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Town Board checks out ELIH to enhance medical services for Islanders

JULIE LANE PHOTO
Showing off the locked cabinets that hold medications for hospital patients is Dr. Z. Micah Kaplan, who explained the “fail safe” system in place to assure the right medication goes to the right patient at the right time.

Whether you’re experiencing a simple or acute medical problem, substance abuse or psychiatric issue, need rehabilitation or any of a raft of out-treatment services from pain control, blood tests or MRIs, Eastern Long Island Hospital (ELIH) is prepared to meet those needs. Dr. Z. Micah Kaplan, long-time physician now retired, joked with members of the Shelter Island Town Board during a hospital tour Friday that he was a volunteer. He is chairman of the Eastern Long Island Hospital Foundation and an honorary member of the hospital’s Board of Trustees.

The recent hospital tour is a part of the ongoing effort by town officials to enhance medical services for Islanders, particularly the aging population that accounts for a significant percentage of the Island’s year-round population.

According to the last U.S. census, 27.5 percent of the population on Shelter Island is at or above the age of 65, compared with 15.4 percent for all of New York state.

Mr. Gerth has been working to increase the hours when doctors would be on the Island to see patients, especially in the off-season. He is currently seeking to meet with both Dr. Peter Kelt and Dr. Nathanael Desire to streamline some of the office needs both have.

But the need for an urgent care clinic here continues to be elusive, forcing patients to seek treatment at such offices on the North or South forks or at emergency rooms.

As for the Friday’s hospital tour, Town Attorney Bob DeStefano Jr. accompanied the Town Board, minus Supervisor Gary Gerth, to examine the hospital from top to bottom to get a sense of services that have developed, especially those that relate to the recent affiliation with Stony Brook Hospital.

While critical patients could always be transferred to Stony Brook in years past, today, many Stony Brook-trained doctors work the halls of Eastern Long Island Hospital offering services close to home instead of at a hospital miles away.

The aim is offer patients on Shelter Island and the North Fork the care they would received from a top teaching hospital like Stony Brook on the Greenport campus, according to information provided to the group.

Unlike some small hospitals, the emergency room team at Eastern Long Island are professionals, able diagnosticians who can rapidly determine the nature of a patient’s illness and the best treatment. When it came to re-designing the emergency room back in 2004, hospital officials sought advice from the nursing staff that works there and they outlined the needs for a decontamination room, an isolation room and room for up to 24 patients.

Much of the triage of emergency patients is performed by EMTs who bring the patients to the hospital.

“Wonderful, wonderful,” is how Dr. Kaplan described Shelter Island’s Emergency Medical Technicians who handle needs at this end to assure patients are quickly moved off Island with the cooperation of North Ferry crews to get those in need to the ELIH emergency room.

Most patients can be treated at the hospital, but where doctors determine the best treatments are available elsewhere, a patient may be transferred to Stony Brook or any of a number of top level hospitals such as the Mayo Clinic, Dr. Kaplan said.

The 90-bed hospital deals with everything from the simple to more acute medical problems and has the equipment often found in only large hospitals — just less of it, Dr. Kaplan said.

Need a mammography, ultrasound, x-rays, CAT scan, bone density test, MRI? The hospital has the latest equipment along with a nuclear medicine suite to detect disease based on biological and anatomical changes, organ functions, certain types of cancers, tumors, bone and joint problems and neurological illnesses.

With the increased dependence on technology, the hospital that once had a single technology expert back in 1999 now has a team of four and a full-time teacher who works with aides, nurses, doctors and technologists to assure they are getting the ongoing training they need.

Guiding the group to the hospital basement, Dr. Kaplan told them if they haven’t seen that area, they don’t know what a hospital is all about.

The basement includes a highly sophisticated laboratory for analyzing blood samples, including tests that can detect heart problems and guide doctors to the right treatments.

About 98 percent of test results can be done on site with rapid results  unless a patient’s insurance coverage requires using a different laboratory for results, he said. That happens with some blood tests, not because the hospital doesn’t have a fully equipped 24-7 laboratory to deal with the blood work, but where samples drawn by the hospital are required to be sent out to other laboratories for analysis.

Those who are tested for tick-borne diseases do have their blood sent to a lab in Massachusetts that specializes in analyzing such samples, Dr. Kaplan said.

Also in the basement is the hospital pharmacy with a sophisticated level of checks on what patient is receiving what medicine and on what schedule. Why medicines are dispensed from machines where nurses have to put in a code to access them and match the medication with the information on a patient’s bracelets, the staff in the pharmacy can stop the process if anything appears wrong — including whether the medication is being administered at the right time. Once stopped, the pharmacist can communicate with the nurses or doctors to determine why they medication is being dispenses as it is and either change the information in the system if that’s necessary or keep an error from occurring.

Islanders are very familiar with their neighbor, Dr. Frank Adipietro, whose Pain Management Clinic at ELIH brings in patients from throughout the area.

The hospital operates the only psychiatric unit in the area along with the inpatient Quannacut substance abuse program. Patients may request to enter the program on their own, although some come in because a judge orders them to enter a rehabilitation program or a family requests that a member be admitted. But Behavioral Health Supervisor Janet Jackowski regards all Quannacut patients as voluntary since they could choose other options.

Heroin addiction is the most frequent problem for most of the Quannacut patients. Once an addicted patient has gone through a detoxification program and received some inpatient counseling, he or she is referred out to a sober house or outpatient clinic, she said.

For all the technological changes, the hospital has also undergone changes in patient comfort.

Gone are gurneys of old for most. When a patient is wheeled into the emergency room, he or she is likely to be set in a chair capable of reclining unless the medical condition requires that because staff have learned that patients are more at ease when they are sitting up and able to talk directly with nurses and doctors.

Hospital beds that once moved up and down and had buttons to elevate the head or feet now twist in various directions and even have built in scales for staff to track weight changes.

In the intensive care unit, chairs that recline into a bed are available so that a family member might sleep by the bedside of critical patient.

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