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Summary Introduction On February 25, 2020, the first 2 patients were tested positive for severe acute respiratory syndrome coronavirus‑2 (SARS-CoV-2) in Tyrol, Austria. Rapid measures were taken to ensure adequate intensive care unit (ICU) preparedness for a surge of critically ill coronavirus disease-2019 (COVID-19) patients. Methods This cohort study included all COVID-19 patients admitted to an ICU with confirmed or strongly suspected COVID-19 in the State of Tyrol, Austria. Patients were recorded in the Tyrolean COVID-19 intensive care registry. Date of final follow-up was July 17, 2020. Results A total of 106 critically ill patients with COVID-19 were admitted to 1 of 13 ICUs in Tyrol from March 9 to July 17, 2020. Median age was 64 years (interquartile range, IQR 54–74 years) and the majority of patients were male (76 patients, 71.7%). Median simplified acute physiology score III (SAPS III) was 56 points (IQR 49–64 points). The median duration from appearance of first symptoms to ICU admission was 8 days (IQR 5–11 days). Invasive mechanical ventilation was required in 72 patients (67.9%) and 6 patients (5.6%) required extracorporeal membrane oxygenation treatment. Renal replacement therapy was necessary in 21 patients (19.8%). Median ICU length of stay (LOS) was 18 days (IQR 5–31 days), median hospital LOS was 27 days (IQR 13–49 days). The ICU mortality was 21.7% (23 patients), hospital mortality was 22.6%. There was no significant difference in ICU mortality in patients receiving invasive mechanical ventilation and in those not receiving it (18.1% vs. 29.4%, p = 0.284). As of July 17th, 2020, two patients are still hospitalized, one in an ICU, one on a general ward. Conclusion Critically ill COVID-19 patients in Tyrol showed high severity of disease often requiring complex treatment with increased lengths of ICU and hospital stay. Nevertheless, the mortality was found to be remarkably low, which may be attributed to our adaptive surge response providing sufficient ICU resources.

Objectives: Telephonic health coaching has been studied extensively as an interventional approach for chronic disease management. No studies have been conducted evaluating the outcomes of a multiyear study on health coaching participation and glycated haemoglobin (A1C) changes. Chronic disease has been widespread in physical laborers, with a high onset of type 2 diabetes. The purpose of this study was to establish the efficacy of telephonic health coaching as a means to manage type 2 diabetes in adults with physical labor occupations. Methods: The eligibility criteria were: 1) Adults aged 20-80 during the study entirety; 2) A diagnosis of type 2 diabetes; and 3) Yearly A1C and Body Mass Index (BMI) testing via verified biometric screenings. Participants completing health coaching for at least 2 years during the study period were assigned to the experimental group and participants who only had yearly biometric screening were assigned to the control group. Results: From 2014-2018, 350 participants met the inclusion criteria. The mean age at baseline was 56 years (SD 8.26), with a mean baseline A1C of 7.14% for the test group, and 5.41% for the control group. Pre-post test changes saw an increase in A1C of 0.85% in the test group, and 0.95% in the control group. BMI changes were not statistically significant. Conclusions: Further study is needed to refine current telephonic health coaching programs for disease management. This study suggests that the efficacy of telephonic health coaching in its current form is not enough to improve BMI outcomes in patients with diabetes, and over the phone coaching alone is insufficient to improve patient A1C levels and sustain them for long-term.

The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.