Nearly one million unconscious patients will arrive in the emergency department this year. Although most hospitals notify patient’s next of kin immediately, that call can often be delayed or forgotten. Without it, there’s no family member present to comfort the patient, make informed decisions for his care or provide the medical history that can make the difference between life and death.

That’s exactly what happened to Elaine Sullivan, a very active seventy-one-year-old woman, who slipped and fell, while getting into the bathtub. When paramedics arrived, they realized that injuries to her mouth and head had made her unable to communicate, or as the hospital later discovered, to give informed consent for her own care.

Although stable for the first few days, she began to slip into critical condition. On the seventh day, Elaine died. But that tragedy was soon overshadowed by another. Despite having her daughter’s phone number and contact information clearly indicated on the front of her chart, the hospital failed to notify her family that she’d been hospitalized until six and a half days after her admission, only hours before she died, unnecessarily and alone.

Elaine Sullivan was my grandmother.

In her case, placing that phone call right away, would have saved her life. Not only would my mother Jan and I have had the time to fly back to Chicago to be at her bedside, but we would have made sure she received the care she needed. We also would have been able to give the physicians treating her, the medical history they needed to prevent the complications and drug interactions, responsible for her death.

After researching our own case and others like it, we realized that failing to notify a patient’s next of kin wasn’t an isolated problem - it’s something that’s been experienced by countless families nationwide. According to the CDC, nearly one million patients come into the ED every year unconscious or physically unable to give informed consent. And with the growing number of emergency room admissions and baby boomers turning into senior citizens, the problem is only going to escalate. Working with medical and trauma professionals, we created an easy-to-implement solution to this growing problem, by bringing together the best practices of successful trauma teams from hospitals nationwide. The result is the Seven Steps to Successful Notification System.

The complete system is presented in Seven Steps to Successful Patient Notification, which is available for download, free of charge, on the NOKEP web site. It’s filled with tools your staff can use on the patient care floor to identify and locate your unconscious patient’s family or surrogate decision makers, identify John Does and improve patient care and satisfaction by locating patient’s medical histories quickly and easily, while complying with HIPAA standards.

Even better, following the Seven Steps system provides the facility with a documentation of the steps taken to find the patient’s next of kin, make the notification, and the staff members responsible for making it. This releases you from subsequent liability, while providing proof that your facility has met its statutory responsibility.

Here is a quick look at the Seven Steps.

Step 1: Patient status confirmed

The moment that your staff realizes that an ED patient is unconscious or physically unable to give informed consent, and that there is no family member or surrogate decision maker in attendance, a nurse or physician is tasked with following the notification process through to completion. The staff member indicates the patient’s status on his chart along with the time, date and the staffer’s initials.

Step 2: Examine the patient’s personal effects for emergency contact numbers

If the patient doesn’t have emergency contact information in his or her wallet, the staff member looks for it in the patient’s personal effects. The System has a comprehensive checklist of places to locate this information, from the usual to the downright creative.

Step 3: Retrieve patient’s home number

If the patient doesn’t have emergency contact information, the staff member then looks for the patient’s home number, going to step five if they find it and four if they do not.

Step 4: Seek other sources for contact information

Next, the staff member looks for the patient’s emergency contact information or home phone number on records from previous admissions at the facility, or by calling his personal physician’s office, or other locations on the checklist. If the staff member finds the information, he proceeds to step five - if not, step seven.

Step 5: Oversee or make the notification call

When a contact has been identified, the staffer places a call to make the notification. They note on the chart when the call was placed, whom they contacted, the phone number and the result.

Step 6: Need to follow up? Recall main contact or second number

If a message had to be left for the contact, or the contact doesn’t come into the hospital within two hours, the staff member places one more call, to the first or a secondary contact. If no one is reached, the staff member proceeds to step seven.

Step 7: Shift to social service or police

When no contact name or number can be located, or if the staff member doing the notification, is unable to speak directly to the contact, they give the information to the social service department or to the local police department, as per your facilities’ policy, for follow up.

The bottom line for laboratories is increasingly being watched by purchasing agents who are looking for cost-cutting ways to still deliver quality service. By purchasing used laboratory equipment, medical facilities can realize 50% to 80% in operational cost savings. This allows for the use of cash to take advantage of other opportunities. This requires purchased equipment that does not compromise on the quality, ensuring patients’ safety at all times. Healthcare professionals must have peace of mind at all times, knowing that they are providing quality care without the worries of equipment malfunctions. To ensure this, most used equipment suppliers offer money back guarantees as well as extended warranties.

