The vast majority of elderly patients are not being screened for mood disorders, problems with falls or performance of daily activities such as housework, says a poll of more than 1,000 adults 65 and older released in April.
In the nationwide survey, patients responded to specific questions about the last year of care they received, such as whether their physician asked if they had fallen or were sad, anxious or depressed.
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Having a family member in the trauma room does not impact the quality of care a child receives, said a study presented at the Pediatric Academic Societies Annual Meeting in April.
Researchers reviewed video and audio recordings of 145 trauma evaluations of patients 15 and younger to evaluate how well physicians followed evidence-based assessment protocols. For the 86 children who had relatives in the trauma room, 97% had their abdomens examined for injury according to protocol. That compares with 98% of the 59 children with no family present. Meanwhile, the median time for assessing the children’s airway was less than a minute for both groups.
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Patients on dialysis are subject to much more intensive medical care in the last month of life than are patients dying of cancer or heart failure, said an analysis of Medicare data that is raising concerns about the end-of-life care that patients with end-stage renal disease receive.
Nearly 80% of Medicare patients on dialysis were hospitalized in the 30 days before death and spent twice as many days in the hospital as patients dying of cancer, said a research letter published April 23 in Archives of Internal Medicine that was based on data from nearly 100,000 patients from the U.S. Renal Data System and Medicare between 2004 and 2009.
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The Wisconsin Medical Society is leading a statewide initiative to dramatically improve the rate at which patients complete advance care planning by training nonphysician health professionals to facilitate discussions with patients and encouraging community discussions of an often taboo subject.
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It looks as though I am no longer golden. I did manage to again land a journalism award from the American Society of Healthcare Publication Editors, but this time around it is a mere bronze — and a tie, at that.
The recognition comes in the best how-to article category, for a story I wrote on how physicians can help ease the strain experienced by family members called upon to make end-of-life care decisions for their loved ones. While the story is obviously geared toward doctors, it may be helpful as a primer on the topic for nonphysicians. Check it out.
Daily remote monitoring of patients with chronic conditions appears to be ineffective in reducing rehospitalizations and emergency department visits, according to the most recent randomized controlled trial of the technology.
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Nearly 80% of physicians at an academic medical center said they experienced a personal crisis within the past year, yet most said they would not seek support from physician-health services or employee-assistance programs.
The 108 surgeons, anesthesiologists and emergency physicians surveyed said they experienced a wide range of stressful events, such as serious illnesses or deaths in their families and severe adverse events in their patients. But most they said they were unlikely to turn to institutional sources of support, with 40% saying they would be willing to consult physician-health services and 29% open to using employee-assistance programs. About a third of the doctors had never even heard of these services, said an Archives of Surgery study published in March.
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On a mild, gray day in February, fatigue lined the face of Anthony Parish, a slight, 39-year-old man who has been through a lot. He had a cancerous portion of his lung removed and struggled with postoperative pain. Chemotherapy treatments caused abscesses in his mouth that ruined his teeth and repeatedly sent him to the emergency department for relief, delivered in the form of painkillers and antibiotics.
Despite his health problems, Parish voiced hope on that midwinter morning. His medical team had developed a plan to help alleviate his dental pain. By the end of the month, his infected teeth would be removed and replaced with dentures. He still has intermittent chest pain, but he is learning to cope with it.
Parish is one of about 950 patients identified by Spectrum Health System in Grand Rapids, Mich., as having used their hospital EDs 10 times or more during the previous year. These patients accounted for more than 20,000 total visits and at least $40 million in costs during that period. In November 2011, Spectrum launched the Center for Integrative Medicine, a $1 million multispecialty clinic modeled on a pilot program that slashed ED use by nearly 90%, to help patients like Parish address the source of the problems that keep bringing them back to the ED.
My latest feature article. Read the whole shebang. And check out the slide show.
A big-wig briefs his company’s employees on the upcoming move to a new office building.
Big-wig: And, as previously announced, there will be free coffee available in the kitchen pantries on every floor.
Assembled workers: Yay!
Questioner: What kind of coffee?
That’s how we got pyramids and rocket ships, folks. Can’t be satisfied.
The National Quality Forum in April added four “efficiency” measures that could be combined with quality metrics as part of the Medicare value-based purchasing plan set to start in 2015.
These metrics join four measures previously endorsed in January and represent the multistakeholder group’s first efforts to measure the intensity of medical services that the health system provides, as well as the total costs. The work is being done under contract with the Dept. of Health and Human Services.
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A group of Hawaii physicians is offering to write lethal prescriptions for terminally ill patients in a bid to test whether doctor-assisted suicide is allowed under state law.
Unlike Oregon and Washington, the only two states where writing such a prescription is explicitly allowed and regulated, Hawaii has no law authorizing physician-assisted suicide. Moreover, Hawaii Attorney General David M. Louie issued an opinion in December 2011 saying that manslaughter charges could be brought against physicians who write prescriptions with the intention of causing death.
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Medical ethics is often the stuff of esoteric academic debates and journal articles littered with $10 words. Now one of America’s most venerable bioethics think tanks is expanding its reach with a public TV special and a patient-focused website that addresses the ethical challenges of emerging medical technologies.
Genetic testing, assisted reproduction, children’s mental health and end-of-life care are among the issues addressed at The Hastings Center’s site, called “Help with Hard Questions.” The website was launched in March to coincide with the airing of an episode of the PBS program “NOVA” that was co-produced by the center and focuses on the brave new world of genomics. The program can be viewed online.
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Three decades after hospice emerged as the standard of care for terminally ill patients, the end-of-life treatments that palliative medicine physicians provide are frequently referred to as murder, euthanasia and killing.
More than half of hospice and palliative medicine physicians say patients, family members and even other health professionals have used those terms to describe care they recommended or implemented within the last five years, according to a nationwide survey of 663 palliative care doctors in the March Journal of Palliative Medicine.
My latest front-page story. Read the whole shebang.
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