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Government funding of hospital coalitions a good deal, ASU research finds

Federal funding increasing efficiency of hospital coalitions, ASU research finds
January 22, 2018

Information sharing helps patients and health-care efficiency, new paper shows

Tragedies like wildfires, floods and mass shootings can’t always be prevented, but the devastating effects can be lessened if hospitals are fully prepared to treat wounded people.

Disaster-preparedness has been a national priority for decades, but efforts were stepped up in the mid-1990s, and, after the 9/11 attacks in 2001, the federal government was spending $500 million a year on various initiatives. One of those was health-care coalitions: partnerships between hospitals and agencies to coordinate disaster response.

Yet lack of coordination remained a major problem during disasters such as Hurricane Katrina and the Las Vegas mass shooting, when some hospitals were overloaded and others had no patients.

Is the government spending worth it? New research by Arizona State University Professor Jonathan Helm finds that not only do health-care coalitions that share information have better patient outcomes, the benefit extends far beyond disasters.

Helm, an assistant professor of supply-chain management in the W. P. Carey School of Business, focuses his research on hospital resources and, with his co-authorsHelm’s co-authors are Alex Mills, Andres Jola-Sanchez, Mohan Tatikonda and Bobby Courtney, all of Indiana University. Their paper was recently posted in the journal Production and Operations Management., created a theoretical model to measure the effectiveness of information sharing among hospitals.

Jonathan Helm

“We came up with some really interesting results that show that the coalitions are significantly more valuable than they thought themselves to be or the government thought they would be," he said. “And it wasn’t the large-scale disasters where they were most valuable, it was the smaller disasters — the three-car pileup on the highway, the bus crash, the small building fire with two to 10 patients.”

Government funding for disaster preparedness doesn’t come with many rules on what the health-care coalitions should do, Helm said.

“It’s fairly nebulous. Some coalitions purchased a lot of supplies and put them in a trailer and said, ‘Here you go, we’re ready for a disaster.’ The problem is that medical supplies are perishable and disasters don’t happen that frequently,” he said.

Helm and his co-authors looked at a coalition founded in 2008 in Indianapolis, which includes 35 hospitals plus emergency and public-safety agencies.

“What they are doing is fairly unique,” he said.

“They created an information-gathering system in which all the hospitals report to the coalition the capacities in their units — in the emergency department, medical-surgical, intensive care, burn beds. They now have a real-time database of all of the medical resources in the city, so instead of stockpiling stuff, they stockpiled information and it updates dynamically.”

Helm emphasized that hospitals are competitors and typically would never share this kind of information.

“They trust the coalition,” he said. “This is information they protect and the creation of this coalition allows them to more freely share it.”

Even for a large hospital, getting more than three patients at one time can be challenging, he said. So when there’s a surge in patients, the coalition can direct where to send them.

“They can distribute the patients across the hospitals in the city. The ones that are less serious they can send a little farther away. The ones that are most serious, they’ll send to this Trauma 1 and when that gets overloaded, they send them to that one.”

The implications can be life-saving.

“If you send a patient to an emergency department that’s overloaded, many things can happen. Morbidity and mortality goes up. Length of stay goes up. Doctors tend to order unnecessary tests because they’re overworked,” he said.

The team created a theoretical model using the variables of incident severity, the capacity at the hospitals and “coordination intensity,” which is how much information is shared. Then they tested it using archived data from the National Trauma Data Bank and hospital census numbers. They found that sharing information on the number of inpatient beds was more valuable than just disclosing how much room is open in the emergency room.

Helm said that proving the credibility of a government-funded initiative was important.

“The question is, given a fixed budget, how do you improve quality?

“We’re having more patients who are able to complete their treatment without being blocked by lack of resources.” 

Top photo by Pixabay

Mary Beth Faller

Reporter , ASU Now

480-727-4503

ASU adds 2 signed books by Martin Luther King Jr. to archive

Historical texts to be part of wider community collaboration


January 22, 2018

This month, Arizona State University added two significant, historical texts to its archive.

