Clinical question For patients presenting with early septic shock, does early goal-directed therapy reduce mortality? Bottom line As compared with usual resuscitation care, early goal-directed therapy (EGDT) using central venous monitoring does not improve mortality in patients presenting to the emergency department with septic shock. Reference ARISE Investigators; ANZICS Clinical Trials Group, Peake SL, et… [Read More]
Clinical question Does a lower transfusion threshold for critically ill patients with septic shock affect outcomes? Bottom line Using a lower threshold for transfusion for patients with septic shock in the intensive care unit (ICU) decreases the number of transfusions received without affecting mortality. Reference Holst LB, Haase N, Wetterslev J, et al. Lower versus… [Read More]
Bob Wachter, MD, MHM, chief of the division of hospital medicine at the University of California at San Francisco, talks about Accountable Care Organizations, trends in managed care, his new book, and why hospitalists need to think, at times, like Machiavelli.
69%: the percentage of hospitals that had perfect compliance with the Leapfrog Group employer coalition’s safe practices for hand hygiene in its 2013 annual quality survey of 1,437 U.S. hospitals. The CDC estimates 2 million patients annually acquire hospital-acquired infections (HAIs), often spread by contaminated hands of healthcare workers. Urban hospitals performed better than rural… [Read More]
$167 billion: Amount of federal Medicaid reimbursement payments that hospitals will forego between 2013 and 2022 in states that have opted not to expand their state programs under the 2010 Affordable Care Act. For every $1 a state spends on expanding Medicaid, $13.41 in federal funding flows into the state, according to a new report… [Read More]
UpToDate, a leading clinical decision support resource for physicians, in July added palliative care as the newest of its 22 medical specialties. The palliative care section covers a variety of topics focused on improving symptoms and providing best quality of life for patients with serious illnesses. The new service resulted from two years of extensive… [Read More]
Hospitals and Health Networks in July presented its 16th annual list of Most Wired Hospitals and Health Systems. Rigorous criteria were used to identify 375 hospitals that use technology to link up disparate care providers and patients. “Most Wired” hospitals are more likely to share critical information electronically with specialists, to use bar codes for… [Read More]
Steven Z. Pantilat, MD, SFHM, medical director of the University of California San Francisco School of Medicine palliative care service, explains palliative care is not end-of-life care, and the role hospitalists should play in palliative cases.
Josiah Halm, MD, and Sahitya Gadiraju, DO, assistant professors of general internal medicine at M.D. Anderson Cancer Center in Houston, discuss the breadth of care provided to cancer patients, a risk assessment being developed there on readmission risk, and factors in care that go beyond the medical.
Government penalties meant to reduce COPD readmissions will unfairly impact hospitals that care for vulnerable patients, according to a report from the University of Michigan. Beginning in January 2015, the Centers for Medicare & Medicaid Services will add COPD to its list of medical conditions for which it penalizes hospitals for excessive readmissions and fines… [Read More]