July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
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Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
June 28th, 2011 by Happy Hospitalist in Humor, Opinion
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You ever wonder what doctors really think but are afraid to say out loud? Here’s one example:
“I wish all my patients were on a ventilator”
There’s a reason vented and sedated patients are considered desirable. In addition to the obvious economic benefits of
There are the less talked about, but equally pleasant side effects most hospitalists, ER doctors, cardiologists, gastroenterologists, pulmonologists, surgeons, infectious disease doctors, endocrinologists, psychiatrists, rheumatologists, dermatologists, nurses, respiratory therapists and physical therapists wouldn’t admit, but would agree, without hesitation. As a general rule:
- Patients on ventilators are just faster, easier and more pleasant to take care of. Read more »
*This blog post was originally published at The Happy Hospitalist*
April 5th, 2011 by Felasfa Wodajo, M.D. in News
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We have reported in the past on AirStrip, a smartphone and iPad app that allows a mobile doctor to monitor the vital signs of patients in an obstetric ward or an ICU. The reverse, where a fixed doctor monitors multiple remote patients is now entering the mainstream and already making a difference in many patients’ lives.
In a compelling anecdote recently reported in Computerworld, a man experienced cardiac arrest while shopping and was taken to a nearby community hospital. An intensivist, monitoring from an eICU miles away, was immediately consulted. The remote doctor guided the treating physicians as they initiated unfamiliar hypothermia therapy to preserve the brain, and continued to follow the patient remotely throughout his 10 day ICU stay. Happily, the patient had a good outcome and is quoted in the article as an enthusiastic proponent of eICUs. Read more »
*This blog post was originally published at iMedicalApps*
March 8th, 2010 by Bongi in Better Health Network, True Stories
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South African society is a completely lawless society. Pretty much everyone does just what they like and more often than not they get away with it. Red lights are just a suggestion, yet it is not uncommon to see a taxi stop in the middle of the road without warning. This attitude goes through almost all levels.
Yet there are some laws that people do obey. The law of gravity comes to mind. Mostly if you trip or fall off a wall or out a window you do approach the earth with increasing velocity and finally come to rest in some form of disrepair when you finally meet said earth, even if you are South African. Another law that is obeyed was well illustrated by a patient we once saw in the old days. Read more »
*This blog post was originally published at other things amanzi*
January 27th, 2010 by Happy Hospitalist in Better Health Network, Health Policy, Opinion
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Have you ever stopped bothering to care about a patient? A doctor sent me his own personal account of the smoking Mr Jones:
Dear Happy. I read your article on bounce backs with great interest, and was astonished by some of the vitriol it elicited. I remember having one COPDer bounce back to me three times within a month at the VA when I was a medicine resident. He would leave, smoke and drink, and then come back and be readmitted to my service with exactly the same course each time. It was like Groundhog Day.
Finally I had a little talk with him and said: “Mr. Jones, each time you come in, you’re on death’s door. So I come down to the ER, stay up with you all night and save your life. But you know, I’m really getting tired of having you come in after drinking and smoking and then working like a dog to save your life. So let me tell you, if you don’t quit smoking, the next time you do this there’s a good chance that I’m not going to bother. Why should I? It doesn’t seem to be doing either of us any good.”
To my complete astonishment, he actually quit smoking and stayed quit for about a year. Then he fell off the wagon, deteriorated too far before getting to the hospital and died. I was frankly proud of him for the effort, but somehow suspect that I’d be shot in a drive-by if I ever told that story in public. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*