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Medicare gives LRGH top score for preventing infections and complications

LACONIA — Lakes Region General Hospital posted the best score for preventing complications that prolong hospital stays, lead to readmissions and increase medical expenses among the 13 hospitals in the state surveyed, according to figures released by Medicare this week.

The Affordable Care Act (ACA) included incentives for reducing so-called "hospital-acquired conditions" (HACs) and authorized Medicare to trim reimbursements by 1 percent to hospitals failing to reach specified benchmarks. Hospitals are graded by the three measures: the frequency of bloodstream infections from intravenous tubes, frequency of urinary tract infections from catheters and frequency of complications, included collapsed lungs, surgical cuts, reopened wounds and broken hips.

Lakes Region General Hospital scored 1.7, while Exeter Hospital at 2.95 and Wentworth-Douglass Hospital in Dover 3.05 recorded the next lowest scores. Franklin Regional Hospital, Lakes Region General Hospital's smaller stablemate, is exempt from this provision of the ACA.

Gloria Thorington, director of medical safety and case management at LRGHealthcare, said yesterday there are some 20 different risks of spreading infection that are routinely addressed. "Teams are working on different aspects of
reducing complications and implementing best practices throughout the hospital. Everyone is working on this," she stressed, "every single employee."

"A lot of it is common sense," Thorington continued, beginning with thorough hand hygiene and staying away from work when ill. Likewise visitors are carefully monitored for conditions they could pass on to patients. Patients at risk of falling wear yellow gowns so they are known to every member of the staff. Bed linen and mattresses are changed regularly and patients with pressure ulcers and healing wounds are watched closely. With recent improvements at the hospital most patients now have private rooms and soon all will, which provides an optimal setting for controlling infections.

Dr. Mary Dacuycuy, clinical director of infection control, stressed the importance of following proper procedures in  operating rooms to ensure nothing is left behind when surgery is completed. Orthopedic patients, she noted, are showered three times before surgery and kept under active surveillance. Likewise, she emphasized the judicious use of catheters, saying: "Catheters should only be used when necessary and removed as soon as possible."

"It's a continuous, ongoing process," said Darlene Burrows, director of infection control. "We've got to learn from every case," she remarked, underlining the importance of drawing on the scientific evidence and applying the best proven practices.

Three New Hampshire hospitals — Catholic Medical Center, Dartmouth Hitchcock Medical Center and Elliot Hospital — scored above seven and were penalized by Medicare. Although Medicare adjusted for hospitals treating the sickest patients and performing the most complex procedures, Kaiser Health News found that nearly a third of those hospitals with the most demanding cases were penalized compared to only 12 percent of hospitals with the least complex cases.

Last Updated on Wednesday, 24 December 2014 01:37

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Officials still unsure of cause for fatal single car crash in Moultonborough

MOULTONBOROUGH – Police Chief Leonard Weatherbee said yesterday that police have yet to determine the cause of a fatal accident at the intersection of Route 109 and Route 25 Saturday at 9:30 p.m.

Weatherbee said there were no witnesses, that he knows of, that there was no signs of braking or skidding and no yaw marks on the road.

He also said that the victim, Alice Dow, 37, of Ossipee, apparently knew the area and the intersection well.

"This isn't a case of a new driver on an unfamiliar road," he said.

Weatherbee said a passerby noticed lights coming from the marsh area and stopped to investigate. He said a Moultonborough Police Officer on routine patrol happened by at about the same time and stopped.

Weatherbee said the accident had likely just occurred because the engine was still warm and the lights of the car were still working.

He said the rear of the car was submerged however the drivers side was above water.

Weatherbee said the autopsy could tell them more however alcohol was not a factor. He also said the State Police Collision Analysis and Reconstruction Team will also investigate the car for possible mechanical failures.

Last Updated on Wednesday, 24 December 2014 01:06

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Shaker superintendent wishes Gale School donor had approached board

BELMONT – Shaker Regional Superintendent Maria Dreyer says she wishes the Save the Gale School Committee had told the School Board about a possible benefactor before they made their latest plan to save the old school public.

Describing what Ken Knowlton said was a "generous offer" for all the on site work to be done by an anonymous benefactor should a new site be located, Dreyer described it as "lovely," but said the person should have approached the board.

