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Much of the recent attention to the high cost of health care has focused on opposing political viewpoints. Less attention has been given to an equally important issue: How do health care delivery organizations reliably deliver high-value health care and, by doing this, ensure optimal patient outcomes?
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Kumar et al set out to describe the cost of ICU telemedicine programs (tele-ICU). They had two objectives: to systematically review the existing literature reporting costs of tele-ICU programs and to provide cost figures for tele-ICU implementation in a Veterans Health Administration (VHA) hospital network.
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Goldberger and colleagues at the University of Michigan sought to determine the variation in duration of cardiopulmonary resuscitation (CPR) attempts following in-hospital cardiac arrest among different institutions across the United States.
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In this issue: Side effects of statins; effects of cannabis use; antihypertensives and lip cancer; and FDA actions.
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Even if continuous cardiac monitoring is ordered, ED patients may be taken off the monitor for transport or to go to the restroom and kept off the monitor due to oversight, warns Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County EMS in Chardon, OH.
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The ED nurse is the "first line of defense" against a malpractice lawsuit alleging missed or delayed diagnosis of sepsis, according to Paula Mayer, RN, LNC, a partner at Mayer Legal Nurse Consulting in Saskatchewan, Canada.
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Emergency medical services (EMS) crews are all on assignments, it's rush hour, the cardiologist hasn't called back, or the transfer center is waiting for approval before assigning a bed. These are all valid reasons for delays in transfer of a patient with an ST-elevation myocardial infarction (STEMI), says Kevin Brown, MD, MPH, FACEP, FAAEM, principal with Brown Consulting Services in Armonk, NY, and former director of the department of emergency medicine at Greenwich (CT) Hospital, but if any of these delays occur, times should be documented by the emergency physician (EP).
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Waiting time has always been the number one complaint against hospital emergency departments (EDs). In an attempt to address the waiting issue, hospitals recently began allowing patients with nonemergency conditions to "schedule" their ED visits through the Internet and then wait at home until their "projected treatment time" in the ED.
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If an emergency department (ED) patient with impending sepsis is discharged, returns hours later in septic shock, and dies or develops organ failure, "you're likely to get sued," warns Bruce Wapen, MD, an emergency physician with Mills-Peninsula Emergency Medical Associates in Burlingame, CA.
