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A patient came into the ED with acute onset of headache. A computed axial tomography (CAT) scan of the brain was performed, and a wet reading (an initial review of the study without definitive interpretation) in radiology reported intracranial hematoma. The patient went to the OR for emergency neurosurgery.
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In the world of bioterrorism drills, this was something special: TOPOFF3, a program mandated by Congress and sponsored by the Department of Homeland Security, simulated terror attacks in several locations in the United States including the entire state of New Jersey.
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An ED manager as the driving force behind a capital campaign for a new facility? It has proved to be a winning formula at Carondelet Health Networks St. Marys Hospital in Tucson, AZ, where a successful $11 million-plus campaign has led to the opening of a new state-of-the-art ED.
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If you had reduced the mean door-to-doctor time in your ED from 64.3 minutes to 39.8 minutes (a 38.1% improvement) in seven months, youd probably be pretty happy. But for Maureen Kelly-Nichols, RN, MSA, the ED nurse director at Providence Hospital in Southfield, MI, that was not the key measure of success in her recent Six Sigma project.
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While the two new requirements involving hand-offs and medication labeling are the most obvious changes in the 2006 National Patient Safety Goals just released by the Joint Commission on Accreditation of Healthcare Organizations, there are other, more subtle changes that also are critically important for ED managers to know about.
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Less than two years ago, the ED at Carondelet Health Networks St. Marys Hospital in Tucson, AZ, was an 8,000-square-foot facility designed to handle 25,000 patients a year, but treating about 50,000. There was no storage space, one utility room, and pumps and carts were sitting in the hallways.
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There are a number of recommendations as to the best available approach to the care of patients with pneumonia. This investigation
is part of a larger study looking at the effect of a pneumonia pathway on patient outcomes.
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How would you interpret the 12-lead electrocardiogram shown in the Figure? What is distinctly unusual about this tracing? What would you ask the technician who recorded this tracing?
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The purpose of this prospective study was to assess whether a strategy of D-dimer testing and multidetector-row computed tomography —without the use of lower-limb ultrasonography —would safely rule out pulmonary embolism in emergency department patients suspected to have PE.