Under the guidance of Paul Carrese, director of the School of Civic and Economic Thought and Leadership, with funds allocated by the Arizona State Legislature and approved by the ASU President's Office, the school purchased signed, first-edition copies of "Stride Toward Freedom," Dr. Martin Luther King Jr.'s 1958 memoir of the Montgomery Bus Boycott, and "Strength to Love," a collection of his sermons published in 1963. Students view signed copies of Martin Luther King Jr. Strength to Love Stride Toward Freedom Students and faculty gather at the library to view signed, first-edition books by Rev. Dr. Martin Luther King Jr. Download Full Image

This acquisition is part of the school's larger project to provide ASU faculty and programs with the opportunity to educate and inspire the university community and the broader public about the extraordinary contributions of figures in American history.

According to Carrese, "each text holds a crucial place in a basic civic education for serious citizens and those who aspire to be leaders in public affairs or civil society."

To evaluate the King books and advise on their purchase, Carrese enlisted the expertise of Lorrie McAllister, associate university librarian for collection services and analysis; Matt Delmont, director of the School of Historical, Political and Religious Studies; and Keith Miller, interim director of the Center for the Study of Race and Democracy.

Carrese knew early on that he wanted to include work from King in acquisitions by the school. He said King was an extraordinary leader because in spite of injustice, he still believed in the Declaration of Independence and the Constitution, quoting them frequently in speeches and sermons.

“He demanded that American political leaders finally live up to the promises of equal justice those great documents embodied," Carrese said. "This belief in the foundational principles of our democratic republic blended with a reasonable but persistent argument for reform is an inspiring example of civic thought and leadership that our school is very proud to showcase."

While adding these significant books to the university archive is motivation in itself for this kind of purchase, Carrese — along with Associate Director of Public Programs Carol McNamara — is committed to keeping them dusted off and circulating outside of the archive through interdisciplinary public programming.

To Carrese and his team, as well as the Hayden librarians responsible for stewardship of the archive, the books are rare and valuable as historical objects, but they are most valuable when we engage with them. To that end, Carrese worked with library staff and Delmont to arrange a reception for the inaugural presentation of the books during the week commemorating Martin Luther King’s birthday.

MORE: ASU events show MLK's contemporary relevance

About 40 people gathered at Hayden Library on Jan. 17 to mark the arrival of the texts and hear from Delmont about King's legacy in Arizona. Delmont described the book acquisition as an important stage in the relationship between Arizona and King — a relationship which dates back to a speech King gave at ASU in 1964 at the invitation of the Maricopa County NAACP.

Faced with opposition from people who felt King was too controversial, then ASU President G. Homer Durham appealed to the Board of Regents by claiming that the university would be negligent in its duty to educate unless it was "engaged in examining unpopular ideas." 

Delmont emphasized that King was an extremely controversial figure. His views on communism and the Vietnam War were unpopular and he was widely criticized, particularly in the last years of his life. If alive today, Delmont argues that King would not fit neatly into contemporary discourse about race and equality.

"There is something about King as a martyr that makes him a more comfortable figure to grapple with," Delmont said. "But, King should make us uncomfortable."

Delmont urged the audience to engage with the texts in their entirety — not just as memes and soundbites. Because King’s writing was intended to be delivered as sermons and speeches, extracting quotes from the larger context of his work limits our ability to understand the depth and history of his role as leader in a very long and hard-fought movement for civil rights.

Delmont described King as an effective and forward-looking leader, explaining that he was unencumbered by the short-term demands of elected public office and unrestricted by party lines. Rather than thinking in term limits, he asked his congregations and the millions of people he helped to mobilize, "Where will we be generations from now?"

Although King is arguably the most recognizable face of the civil rights movement, Delmont cautioned against honoring his legacy as an individual at the expense of recognizing the long grassroots civil rights movement that elevated him, noting that while he is an extremely important figure, a day to honor his memory would be incomplete without remembering the 250,000 black people who made their way to the Lincoln Memorial to see him speak, and the thousands of others who fought for decades to bring the movement to a head.

Delmont reminded the audience, "it’s not about him, it's about we."

 If you are interested in arranging a presentation of these or other archived texts, or you would like to schedule an appointment to view the texts, email Kathy.Krzys@asu.edu.

Ty Fishkind

Communications specialist, School of Civic and Economic Thought and Leadership

480-965-6130