A three-year collaboration between Mount Desert Island Hospital and an urban medical complex in Philadelphia brings leading technology and techniques to MDI while also providing urban practitioners with experience in rural health care delivery.
Now in its second year, the privately-funded collaboration between MDI and the Perelman School of Medicine is viewed as a model for partnership between vastly diverse organizations coming together to achieve a common goal of bettering patient care.
MDI is a critical access hospital that is a key provider of primary health care and rural medicine in areas where access to health care is challenged by location and provider availability.
Perelman ranks among the top five research-oriented medical schools in U.S. News and World Report‘s rankings.
The collaboration includes continuing medical education programs on topics ranging from therapeutic hypothermia for cardiac arrest patients to specialized training in treating victims of cold water drowning. In addition, physicians, residents, and nurses from Penn Medicine have been working in MDI’s emergency department for several weeks each summer.
Most recently, Penn medical personnel were at MDI training physicians, nurses and ambulance paramedics in a new protocol for sepsis treatment that was developed in part at Penn Medicine.
Septic shock is a systemic condition in which the body is fighting an infection that has spread via the bloodstream. Nationally, as many as 25 percent of patients with sepsis die. In cases where patients are severely ill, mortality can be as high as 45 percent.
It is expected the new protocol may reduce those numbers by half of more.
According to MDI’s director of emergency and obstetrics services, Chris Costello, RN, the swift identification of sepsis is essential for better mitigation and better outcomes. Many local emergency medical services have acquired meters to test lactate levels, one indication of potential sepsis, as soon as a patient is in an ambulance. The hospital is working to obtain similar meters and develop joint protocols with EMS providers, she said.
This year, Penn personnel also provided education in peer-to-peer violence, pychotropic overdoses, use of CAT scans with abdominal pain, a rapid sequence intubation refresher course, organ transplant-related disorders, identification of pulmonary embolism in the emergency room, sedation, nursing roles in a disaster, patient safety and transition of care in the emergency room, trauma, approaches to wound management, and complications in the treatment of endurance athletes.
In turn, Penn physicians, residents and nurses worked in MDI’s emergency department to enhance their knowledge of rural health care delivery. Psychiatry residents from Penn practiced at MDI’s Behavioral Health Center this year to experience how mental health services are delivered in a rural environment.
In 2011, Penn introduced other cutting-edge practices, such as therapeutic hypothermia. The reduction of a patient’s core temperature during cardiac arrest increases the chance of survival and improves the odds for normal neurological function. Rapid sequence intubation deploys a tiny video camera that offers visual guidance while a medical provider inserts a breathing tube into the patient, saving critical time.
Currently, said Costello, the two institutions are planning sessions in pediatric respiratory emergencies; and the use of telemedicine for sepsis resuscitation and, tentatively, therapeutic hypothermia.
The collaboration has resulted in important working relationships, Costello said.
“A lot of big hospitals have no concept of small hospitals and what they have for resources,” she said. “Big hospitals think, ‘Of course they want to have some sort of relationship with the big hospital.’ They think it’s one-way. But really, it’s two-way. They learn about what we have to work with, given what we have for resources and all the external factors that affect our care.”
Costello said the concept of collaboration is new, and she and others are exploring ways to share the concept with other medical institutions.
“One of the things I think about is, this is so successful for us, how can we make it so other people can do this, too?” she said. “You’ve got to, first of all, cross the threshold of small and big hospitals getting together.”
Institutions are known to share resources in emergencies, such as when there is a staffing shortage, she said.
“But this is multi-disciplinary, and you’ve got to think about this as a two-way street,” she said. “I want to get the wheels turning in other people’s brains, ‘How can we do this so we can learn from one another?'”
As they did last winter, registered nurses at MDI, and possibly some physicians and physician assistants, will travel to one of Penn’s facilities this winter for additional training on topics such as trauma and emergency care in a high patient volume setting. Next summer, plans are in the works for hands-on training on trauma assessment, and there will be a 12-week period of staff exchange.
So far, there have been 30 educational sessions with 504 attendees to date, along with 1,436 hours of staff exchange. For the third year, planning is underway for an additional 1,200 hours of staff exchange.
Costello and Leigh Anne Schmidt, nurse manager of emergency nursing at the Hospital of the University of Pennsylvania, concluded that the collaboration “has changed the accessibility of evidence-based practice education and in turn affected patient safety and outcomes through educational opportunities and staff exchange between the two facilities.”
In other developments, MDI also recently completed a capital campaign to build a larger Women’s Health Center. The current center opened in 1993. The new center will feature additional exam rooms to accommodate more outpatient services. Construction is expected to start in January 2013, with completion expected in late fall 2013.
Laurie Schreiber is a freelance contributor living in Bass Harbor.