Brandon Klotz – IS 200 – Take-Away Memo – 4/10/2019 1

I. Community Issues

Drug abuse and access to healthcare remain two of the greatest needs facing the

Cincinnati community and the Tristate at large. At first, I couldn’t figure out why the

ED waiting room was full of people who were black and appeared to be from the

lower income bracket. I was surprised but couldn’t pin point a cause. I have come to

the following conclusion regarding this observation: the local community (primarily

black/lower income) uses the ED as the “catch-all” medical center. The reason the

waiting room is full is because the patients are not admitted. This isn’t due to lack of

room since I stocked rooms and know that rooms were empty. The patients are not

admitted because their ailment is rated on a five point scale when they arrive, without

the higher numbers getting priority admittance. The conclusion follows logically:

black people using the ED have lower ratings leading to a full waiting room. This

raises some questions. What percentage of Cincinnatians have a primary care doctor

they can visit for minor ailments? How many lack quality healthcare? How many rely

on Medicare and Medicaid?

It appears that healthcare remains one of the most important issues in the local

community. The only times I saw the two trauma rooms being used were for an

overdose of a black male, and lack of oxygen for what appeared to be a homeless

white male (he had his hat with money on the bed in front of him). Cincinnati is a

changing place with development and business investments. It is likely that the

demographics of Cincinnati will be completely different in the next few decades. The

one area Christ Hospital needs to improve moving forward is their trauma care.

II. Biggest challenge to meeting those community needs

Brandon Klotz – IS 200 – Take-Away Memo – 4/10/2019 2

The Christ Hospital cannot handle trauma cases (gunshot, stabbing, burn victims,

etc). They do not have a Level 1 trauma rating which means they cannot serve the

most extreme emergency cases. University Hospital is the only hospital in the region

equipped to handle Level 1 cases, and from what I have heard are stretched thin in

personnel and equipment which leads to less than ideal conditions.

The Christ Hospital also has limited facilities. I observed a “full hospital” situation

one Saturday during which less serious patients were placed on beds in the hallway.

Not only could Christ hospital increase their trauma rating, but they could either

invest in a larger ER facility or an acute care center to assist the less serious ER cases.

III. Collective Takeaways from the experience

Overall, I had a great experience, learned many things, and look forward to

volunteering in another area of the hospital.

I learned a lot about patient interaction. Some want help some don’t. Some want to

talk and joke, others don’t. Smiling and showing you care go a long way.

ED nurses become rather callous over time. After seeing strange things, sometimes

from the same people, they became slightly perturbed at providing care. I saw a white

male rush into the ED waiting room and tell the nurse he had on overdose outside.

The nurse rolled her eyes and let out an exasperated sigh as she got up to walk

outside.

Little things help. I have been thanked by doctors, nurses, patients, and family

members for seemingly doing nothing (folding towels, stocking gowns, etc). Some

patients are blown away that someone cares about their well-being and takes the time

to get them a cup of water or coffee. Those times feel good and encourage me.
Brandon Klotz – IS 200 – Take-Away Memo – 4/10/2019 3

IV. Suggestions for the organization to improve to meet the needs

Hire employees whose job description is “providing the finest experiences”. Nurses

are busy and overdrawn. Offering a patient a drink could mean they need to make

more than one trip to the other side of the ED to get refreshments. Volunteers are

short-term, work only a few hours, and are schedule irregularly. Hiring nursing

students to help provide “the finest experiences” will help improve patient

satisfaction.

Increase trauma rating. UC does the hard stuff. They are overdrawn and from talking

with people who have worked there, it gets pretty crazy. The Christ Hospital could

greatly impact the health of the community by providing care to critical patients.

Right now, Christ ED only stabilizes the serious then sends them to UC. I recommend

establishing a committee to evaluate the resources, facility, and steps needed to

become a Level 1 Trauma center.

Invest in an Acute Care Center. Not only could Christ hospital increase their trauma

rating, but they could either invest in a larger ED facility or an acute care center to

assist the less serious cases. The ED is frequently full and could use more rooms. An

Acute Center would allow the ED to focus on the higher emergency ratings while

ensuring enough beds for the patients by sending the less serious to the Acute Center.

This center could always be used as overflow from the ED without leaving patients in

the hallway. As a top US hospital, we should be leaving people in the hallway.

Brandon Klotz – IS 200 – Take-Away Memo – 4/10/2019 4

V. Service-Learning Verification Form