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In 2008, there was plenty of evidence that things weren't working very well in the ED at St. Vincent's Medical Center in Bridgeport, CT. The leave-without-being-seen (LWBS) rate was at 5%, the average wait time to see a physician was over two hours, patient satisfaction was in the single digits, and the hospital recorded eight serious safety events in that one year alone.
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With Medicare's new value-based purchasing (VBP) program set to begin impacting payments to most acute-care hospitals in October 2012, providers have been put on notice that the fee-for-service payment methodology is being gradually replaced by payment formulas that reward quality.
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Knee dislocations have the potential to result in significant morbidity and mortality if not correctly diagnosed and optimally managed. Early identification and treatment of neurovascular injury and compartment syndrome may avert disaster for the patient.
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Much attention has been given to injuries of the cervical spine, but injuries to the thoracolumbar region are actually more common. Because of the anatomy involved, these injuries are often accompanied by multiple serious injuries to other areas of the body and may be overlooked during resuscitation and stabilization.
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When patients sustain a sudden cardiac arrest, they require immediate life-saving therapies to restart cardiac function and prevent secondary anoxic brain injury.
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Bedside ultrasound is increasingly being performed in the intensive care unit (ICU) for a variety of purposes including guiding volume resuscitation, central line placement, and marking pleural fluid collections for drainage.
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Rodríguez and colleagues report on a prospectively enrolled cohort of 235 consecutive patients admitted to two ICUs in Spain who required mechanical ventilation for at least 48 hours and had indications for ventilatory support other than respiratory infection or acute exacerbation of chronic obstructive pulmonary disease (COPD).
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In this issue: Calcium supplements and MI; birth control pills and VTE; ACE inhibitors and breast cancer risk; spending on pharmaceuticals; and FDA actions.
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