Over the weekend, before last week began, I reviewed a series of 7 episodes from We Are New York which are to be displayed on television after they are reviewed by patients in the hospital. They deal with a wide range of topics but, their main goal is to educate people, especially Hispanic immigrants, who are new to New York on how they can take advantage of the great programs the city offers for all its residents regardless of their status. The videos focused on changing one’s lifestyle to fit a diagnosis of diabetes, how serious asthma is as a disease, the seriousness of domestic violence, being a good parent and other important messages. The shows were taped with subtitles and the actors purposely speak slowly for people who are just learning English. This coming Friday, I will be hosting a focus group with 8 patients from the HIV/AIDS Clinic. They will be reviewing two videos for the program. The videos are about 20 min in length and these patients have graciously volunteered their time to watch them.
On Monday of last week the Asthma Care program coordinators held a meeting with principals of schools in Ward 14, the school district that surounds the hospital. They presented a proposal for phase two of their program with the school district. They hope to help train all staff and nurses on the attention necessary for a patient with asthma. They discussed the importance gaining permission to disclose a student with asthma’s 504 medication sheets, filled out by their parents, to the hospital program. They hope to run training sessions on how to detect warning signs of an asthma attack. And they proposed a way to keep data on absenteeism due to asthma (through nurse documentation) in order to identify students who need further attention from their primary care providers and to assess the progress of the program. The next step is to receive the memorandum of understanding handed to principals that grants permission to have the asthma program work with them.
I also attended a meeting for another project on Wednesday of this past week, that I will be helping with called Hospitals to Homes. The program is in the trial phase at three New York public hospitals: Bellevue, Elmhurst and Woodhull. We are still working on creating a role for me within the framework of the project as it gets up and running. But, the basic purpose of the program is to provide care teams for patients with chronic illness. The team works with the patient helping them to understand their medications, helping to find them housing and food services and working with their provider. This seems like a great example of the good community health work done at New York City hospitals. The program is supported by a grant from the New York State Department of Health.
This past week I worked on preparing for a seminar we held called PACE, Provider Asthma Care Education. The seminar was sponsored by a grant from the New York State Department of Health and trained/educated physicians with specialties in pediatrics, family medicine, internal medicine, etc. in how to properly diagnose and care for asthma patients. A large number of the physicians were from the community.
And finally this past Friday I attended a presentation given by some members of the Woodhull Asthma Care Team to the New York Chapter of the Latino Nurses Association at their conference at Beth Israel Hospital in Manhattan. Among the presenters were two of my bosses, Dr. Edward Fishkin and Asthma Care Manager Desiree La Tempa. Dr. Fishkin presented a system the hospital uses to track Asthma patients and also spoke on the high incidence of Asthma in North Brooklyn.
He mentioned that 50% of Manhattan’s waste is carried off the island and into Brooklyn, specifically North Brooklyn, daily. 5,000 waste trucks pass through the streets every day. In addition, the Brooklyn neighborhoods were poorly zoned, placing residential buildings next to factories and junkyards. All of these factors are major contributors to the high rate of asthma among children and adults in North Brooklyn. It’s amazing sometimes to here these facts because it makes me feel like we are creating our own problems day in and day out and that this is a situation that could be fixed if people started to take action about their environment. It just shows that you can’t single asthma out as the only problem. You have to attack all aspects of the situation. Starting to work in the schools and communities will reach patients and their families. It will start to improve their lives but there is a large portion of factors that is out of the hospital’s control and have to be addressed by other groups in coordination with the programs offered for asthma victims of environmental hazards.
These environmental triggers also exist in poorly ventilated classrooms, moldy environments and pests and rodents within schools. Dr. Fishkin highlighted this with statistics that indicate within the last school year 12% of students with asthma missed 28 days of school a year! and at least 75% missed one day of school! He also shared that 100 kids a day are sent home from the nurse’s office with asthma related complications. This statistics are incredible and it’s very clear that Woodhull identifies them as very important community issues. Phase II of this school program being implemented will hopefully greatly reduce these numbers by increasing asthma education among school staff.