The timing of the American Medical Association's new guide to help doctors assess the ability of older drivers couldn't have been better-just weeks after two tragic accidents involving elderly drivers who lost control of their vehicles.
But the Chicago-based AMA was fine-tuning its new Internet guide long before the highly publicized accidents-one involving an 86-year-old man who killed 10 people when he plowed through a farmer's market in Santa Monica, Calif., last month, and the other a 79-year-old man who lost control of his car and injured three pedestrians at a farmer's market in Flagler Beach, Fla.
In fact, the AMA says it's been working for several months on the updated version of the Physician's Guide to Assessing and Counseling Older Drivers. It debuts as an online tool but will be available in pamphlet form in the fall. It features an office-based assessment of medical fitness to drive a car, a reference table of conditions and medications that may affect driving, and recommendations for rehabilitation options and counseling strategies for patients who may be at risk.
Top AMA officials say older-driver safety is a growing public health concern-one in five Americans will be 65 or older by 2030, which means a lot of senior citizens on the road. The National Highway Traffic Safety Administration says motor vehicle accidents are the No. 1 cause of injury-related deaths for people ages 65 to 74.
"Safe driving is a matter of function and not age," says John Nelson, the AMA's president-elect and an obstetrician-gynecologist from Salt Lake City. "However, the incidence of chronic health problems that impair driving increases as people age. We really need to look at this on a patient-by-patient basis."
The AMA, which hasn't exactly had the best timing in recent years in terms of its public relations prowess, has earned lots of press coverage across the nation for its driver-safety initiative.
On the job and accredited
You might say that Pitt County Memorial Hospital in Greenville, N.C., is three parts "ER," one part "NYPD Blue."
The 731-bed hospital's force is the first hospital-based police department to be accredited by the Commission on Accreditation for Law Enforcement Agencies, although other hospital-based police may have earned state accreditation, according to Douglas Boyd, a spokesman for the hospital's parent, University Health Systems of Eastern Carolina. The system is affiliated with the Brody School of Medicine at East Carolina University. Some hospital systems affiliated with universities may be patrolled by university police that are accredited, he says.
Chief Alton Richardson leads a force of 27 full-time officers, five reserve officers, five radio dispatchers and a secretary to provide 24/7 police protection for Pitt County Memorial's 160-acre campus and its 7 million square feet of buildings.
"We thought (accreditation) would increase the department's morale, and it has," says Richardson, who has been with the department since its 1990 founding. The accrediting standards mandate better equipment both for the department's squad cars and recording all dispatch and radio conversations, he says.
Accreditation also helps the Pitt County Memorial department overcome the general public's perception that it's just a security force, rather than a state-chartered agency.
The need for the department was brought home when an employee was shot and killed by her estranged husband in the parking lot a few years ago, Richardson says. Although the chief wishes the crime could have been prevented, he says, "we had a police officer in that lot, and (the officer) was able to keep him from leaving. That's just an indication of the value of the force."
Bigger bikes for urgent care
Emergency department directors looking to streamline their operations might turn to sleeker two-wheeled vehicles for providing urgent care.
Two motor scooters on loan from GoManGo Lifestyles, based in Dudley, Mass., will test out the idea this summer at 707-bed UMass Memorial Medical Center in Worcester, Mass.
It's not a new idea, says Scott Kasper, director of emergency medical services at the hospital, which provides 911 service for the city of Worcester. He currently uses mountain bikes for navigating crowds at the annual outdoor concert with 20,000-plus people and the St. Patrick's Day parades stretching several miles long. Kasper says the moped is a "hybrid" idea that "elevates it to the next level."
Scaling a city of seven hills can be tiring for paramedics on bicycles weighed down by medical-supply saddlebags. Also, with flashing lights and a siren, there's no mistaking the paramedics on scooters for "just a kid on a bike," says a spokesman for the hospital. "People get out of the way."
The test run this month will help administrators decide if adding the motor fleet will help provide better and faster access to patients and a safer ride for staff. Standing next to $100,000-plus ambulances, the $3,500 scooters might seem like just a drop in the emergency services bucket, but they're "a capital cost nevertheless," Kasper says.