"The School District owns the building," she said yesterday. "Wouldn't the right thing to do would have been to come to the board?"

Dreyer reiterated the most-often-asked questions relating to saving or demolishing the old school: Where's it going to go, and who's going to move it?

"Who's going to abate the asbestos?" she asked.

She said the members of the School Board "do care" about what happens to the Gale School but that their obligation is "to educate our children safely and expeditiously."

At the request of the School Board, Facilities Manager Doug Ellis has obtained three quotes to demolish the school, but save the bell and the bell tower. On Monday, Ellis said the estimates range between $42,500 to $63,630, and all of them include asbestos removal.

He said the board hasn't reviewed the bids and has not voted on whether to include a warrant article on next year's town meeting ballot to tear down the school.

Knowlton sent a letter that ran in the Daily Sun yesterday that said an anonymous benefactor has offered to donate all the site-work when and if another site is found.

When asked, he declined to identify the benefactor, but said he believes the person has the resources to make good on his promise.

He also said the committee was evaluating a different spot for relocation, but declined to say where.

The school was built in 1897 and was used by the school district until the 1980s when it was abandoned. It was named after Napoleon Gale who donated money for schools and the town's library.

Most recently, the Save Our Gale School Committee suggested that it be moved to Concord Street and used as a town library, but the Library Trustees said no.

The committee also approached the town government to see if it would sponsor an application for a historic preservation grant. However, selectmen said they already had enough building projects on their hands and were not in a position to assume another.

The problem, said Dreyer, is that because of its size, location and condition, the school district can't use the building. While getting estimates for its demolition, she said the district learned there would be some asbestos abatement needed as well.

She said that while no one would like to see it destroyed, there is no money – in either the school district's or the town's budget – to move it to a different location and restore it.

Dreyer also said that before the School Board asked Ellis to get quotes on demolishing it, she and School Board member Donna Cilley – who serves as a liaison to the Save Our Gale School Committee – invited all of the members to a meeting but no one came.

Dreyer said that in recent years the most compelling argument the board has heard from the voters is to reduce costs and keep the school budget as lean as possible. She said over the past few budget cycles, Shaker Regional, as well as other school districts in the area, have delayed much-needed infrastructure and building improvements and repairs to keep the tax burden as low as possible.

At Shaker, she said the board believes any available building resources should be spent on improving the school facilities that are in use now.

Last Updated on Wednesday, 24 December 2014 01:11

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Selectmen decline to fund Gilmanton Year-Round Library

GILMANTON — Despite a request by one of the budget members of the Gilmanton Year-Round Library, selectmen chose not to include its annual budget request in the selectman's operating budget.

Like in previous years, the $46,000 request for 2015 will be a special warrant article.

According to minutes from the late November meeting, Anne Kirby came before the board and asked them to include next year's request in the operating budget. Kirby noted the request was $46,000 for 2015 which is down by $6,000 from last year.

Kirby said she was under the impression that selectmen would include the year-round library in its operating budget if the warrant article passed in 2014.

Selectmen Brett Currier said the article passed by 17 votes in 2014 and that, in his opinion, does not constitute a landslide. He said that he fears that by adding the $46,000 to this year's operating budget could lead to future year-round library requests growing out of control.

Selectman Don Guarino agreed, noting the vote in 2014 was very close and it was only fair to have the town vote on it again by special warrant.

The Gilmanton Year-Round Library opened as a private library in 2009 and is largely funded through donations and in-kind contributions. Each year the library has asked the town to fund some portion of its operations and with the exception of two of those years, the voters have agreed.

Now in its sixth year of operation, Kirby made the point that the operating budget requested from the town through special warrant articles, has remained flat, whether or not those warrant articles have passed. She noted that the library Board of Directors has been very fiscally responsible in spending the funds they get.

Both Currier and Guarino said they needed to see an overwhelming number of people support a warrant article before they would recommend it becomes part of the regular operating budget.

Both also made it clear that there is nothing wrong with the library and neither selectman personally has anything against it. Currier said that as a selectman he feels he needs to be a fiscally responsible as possible.

Kirby said she timed her request so the directors could prepare a petitioned warrant article in a timely manner if selectmen declined to include it.

Last Updated on Wednesday, 24 December 2014 01:21

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