for hospitals around the country, go to: 
www.hospitalcompare.hhs.gov


How we got the story


To examine how well Georgia hospitals performed on patient satisfaction surveys, The Atlanta Journal-Constitution studied the most recent data collected by Medicare for every hospital in Georgia. The newspaper reviewed the latest quality measures published for each hospital. The AJC also interviewed hospital executives and experts in hospital quality and management.

Source: http://www.ajc.com/news/emorys-name-doesn-t-189072.html