Used laboratory equipment is probably the most expensive capital purchase for any medical facility. Additionally, rules and state laws have restrictions which govern the handling, storage and disposal of biological materials. This requires used equipment to be reconditioned in order to meet those standards before they can be resold. Avoiding cross contamination is a major concern because erroneous test readings can lead to improper treatment. This type of equipment is divided into two categories. One-time use items include scalpels, vials and other sample taking tools. The larger machines can be used multiple times on all patients.

There are many examples of used laboratory equipment and there are online vendors that provide inventory listings. Some include the list price, but most require customers to call for a price quote, depending on the type of equipment. The Tuttnauer/Brinkmann 2540E model is a programmable bench top sterilizer/autoclave that ensures safe and convenient sterilization. The features on this sterilizer include a self-contained water supply that controls steam purity, automatic cycles, and adjustable temperature, time and pressure settings. Another good buy is the Perkin Elmer Plasma II, a plasma emission spectrometer that has long-term wavelength stability. The used version costs $14,950, considerably less than a newer model.

Medical facilities will be able to maintain compliance by purchasing used laboratory equipment from the right vendor. This requires that the equipment does not lead to lab testing errors which can cause serious illness or even death. Selecting the right vendor takes careful consideration. Some vendors offer installation services along with warranties for pre-owned laboratory equipment.

Are you or someone you know struggling to pay for prescription medicine? If so, you may be able to identify with Peter. Pete is a retired mechanic who suffers from COPD. The majority of his income is supplied by Social Security. He also receives a small monthly pension from the factory he retired from. Pete manages to pay the rent on his tiny apartment, and pay his other bills, but he can’t afford all of the prescriptions he needs to control his condition. Medicare helps Peter out by paying for a part of his medical bills, but his Medicare Part D only pays for his prescriptions until April of each year which is when he falls into that not so sweet donut hole where nothing is covered. Up until he retired, Peter managed to keep a modest savings account in the bank. Since he’s retired, though, he’s been using his savings to buy his prescriptions every month. And now, his account is just about exhausted.

What Pete probably doesn’t know, is that he could be eligible to receive his prescription drugs directly from the manufacturers for free. The manufacturers that offer patient assistance programs are just beginning to advertise that this help is available. Most of the major drug manufacturers including Pfizer, Merck, GlaxoSmithKline , Parke-Davis, Novartis, Wyeth, and nearly a hundred more offer an array of over a thousand free prescription drugs for those who qualify. The pharmaceutical companies decide if they will have a PAP and, if they do, which of their medicines will be available through the program. Some include many or all of the medicines they manufacture while others include only a few. The reasons for these decisions are not something they reveal. Sometimes a medicine or a certain dosage of that medicine will be on a program, then off, and then back on again. Or one dose of the medicine will be on the program but a different dose won’t be.

Although no two programs are exactly the same, most require that the applicant complete an application form. The amount of information required varies. Some programs require detailed medical and financial information, others very little. All require a doctor’s signature. Some patients need drugs for a long time. Most, but not all, programs that cover medicines used to treat chronic diseases offer refills. As you can imagine, this process can at times be very daunting and even overwhelming. Peter was fortunate because he was referred to a prescription assistance company by his physician and was able to receive most of his medicine directly from the drug companies for a small monthly service fee. If you or someone you know are struggling to pay for prescription medicine, I urge you to apply for assistance today. If you qualify, you can get your drugs free from one or more of the assistance programs.

If you have health insurance, your plan may or may not pay for prescription medicine. It depends on what kind of insurance you have. For example, if you have private health insurance through your employer, some or all of the cost of your medicine may be covered. If you have the traditional Medicare plan (sometimes called fee-for-service), your medicine probably isn’t covered. If you have a Medicare managed care plan, some of the cost of your medicine is probably covered. In many cases, the Medicaid plan in your state covers the cost of prescription medicines.

Some state governments offer affordable medicine programs for seniors, people who are disabled and people who have low incomes. Community health centers, Area Agencies on Aging, free health clinics and other community programs may also offer help. To use these services, you may need to show that you don’t qualify for private health insurance or that you don’t make enough money to pay for your medicine.

If you or someone you know are struggling to pay for prescription medicine, there is help available, you just need to be creative and persistent in finding it.