Medpedia: Online Encyclopedia of Medicine

From Medgadget:

A group of American medical schools is working on a project to essentially collect and organize all medical knowledge in a Wikipedia-like form. Access to MedPedia will be available to all, but editing rights will be limited to M.D.’s and Ph.D.’s in relevant fields of research. Harvard, Stanford, the University of Michigan, and Berkeley will kick off the site with initial content and work with the rest of the medical community to make it comprehensive. With that in mind, the project organizers are calling on all M.D’s and Ph.D’s to register to become editors of what they believe will be the largest and most complete encyclopedia of medicine in history.

Dropping the Baton: A Qualitative Analysis of Failures During the Transition From Emergency Department to Inpatient Care

From the Annals of Emergency Medicine:

The transfer of a patient from the ED to internal medicine can be associated with adverse events. Specific vulnerable areas include communication, environment, workload, information technology, patient flow, and assignment of responsibility. Systems-based interventions could ameliorate many of these and potentially improve patient safety.

Staff Finds Rx for Hospital Via Board Game Strategy

Associated Press Stacom, Don

“Friday Night at the ER” provided department heads, managers and staff with an in-depth look at staffing levels, revenues and hospital administration after simulating a 24-hour period at Bristol Hospital in Connecticut. The program is based on a board game and divided staff into groups of four charged with managing growing numbers of patients and shortages of beds and nurses. The number of patients in the ER waiting room continued to increase during the game, and teams managing the operating room, critical care unit, medical surgical floor and the ER discovered that when they worked together the number of patients in the waiting room declined.

Is Your Patient Throughput Sending Out an SOS?

Healthcare Financial Management Vol. 62, No. 7, P. 86; McLarty, Jim; Jeffers, Lori

The emergency department (ED) is used to gauge a hospital’s operational health and reputation and generally provides a substantial amount of revenue. However, inadequate patient throughput–not just increased demand–can lead to overcrowding in the ED and often is characterized by longer lengths of stay in the ED, higher rates of patients leaving before being seen, longer boarding periods in the ED and increased patient diversions to other beds. Even small, inexpensive improvements, such as expanding transport personnel at times when admission and discharge tend to be high, can be a big help; but regardless of the steps hospitals take, a culture change, staff training in new processes, front-line managers’ buy-in and continual monitoring are required.

Vultures eye Wis. hospital patients

From UPI.com

Patients at a Milwaukee-area hospital say the last thing they want to see while facing surgery are vultures perched outside their windows. 

Yet, that’s the view from some patient’s rooms at the Orthopedic Hospital of Wisconsin in Glendale, Wis., the Milwaukee Journal Sentinel reported Wednesday. It said patients about to go under the knife can watch up to six turkey vultures sitting on ledges of the three-story building.

Is The Lateral Cervical Spine Plain Film Obsolete?

From the Journal of Surgical Research

Background

The objective of this study was to determine the utility of a lateral cervical spine plain film in the evaluation of blunt trauma patients.

Methods

We prospectively evaluated blunt trauma patients from February 2004 to September 2006 who had both a lateral cervical spine (LCS) film and a computed tomography of the cervical spine (CTC), comparing the diagnostic accuracy of the LCS to the CTC.

Results

There were 1004 patients who met inclusion criteria. Eighty-four patients had a cervical spine fracture while 920 patients had no fracture on CTC. Of the 84 patients with fractures by CTC, 68 had a negative or incomplete LCS. Of the 920 negative CTC, there were 7 false positive LCSs. LCS compared with CTC showed a sensitivity of 19% (16/84) and positive predictive value of 69.6% (16/23). Of the 981 negative or incomplete LCS films, 96.9% were incomplete (951/981). Of the seven patients with a false positive LCS (negative CTC), none was subsequently found to have a cervical spine fracture on further evaluation. Elimination of the LCS would result in charge savings of $265,056.00 (LCS charges with interpretation, $264 each) and increase patient safety by eliminating error.

Conclusions

LCS has no value as a screening tool in the blunt trauma patient since most are either inaccurate or incomplete. It should be eliminated from the Advanced Trauma Life Support algorithm, and CTC should receive emphasis as the diagnostic gold standard.

Injured By a Spacecraft? There’s a Diagnostic Code for That

From the Wall Street Journal Health Blog:

So we’ve got this patient here who was injured in this spaceship accident. You know, just a routine, uh, orbital mishap. But how do we account for that? Oh, right, it’s ICD-9 code E845 — “Accident involving spacecraft.”