Lean management improves employee satisfaction

From Fierce Healthcare:

In the first independent comparative study of 13 Lean projects, staff at all levels reported higher employee satisfaction at every institution, citing better front-line staff involvement in problem-solving and employee collaboration, according to the Agency for Healthcare Research and Quality.

However, some staff didn’t fully embrace Lean initiatives–the management approach rooted in quality efficiency–at their institutions, according to a column inHospitals & Health Networks. Some employees noted they were frustrated that committing time to Lean and working with other departments took away from their regular duties.

No ER, So Critically Ill Patients Look to Local Doc

From WJBF:

Because of cuts to Medicaid, Hospital officials say they were forced into bankruptcy last year.  A private investment company then agreed to buy it in order to build a new regional health care system, and for a short time, they kept hospital doors open and ran an urgent care clinic here.

But then the company closed that too, and now some residents fear the worst is yet to come.

This is the area where an ambulance would drop off a patient in an emergency, but as you can see, the sign says the hospital is closed. One local doctor says sometimes when patients can’t come here; they walk across the street and come here to his office looking for help.

“We sent two people out with chest pain, one we knew was having an MI or a heart attack, and the other, we suspected it was,” said Dr. Dale Padgett.

Dr. Padgett has been running this small practice in Bamberg for 29 years, and he says it was hard to prepare for something like this.

“We will always do the best we can, but it’s not an emergency room,” he said.

Study: Psychiatric patients’ Emergency Department average length of stay was 11.5 hours

From Annals of Emergency Medicine, via Becker’s:

Researchers studied patients with psychiatric illnesses who were treated at one of five EDs between June 2008 and May 2009. They found while the overall average ED length of stay was 11.5 hours, this measure varied depending on discharge disposition. Patients who were discharged to home had stayed an average of 8.6 hours in the ED, and patients who were later transferred to a hospital outside the system of care had stayed an average of 15 hours. Other factors associated with increased ED length of stay include a positive toxicology screen result for alcohol, the use of diagnostic imaging and restraint use.

Post Resuscitation Cooling by Bystanders?

From MedGadget:

Brain damage post cardiac arrest is a problem that seems to be at least somewhat effectively ameliorated by cooling the body of the patient as soon as possible to around 91°F (33°C).  Current commercial systems are intended to be used by paramedics or clinical staff in the ER (see ThermoSuit and Arctic Sun for examples), but cooling patients as early as possible and bringing this technology to more places may help more people survive with better outcomes.

Researchers at Hohenstein Institute in Boennigheim, Germany have developed a vest that, once put on a patient can deliver rapid cooling.  The system depends on a zeolite cartridge that releases its contents into the volume of water inside the vest, cooling it through adsorption and so the patient.  The researchers believe that this type of devices will one day come as part of AED packs, allowing bystanders that managed to keep the person alive deliver an even greater level of care without any previous training.