Search

Physical therapists are part of the professional teams involved in the management and care of patients infected with coronavirus disease (COVID-19) (1,2) Their specific role varies widely in different parts [...], Objective. The purpose of this case report was to describe the role of physical therapists in a neurosurgical center that was converted into a COVID-19 center for critically ill patients. Methods (Case Description). On March 16, 2020, the state government of Rio de Janeiro, Brazil, determined that a neurosurgical center with 44 ICU beds equipped with mechanical ventilators should immediately transfer all patients with neurological conditions to other institutions and prepare for patients who were critically ill with COVID-19. The staff, including physical therapists, were trained to handle patients with COVID-19, many of whom were developing acute respiratory distress syndrome (ARDS) with complex and multifactorial ventilatory support needs. Adjustments were made to the physical therapy routine and protocols. Following the stabilization of patients' respiratory condition, physical therapist interventions focused on restoring physical function. Results. A total of 116 confrmed COVID-19 cases were treated from March 17 to May 17, 2020. Sixty percent were men (70) and 40% were women (46), with a median age of 59 years. Eighty-nine percent (103) underwent mechanical ventilation during hospitalization, of which 11% (11) were successfully extubated. Thirty percent (31) of patients underwent tracheostomy, and 26% of those (8) were successfully decannulated. Of the total patients, 57 patients died (mortality rate of 49%), 4 (3%) were transferred to another institution, 23 (20%) were discharged home, and 32 (28%) continued to be hospitalized. Conclusion. Physical therapists in the ICU can facilitate care for critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training. Impact. The coronavirus pandemic has highlighted the importance of physical therapists, specifically in the care of patients who are critically ill with COVID-19. The availability and expertise of physical therapists in the ICU are important for managing critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training.

In the face of numerous market challenges, most healthcare organizations are seeking to enhance their business model by expanding their patient base, securing greater access to advanced technology, and achieving [...]

Health systems and universities seem to be at constant odds, stuck in perpetual negotiations despite having long-term affiliation agreements. Whether the debate is over faculty recruitment packages, purchased services and [...]

In this article ... As health care demands more efficiency within hospitals, it's possible to adapt existing teams to respond to the challenge in a transformative way. Here's how physician [...]

Physicians and data experts at Santa Clara Valley Medical Center, located in one of the first COVID-19 hot spots, have developed a risk score that aims to maximize resources and [...]

The patient-centered medical home has increasingly been looked to by policy makers, health care providers, and private insurers as a potential solution to the fragmented and inefficient U.S. health care [...], Objective. To evaluate the effect of medical home implementation on primary care delivery in the Veterans Health Administration (VHA). Data Sources/Study Setting/Study Design. We link interview-based qualitative data on medical home implementation to quantitative outcomes from VHA clinical encounter data. We use a longitudinal analysis with provider fixed effects (taking advantage of variation in timing of implementation and allowing each provider to serve as a control for him or herself) to test whether patient-aligned care team (PACT) implementation was associated with changes in organizational processes and patient outcomes. Principal Findings. Among 683 PCPs, caring for 321,295 patients, the uptake of eight of nine PACT structural changes significantly increased from July 2010 to June 2012 as did the percentage of primary care appointments occurring by telephone and hospital discharges contacted within 2 days of discharge. We found that PACT implementation was associated with significant improvements in 2-day post-hospital discharge contact, but not primary care visits occurring by telephone or within 3 days of the requested date. We found no association between medical home implementation and rates of emergency department use by patients. Conclusions. Medical home implementation at the VHA resulted in large changes in the structure of care but few changes in patient-level outcomes. These results highlight both the complexity of studying the effect of the medical home as well as implementing this model to change primary care delivery. Key Words. Medical home, veterans, primary care delivery

Between 1997 and 2005, 9 of 19 obstetric units in Philadelphia County closed, resulting in a 40 percent reduction in the number of obstetric beds (Maternity Care Coalition 2005). The [...], Objective. To define the association between large-scale obstetric unit closures and relative changes in maternal and neonatal outcomes. Data Sources/Study Setting. Birth and death certificates were linked to maternal and neonatal hospital discharge records for all births between January 1, 1995 and June 30, 2005 in Philadelphia, which experienced the closure of 9 of 19 obstetric units between 1997 and 2005, and five surrounding counties and eight urban counties that did not experience a similar reduction in obstetric units. Design. A before-and-after study design with an untreated control group compared changes in perinatal outcomes in Philadelphia to five surrounding control counties and eight urban control counties after controlling for case mix differences and secular trends (N = 3,140,782). Results. Relative to the preclosure years, the difference in neonatal mortality (odds ratio (OR) 1.49, 9,5 percent CI 1.12-2.00) and all perinatal mortality (OR 1.53, 95 percent CI 1.14--2.04) increased for Philadelphia residents compared with both control groups between 1997 and 1999. After 2000, there was no statistically significant change in any outcome in Philadelphia county compared with the preclosure epoch. Conclusions. Obstetric unit closures were initially associated with adverse changes in perinatal outcomes, but these outcomes ameliorated over time. Key Words. Neonatal mortality, obstetric unit closures, bed supply

Unbilled account management in the hospital setting is a microcosm of revenue cycle management in general. The root causes of issues can be found at almost any point in the [...]

