Research is one thing, and practice quite another. Itâ€™s been nine years since a New England Journal of Medicine study showed ICU patients recover more quickly when their sedation medication is routinely stopped. Itâ€™s been over a year and a half since a Lancet study found that combining this practice, called spontaneous awakening trials, with spontaneous breathing trials further decreased patientsâ€™ time on mechanical ventilation and in the ICU. Yet a sizable number of hospitals still donâ€™t do it.
Portable â€œMASH-likeâ€ï¿½ hospital units are helping communities across the country improve their ability to respond to disasters and other events requiring extra capacity.
The Hospital to Home program targets changes by 2012.
At St. Johnâ€™s Mercy Medical Center in St. Louis, Mo., a hospitalist-developed Web site makes it easy to identify and contact each patientâ€™s attending physician.
For Suren Pathman, MD, doctoring is all about service.
Studies have shown that critically ill patients who are given â€œsedation vacationsâ€ï¿½ consisting of spontaneous awakening trials (SATs) and spontaneous breathing trials spend less time on the ventilator and less time in the ICU overall. But many hospitals donâ€™t follow written policy on performing SATs, and a large proportion donâ€™t use SATs in the majority of their patients.
Accurate ICD-9-CM codes for diagnoses and procedures performed during a hospital stay will only partially determine payment. Discharge status codes must be given equal attention.