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Noting that only about one-third of hospitals provide emergency care to heart attack patients quickly enough to meet scientific guidelines for saving lives, the American College of Cardiology (ACC) has debuted a campaign called "D2B: An Alliance for Quality," aimed at helping EDs and their hospitals cut an average of 30 minutes off their door-to-balloon (D2B) times by adopting six core strategies:
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A new web-based mapping system in Loma Linda, CA, provides EDs and emergency service organizations in a wide geographical area with real-time information that helps ensure that accident and disaster victims will get to the closest available ED in the shortest possible time. Called AEGIS (Advanced Emergency Geographic Information Systems), it was developed by the Redlands, CA-based Environmental Systems Research Institute (ESRI) for the Center for Prehospital Care, Education, and Research at Loma Linda University Medical Center.
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What causes missed diagnoses in the ED? A research team from Brigham and Women's Hospital in Boston decided that one of the best places to seek the answer was in actual malpractice cases, so they reviewed 122 closed malpractice claims from four liability insurers in which patients had alleged a missed or delayed diagnosis in the ED. Their findings?
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Health care-associated infections (HAIs) have traditionally been viewed with a certain air of epidemiological inevitability, seen in many cases as the unpreventable result of keeping very sick patients alive via invasive devices and other medical interventions.
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It may seem intuitive, even obvious to experienced ICPs, but acquiring an infection during hospitalization is about as bad as it gets for a patient. Even patients with a host of maladies that compromise their recovery fared significantly better in outcomes than patients who acquired infections.
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Having worked with a "physician champion" and greatly lowered infection rates by adopting an industrial process model, an infection control professional has joined the chorus that say infections are not an inevitable byproduct of medical care.
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Empowering nurses and other clinicians to speak up when they perceive a patient safety problem may be the most important component of emerging new programs designed to drive infection rates to zero, emphasizes Sara Cosgrove, MD, hospital epidemiologist at John Hopkins in Baltimore.
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Sandiumenge and colleagues evaluated the effects of three strategies of antibiotic prescribing in a 14-bed ICU. The strategies were applied serially, beginning with an initial 10-month period during which patients with suspected ventilator-associated pneumonia received "patient-specific therapy" in which multiple antibiotic regimens, chosen on the basis of length-of-stay and recent antibiotic exposure, were used.
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Infection control practices and other "hospital factors" specific to individual institutions appear to be a greater influence on infection risk than a patient's severity of illness, researchers found.