In Brief We performed a 130-patient case-control study to examine the patient and hospital care risk factors for experiencing a hypoglycemic patient-day, comparing these factors to similar control patients who [...]

THE face of the Army in Europe has been changing dramatically since the fall of communism nearly two decades ago. U.S. installations have closed as a result of the Department […]

Risk management programs must be installed in hospitals to avoid incidents of clinical medical negligence that will prove to be financially crippling. Medical institutions need to identify all hazards and related risks as well as install a program of reasonable control to reduce expenditures arising from litigation claims for clinical negligence. The risk management programs should be reviewed and evaluated on a yearly basis to add emerging new risks and weed out those that have been eliminated., Abundans cautela non nocet (Great caution does no harm) (Legal maxim) Risk management is a recent advent within the health care setting. The identification of all risks and associated hazards, [...]

Engaging academic medical center doctors in population health management Involve physicians in all major decisions. Provide evidence supporting new strategies. Provide leadership training and other nonclinical education opportunities. Build consensus [...]

The privatization of clinical research is widely known. Up until the early 1990s, academic medical centers (AMCs) were the primary and predominant home of industry-sponsored clinical trials. As these programs [...]

Peninsula Regional Medical Center in Salisbury, Maryland, sought to implement a case management program to reduce a rising number of denied claims for avoidable, nonacute-care inpatient days. Initial efforts focused [...]

There are 17 members who were voted on by the former Detroit Medical Center board, all serving six-year terms. Of those, 11 were members of the DMC board, and six [...]

Byline: NANCY KAFFER Word went out at 9 a.m. Thursday that a new program called 'Live Midtown' would offer employees of the Detroit Medical Center, Henry Ford Health System and [...]

Centers of excellence provide high technology medical procedures at reasonable prices and with high quality results because of the volume of procedures performed. Employers who wish to use these centers are encouraged to evaluate them and their surgical teams before sending employees to them. Since transplants are now routine and not experimental procedures, employers must select medical facilities that will give them the most for their health care dollar.

At University of Pittsburgh Medical Center, being an early adopter of technology isn't good enough. UPMC's culture is about innovation and entrepreneurship--developing and deploying technology-based products and services not only [...]

Sloan-Kettering Cancer Center Memorial Sloan-Kettering Cancer Center, the world's oldest and largest private cancer center, spent 18 months in the RFP process before it settled on Courion's Identity and Access [...]

Henry Ford Health System, Detroit The health system, which began with Henry Ford Hospital, is one of the many lasting contributions of the original Henry Ford. The hospital was staffed [...]

Chairman Steve D'Arcy, vice chairman, PricewaterhouseCoopers L.L.P. Keith Crain, chairman, Crain Communications Inc. Roger Penske, chairman, Penske Corp. Alan Schwartz, chairman, Karmanos Cancer Institute board; vice chairman and partner, Honigman [...]

By Bob Trebilcock, Executive Editor One of the nation's premier medical centers transformed a manual, paper-based warehouse into a state-of-the-art facility using automated materials handling technologies to optimize the delivery [...]

Surgical departments often generate the bulk of revenue at many hospitals. So improving efficiencies and data collection in the operating room can really help the business of caring for patients. […]

Bandwidth quickly becomes an issue when you're dealing with large digital images so Hot Springs Health doesn't use the system to send diagnostic digital images, like X-rays, over the network. […]

In 2006, William Beaumont Hospitals in Royal Oak determined it needed to coordinate its growing network of physician-led medical centers to compete with other major health care systems in Southeast [...]

Stimulus funds target metro Detroit uninsured Six federally qualified health centers in metropolitan Detroit this week will receive $1.4 million in federal stimulus funding to expand services to the uninsured. [...]

A 55-bed inpatient adult behavioral health facility is expected to open in March at Detroit-based Samaritan Center. The Samaritan Behavioral Center, 5555 Conner Ave., eventually will employ 100 nurses, psychiatrists [...]

Byline: ROBERTO CENICEROS Should a pandemic strike the Chicago area, panicked mobs could overwhelm Advocate Health Care Network's hospitals. Churches and community recreation centers, meanwhile, could refuse to let their [...]

LEAD STORY Creating Value in the Medicaid Expansion: A Strategic Framework for Academic Medical Centers Amid the ebb and flow of efforts by congressional Republications to repeal and replace the [...]

St. Vincent Catholic Medical Centers, New York, named Guy Sansone, managing director at turnaround firm Alvarez & Marsal, as its CEO and chief restructuring officer. U.S. Bankruptcy Court approved Sansone's [...]

SALISBURY -- Heavily booked surgery suites have prompted Rowan Regional Medical Center to launch a $7.2 million outpatient surgery center. It will open in the fall of [...]

While extending applications across a WAN can be a boon to productivity, it can also create a rat's nest of problems. This is because moving applications beyond the LAN exposes […]