July/August 2005 Annals of Family Medicine tip sheet
Posted on Eureka Alert
Improving the quality of hospital care in America.
Author: Romano Patrick S PS
From: The New England journal of medicine
Date: 20057
Volume: 353
Issue: 3
ISSN: 0028-4793
Pages: 302-304
In recent years, American hospitals have made significant improvements on standardized, evidence-based measures of clinical performance for several medical conditions, including heart attacks, heart failure, and pneumonia. But an editorial, published in the July 21 issue of the New England Journal of Medicine, says it's not clear how much effect these improvements in patient care have had on public health, especially in reducing morbidity and mortality. The editorial, authored by Patrick S. Romano, professor of general medicine at UC Davis School of Medicine and Medical Center, is published along with two new quality-of-care studies.
Read more...I-Newswire.com
UCLA investigators found large gaps and marked variation in U.S. hospitals' heart failure treatment based on adherence to four standard quality measures. The study points to the need for hospitals to establish education programs and systems to improve quality of care for this patient population.
(I-Newswire) - Published in the July 11 issue of the Archives of Internal Medicine, researchers compared four standard measures for heart failure treatment used by the Joint Commission of Accreditation of Healthcare Organizations, the national agency that accredits hospitals.
“We found that the quality of care for heart failure treatment really depends to a very large extent on which hospital patients are admitted to. This is one of the first studies to take a scientific look at the variation in performance measures in hospitals across the country,” said Dr. Gregg C. Fonarow, lead study author, The Eliot Corday Chair in Cardiovascular Medicine and Science, professor of cardiology, David Geffen School of Medicine at UCLA.
Read more...I-Newswire.com
Becoming a frequent question as cost-conscious hospitals turn to in-house specialists who reduce stays and standardize treatment. But 'handing off' patients can be risky.
By Kelly Kleiman. Kelly Kleiman is a regular contributor to the Magazine
Published July 24, 2005
She went to the hospital in an ambulance. We didn't realize at the time that her internist no longer visited patients in the hospital. She was having a lot of pain and was inappropriately medicated, which I attribute to the fact that it was not her regular physician treating her. The whole experience was just hideous. Not having any medical professional who'd ever dealt with her before made it worse."
-Laura Stempel, daughter of a patient at Evanston Northwestern Hospital (not affiliated with Northwestern Memorial Hospital).
Read more...Chicago Tribune
Friday, 22 July 2005, 11:34 am
Press Release: College for Emergency Medicine
Poisoning: are current treatments best?
Friday 22 July 2005
Over the years, poisoning has been variously treated by attempting to bring the poison back up, rushing it through the body, or binding it in the gut so that it doesn't spread to other body parts.
And relatively recently, treatments such as syrup of ipecac, orogastric tubes, and activated charcoal have been largely discarded.
Activated charcoal is still used, however, for potentially serious poisoning if the patient is treated within an hour of ingestion.
At the Winter Symposium of the Australasian College for Emergency Medicine being held at the Millennium Hotel in Queenstown NZ, Professor Mike Ardagh, Professor of Emergency Medicine at Christchurch School of Medicine and Health Sciences, will canvass whether the current treatment of poisoning is in fact the best.
Read more...SCOOP Independent News
Standard therapies for such ailments as pneumonia, heart attacks often ignored.
By Elizabeth Weise / USA TODAY
Health update
Chemical levels dropping
Americans have lower levels of lead, secondhand-smoke byproducts and other potentially dangerous substances in their bodies than a decade ago, the Centers for Disease Control and Prevention said Thursday. It tested for 148 environmental chemicals, including pesticides and disinfectants.
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Years and even decades after doctors agreed on life-saving standard therapies for heart attacks, pneumonia and congestive heart failure, disturbingly large numbers of patients aren't receiving them, according to two papers in Thursday's New England Journal of Medicine.
Reviewing data from the Centers for Medicare and Medicaid Services on 10 indicators for quality of care at 3,558 hospitals in the first half of 2004, researchers at Harvard School of Public Health found that simple, universally accepted treatments were not provided for:
• 11 percent of heart attack patients.
• 19 percent of those with congestive heart failure.
• 29 percent of pneumonia sufferers.
Read more...The Detroit News: Healthcare
By Elizabeth Weise, USA TODAY
Years and even decades after doctors agreed on lifesaving standard therapies for heart attacks, pneumonia and congestive heart failure, disturbingly large numbers of patients aren't receiving them, according to two papers in today's New England Journal of Medicine.
Reviewing data from the Centers for Medicare and Medicaid Services on 10 indicators for quality of care at 3,558 hospitals in the first half of 2004, researchers at Harvard School of Public Health found that simple, universally accepted treatments were not provided for:
•11% of heart attack patients.
•19% of patients with congestive heart failure.
•29% of pneumonia patients.
Treatment can be as simple as giving a heart attack patient an aspirin, something only 92% of hospitals do for all appropriate patients, says Ashish Jha of the Harvard School of Public Health and lead author of one of the papers.
But despite authoritative, universal agreement that those measures should happen quickly and be given to all patients, a surprising number didn't receive them.
Read more...USA Today
By Dr. Jeff Hersh / Daily News Correspondent
Tuesday, July 19, 2005
Q: I just read an article about Lorenzo's oil in the newspaper that said a new medical study showed it works. Years ago when that film "Lorenzo's Oil," starring Susan Sarandon, came out, medical studies at the time showed that is was not helpful at all. Is it common that medical studies contradict themselves?
A: I will not discuss the specifics about the recent Lorenzo's oil article. I think it showed some benefit from Lorenzo's oil in preventing symptoms in patients with adrenoleukodystrophy (ALD), a progressive degenerative disorder, before they become symptomatic rather than in treating patients who were already sick). Rather, I will discuss the very important point you raise, that of the reliability of medical studies. There are still many weaknesses in the medical literature, and I will discuss the good, the bad and the ugly of the medical literature in today's column.
Read more... Posted by gruwell at 7:02 AM | TrackBack