Archive for July 2010

CPR without rescue breathing as effective as with

In this randomized trial of out of hospital cardiac arrest patients, those who were randomized to chest compressions with rescue breathing fared just as well as those without rescue breathing. Survival to hospital discharge and favorable neurologic outcome were not significantly different between the groups. Chest compressions without rescue breathing is as effective as chest compressions alone in cardiac arrest (abstract)

Hospital delirium portends grim long-term prognosis

In this meta-analysis, patients who experienced delirium were almost twice as likely to die or be institutionalized within about 2 years, even after adjusting for confounders. Although delirium is temporary, it is important to discuss (with the patient or family) the implications of prognosis in those that experience it (abstract)

Reporting of colleagues

In this large survey of 1891 physicians, only 2/3 completely agreed that they should report colleagues who are impaired or incompetent, and 17% had direct personal knowledge of an incompetent or impaired colleague. We need to ensure that seamless processes are in place to report and act upon incompetent or impaired physicians (abstract).

Linking SCIP measures to patient outcomes

In this large retrospective database analysis, researchers found that composite measure adherence to SCIP measures was associated with lower rates of postoperative infections, but not with the individual measures. This is consistent with "bundling" theory, whereby outcomes can be affected by a number of processes, which need to be combined to successfully improve the outcome of interest (abstract)

SHM and ACO’s: All Systems Slow

Public Policy Contributor Brad Flansbaum writes... I follow the literature on Accountable Care Organizations (ACO) because of its topical nature and its promise, as well as how it may fast track needed change in our healthcare delivery system.  I have written on this subject once before, and wish to return to it. A Google search of ‘Accountable Care Organization’ published within the last 4 weeks returned 1.3 million hits.  In the result leads, phrases such as “promising,” “reduce costs and improve quality,” “hottest topic in reform,” abound.  Hospitalists acting as the fulcrum coordinators of inpatient care will play more than a minor role in any pilot or demo (more…)