January 1^st stands as a marker for many events, not least of which is the half way point of the 2009 – 2010 flu season. Though it has been a difficult few months, statistics confirm that we are indeed riding the crest of the second wave of the H1N1 pandemic, and cases are expected to drop off in the weeks to come.

That said, the Los Angeles County Department of Public Health (LACDPH) warns of the possibility of a third wave of infections in the months to follow. With this in mind, it is important to remain vigilant against the spread of infection by adhering to the Hospital Hand and Respiratory Plan when dealing with individuals who exhibit signs of flu. The best way to prevent a third wave of H1N1 is to stop it in its tracks, and hospital employees are our first line of defense in doing so.

To further combat the pandemic, LACDPH has approved the expansion of H1N1 vaccination beyond the normal priority groups. Effective December 16, 2009, providers in Los Angeles County may provide H1N1 vaccine to any patient over the age of six months for whom the vaccine is not medically contraindicated. The vaccine is in ample supply, and it is important to immunize as many people as possible, especially those who are in one of the five following priority groups:

• Pregnant women
• Caregivers and family members of persons less than 6 months of age
• All persons between the ages of 6 months and 24 years
• Persons between 25 and 64 years of age with a chronic medical condition
• All health care/emergency medical services workers

Continued vigilance is of utmost importance in curtailing the H1N1 virus and reducing the chances for a third wave of infection.

On a similar note, the Joint Commission has just released a study detailing the hand hygiene habits of health care workers. As we all know, good hygiene plays an important role in a hospital setting for both patients and employees, with over 90,000 deaths attributed each year to health care associated infections. And yet, this recent study found that staff members washed their hands less than 50 percent of the time. Following are the top reasons workers neglected to perform the required ablutions on a regular basis:

• Ineffective placement of dispensers or sinks
• Lack of accountability
• Safety culture doesn’t stress hand hygiene at all levels
• Ineffective or insufficient education
• Health care workers have too many items in their hands
• Perception that hand washing is not needed before wearing gloves

As you always do, I urge all of you to continue to follow your normal standards of professionalism and wash your hands at every given opportunity so as to minimize potentially fatal patient infections and as well as costly and unnecessary employee sick days. While the EPA has recently registered brass that kills bacteria on door handles, IV poles, countertops, keyboards and hundreds of other oft-touched surfaces, there is still no substitute for good old fashioned soap and water.

In a dramatic Christmas Eve vote, the Senate passed an $871 billion bill intended to extend health care coverage to the tens of millions of Americans who find themselves uninsured, and attempting to address the issue of skyrocketing healthcare costs.

This bill follows on the heels of a House of Representatives approved bill passed November 7th. These bills now advance to a conference committee, where representatives of the House and Senate must combine the measures. One major difference between the two is that the House bill contains a government-run insurance plan, the “Public Option,” which was recently dropped from the Senate bill.

If passed, the bills would expand coverage by making more lower-income people eligible for Medicaid, as well as offering subsidies to help moderate income people buy insurance. They would also forbid insurance companies from denying coverage of pre-existing conditions. The bills also call for “insurance exchanges,” new government regulated marketplaces where individuals and small businesses could come together to buy coverage.

Stay tuned for more updates detailing this hard-fought, controversial legislation.

In the weeks to come, I will be highlighting different areas within the hospital, with a view toward promoting awareness between departments. This week’s spotlight falls upon the many healthcare practitioners who make up the Coast Plaza Orthopedic Care Team.

The study of orthopedics is fascinating in its complexity. From broken bones to injuries of the joints, from fractures to surgical implants to spinal rehabilitation, our Orthopedic Center has both the technology and surgical expertise to correct the issue at hand.

• Arthroscopy for the knees and shoulders
• Pain management using lumbar, cervical, caudal steroid injections
• Kyphoplasty
• Lumbar Laminectomy
• Anterior Lumbar Interbody Fusion (ALIF)
• Anterior/Posterior Spinal Fusions
• Anterior Cervical Discectomy

Whether a patient’s malady is the result of a work or sports related injury or trauma, or a gradual deterioration of the joints, muscles, and back over time, our Orthopedic Care Team is equipped to address the situation and restore the patient to a pain-free and productive lifestyle.

In closing, I look forward to sharing with you the changes 2010 is sure to bring, both to healthcare in general and to Coast Plaza in particular. We are perfectly poised to make this a banner year for patients, employees, and community alike.

I wish you all a very Happy New Year.