I never met Brittany Hightower, the 22-year-old African-American female who presented to the emergency room at Fort Worth Texas on Christmas Eve of last year with sickle cell disease and died 8 days later after being given the choice of leaving in pain or being arrested for trespassing. Her story has inspired the work that we do at Marti health. In memory of Brittany and in the hopes of raising awareness of the clinical, cultural and structural impediment to quality of care for individuals with sickle cell I am sharing the results of a previously reported needs assessment survey from the Annals of Emergency Medicine. Please take note that "Of surveyed ED providers, 75.1% were unaware of the National Heart, Lung, and Blood Institute recommendations for vaso-occlusive crises, yet 98.1% were confident in their knowledge to care for patients with SCD.
"Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death"-MLK, Jr
A survey-based needs assessment of barriers to optimal sickle cell disease care in the emergency department."
Elizabeth A Linton, Dania A Goodin, Jane S Hankins, Julie Kanter, Liliana Preiss, Jena Simon, Kimberly Souffront, Paula Tanabe, Robert Gibson, Lewis L Hsu, Allison King, Lynne D Richardson, Jeffrey A Glassberg, Sickle Cell Disease Implementation Consortium
Ann Emerg Med. 2020 September ; 76(3 Suppl): S64–S72. doi:10.1016/j.annemergmed.2020.08.013.
This needs assessment identified institutional, provider, and patient-level barriers to care of Sick Cell Disease (SCD) in the Emergency Department (ED) to inform future interventions conducted by the multi-center Sickle Cell Disease Implementation Consortium (SCDIC). Method
In total, 516 adolescents and adults with SCD and 243 ED providers from seven and five regions of the US, respectively, responded to the ED care delivery for SCD survey.
Results: Survey results demonstrated that 84.5% of respondents with SCD have an outpatient provider who treats many patients with SCD. In the ED, 54.3% reported not getting care fast enough and 46.0% believed physicians did not care about them and similarly of nurses (34.9%). Consequently, 48.6% were “never” or “sometimes” satisfied with their ED care. Of surveyed ED providers, 75.1% were unaware of the National Heart, Lung, and Blood Institute recommendations for vaso-occlusive crises, yet 98.1% were confident in their knowledge to care for patients with SCD. ED providers identified the following factors as barriers to care administration: “opioid epidemic” (62.1%), “patient behavior” (60.9%), “overcrowding” (58.0%), “concern about addiction” (47.3%) and “implicit bias” (37.0%).
Conclusions: The results underscore that many patients with SCD are dissatisfied with their ED care and highlight challenges to optimal care on the practice, provider and patient levels. Exploring these differences may facilitate improvements in ED care.
Chief Executive Officer RANZCP
2wWoohoo! So great to this investment…it has been a long road toward our vision of “no postcode untreated for stroke” . Thanks to every clinican, survivor, family member, researcher, donor, volunteer and the unstoppable Stroke Foundation