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A new year means new provisions to be put in in place under the Affordable Care Act, the National Association of Healthcare Access Management reports.
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In a study dubbed Emergency Department Telemedicine Initiative to Rapidly Accommodate in Times of Emergency (EDTITRATE), investigators at the University of California San Diego Health System are gauging whether remote physicians can be quickly and cost-effectively mobilized to evaluate patients when the ED is busy. While there have been administrative hurdles involved with implementing the approach, investigators say the strategy could offer big savings in terms of time and efficiency.
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Administrators interested in implementing the Safer Sign Out process should first reach out to physicians and nurses to discuss problems related to handoffs and get their feedback, advises Fuller. If you show them what the issue is up front, then they will be more prepared for it, he says.
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Getting the entire clinical staff on board with a new process for assessing and treating sepsis was a daunting task when administrators at Wake Forest Baptist Medical Center in Winston-Salem, NC, began the effort in April of 2012. However, by eliciting the assistance of department champions, and by mandating that everyone complete an online module that explains the new process, the transition to the new process was smooth. We had a very strong expectation and we followed through, explains Catherine Messick Jones, MD, MS, associate chief medical officer, medical services.
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To reduce mortality and improve the care of patients with sepsis, Wake Forest Baptist Medical Center in Winston-Salem, NC, created a new rapid-response protocol aimed at facilitating earlier diagnosis and treatment. In this approach, clinicians who suspect a patient may have sepsis can call a Code Sepsis, which will fast-track the series of tests and evaluations that are needed to confirm the diagnosis and get appropriate patients on IV antibiotics quickly. Administrators say the approach fits in with the culture of the ED, and it has quickly slashed time-to-treatment in this environment.
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The need to reduce, avoid, or not to adopt costly treatments which provide very small benefits, and the need to provide everyone with treatments that are very effective and reasonably priced, present ethical challenges.
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Bioethicists disagreed with the U.S. Office for Human Research Protections' position that a large multisite clinical trial failed to obtain proper consent from the parents of enrolled infants.
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Bioethicists can help clinicians who suspect a colleague may be impaired by giving advice on how to proceed and assisting in creating a confidential process.
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Many ethical considerations will be examined with The Brain Research through Advancing Innovative Neurotechnologies initiative, including privacy, moral responsibility for one's actions, stigmatization and discrimination, and ensuring protection of vulnerable populations.