Evening star., 1898-02-15
REFORM OF THE HOSPITALS
Recommendations Made by Investigating
Physicians.
Municipal Institution Favored
Curtailing Emergency Service
Isolated Wards Suggested.

DR.. Henry NJ. Hurd, superintendent of
| the Johns Hopkins Hospital of Baltimore,
and DR.. John B. Chaplin. physician-in-
| chief and superintendent of the depart
| ment for the insane of the Pennsylvania
Hospital, at Philadelphia, who were dele
gated in November by the joint select
| committee on District charities to investi-
| gate the hospitals of the District, have
made their report to the committee.
The report takes up in detail the con-
dition of each hospital visited Provi-
dence Hospital was found in excellent
shape. every part being clean and or
derly, and the furnishing appropriate and
attractive.
The wards of Garfield Hospital are clean
| and the hospital appears orderly and we'll
administered. 1t has all the essential
equipment for the treatment of acute med
ical cases, of those suffering from inju-
ries and Of others requiring surgical aid.
Attention is called to the need of safe
guarding the inmates at the Childrens s
Hospital from fire. The small ward for
the isolation of contagious diseases is
regarded as very inadequate, as well as
the provision for the treatment of ortho-
pedic cases.
The building and site of the Emergency
Hospital are declared inadequate for the
demands The building is contracted and
too high. The superficial space is divided
crowded and imperfectly ventilated.
The structures at Freedmen's Hospital
are condemned by the physicians, although
they found the nursing and the medical
care there excellent.
The wards pavilions of the Almshouse
Hospital are lacking in conveniences, have
inSanitary water closet arrangements, the
furnishings are poor and the number of
nurses insufficient for the proper attend
ance upon the sick.
The physicians say that the Home for
Incurables is badly located and badly ar
ranged for active work.
To undertake to modify and modernfZe
Columbia Hospital for Women would, they
think. involve considerable outlay and
would be unsatisfactory. They assert that
It would be better economy to sell the
valuable ground on which the old build
ings stand.
Some of the hospitals. like Providence,
Emergency and the Central DiSDensary,
the almshouse and asylum are much
crowded while other hospitals are over
crowded in special departments. There is
no adequate provision for the care of con-
tagous diseases. Excepting Garfield Hos
pitaI no rules exist for the admission ana
disc barge of patients. They find also that
a lach of coordination exists in the work
of various hospitals receiving government
aid. They say that no hospital for chronic
diseases, worthy the name, exists In the
District. The only approach to such
hospital is a group of temporary buildings
in connection with the almshouse.
The physicians make the following recon-
mendations:
Providence and Garfield.
/. 1t is recommended that the Providence
Hospital and the Garfield Hospital be Sc
lected to assume the charge of cases OF
acute diseases and such accident and emer-
gency cases as may be in their immediate
nelghborhood. and that the police or Dis
trict officers empowered to send such pa
TOD 20 cn,N1 hnr n ~
hospital for which they express a prefer
Slce. In every instance an effort should
be made to ascertain the legal settlement
of the patient, and If he is found to be
nonresident he should be sent to his proper
place of residence whenever practicable.
All admissions of such acute cases should
be for period not to exceed ninety days,
unless sooner recovered, and at the end of
this period he should be reported to a
proper authority If uncovered or not
likely to improve, for transfer to a hos
pital for chronic diseases. For this service
a liberal daily per capita sum should be
paid by the government, such sum as may
be deemed equitable by both parties.
1t should be the understood policy to be
encouraged that these two hospitals. as
now existing, being well equipped to render
to the sick and injured the best quality of
service of healing and also the largest
quantity of It, should be used for cases of
acute disease, and that cases of chronic
disease should be removed to other less ex-
pensive institutions or transferred to
municipal hospital.
This will insure a more rapid movement
of patients and better care anG attention
for sick patients. Hence there should be
power vested in some competent central
authority to direct the removal and trans
fer of such chronic cases who are public
charge.
If there are INDECENT patients WHO prefer
this form of medical treatment, power
might be given to this officer TO send such
patients likewise 10 the National Homeo-
r.oth h g., 81
those prescribed for the above mentioned
hospitals.
CurtailinE Emergency Hospital Ser
vice.
2. 1t is recommended to abandon or cur
tail the Emergency Hospital service, in
view of the fact that the hospitals named
above have or Should have sufficient room
for most of the bed cases now received at
the Central Dispensary and Emergency
Hospital: 1t is believed that If any beds
are maintained at this institution thew
should be a limited number where accident
cases too feeble to be moved might remain
two or three days. No other cases neel be
taken to this hospital, as with an efficient
ana active ambulance service either of the
TWO hospitals named could readily bring all
patients directly to their wards.
Columbia.
3. 1t is recommended that the Columbia
Hospital surrender the valuable grounds
upon which 1T is now located and be es-
tablished elsewhere. The present build
lngs, except the nurses houses have no
special value, and the cost of modification
and reconstruction would be attended with
an outlay equivalent to the cost of q new
hospital AS the genealogical and mater
hity services have no necessary connection
except In exceptional cases, it is recon-
mended that they be disasscciated, with
advantage to both classes, and that the
new hospital to be erected be a maternity
hospital of sufficient size to render all Of
the charitable hospital maternity service
now performed in this or other HOSPITALS of