Given the coming wave of patients from the baby boomer generation, hospitals can't afford to take geriatric care lightly. Elderly patients require a special degree of management, since the failure of one organ system can quickly cascade into the decline of another—or several others. While many hospitals have developed standard Acute Care for the Elderly (ACE) units to deal with these sensitive patients, others have devised alternative means of providing top-notch geriatric care. Stacey Butterfield's cover story looks at the benefits and problems with traditional ACE units, and outlines some of the alternatives, including mobile ACE units and hospital-wide integration of interventions originally developed in ACE units.
For some hospitalists, publishing the results of a quality improvement project seems like a natural goal to reward the work of designing, implementing and measuring an intervention. We offer tips for would-be authors on how to maximize one's chances of getting a manuscript accepted for publication, from steps to take before starting a project to the best journals to target. Meanwhile, another article deals with journals of a different sort: the type for recording daily events. Such diaries, when kept by ICU patients, their family members and nurses, can help avert post-traumatic stress disorder after discharge, say the authors of a study on the topic. Q&A subject Richard D. Griffiths, MD, shares his insights on how and why to implement this simple intervention in your hospital.
Our clinical focus this issue is on catheter-associated infections, which are covered in our Coding Corner column and our MKSAP quiz. Also, a session recap from the recent American Society of Nephrology annual meeting discusses best practices for ensuring catheters are used, inserted and cleaned properly—which can have huge effects on patient outcomes and hospitals' bottom lines.
Catheter insertion is on the menu at the Herbert S. Waxman Clinical Skills Center, where attendees of the upcoming Internal Medicine 2011, to be held April 6-9 in San Diego, can practice this and many other practical skills for free. Also at the meeting, an exciting new precourse in hospital medicine, created by ACP Hospitalist's editorial advisor James S. Newman, FACP, will cover inpatient care from admission to discharge.
Has your hospital implemented any interesting interventions you'd like to share with readers? Email us. We'd love to hear from you.
Editor, ACP Hospitalist