Hospitalist News - March 2012 - (Page 1)
VO L . 5 , N O. 3
T he Leading Inde p endent Ne wspaper for the Hospitalist
MARCH 2012 Hospital used SWAT team, flash cards, and truth telling to cope with changes.
W H AT ’ S N E WS
Repeat BAL for VAP. Additional
bronchoalveolar lavage can help tailor antibiotic therapy against resistant infection. 6
Rapid EHR Rollout Rattles Rhythms, Revenues
B Y P AT R I C E W E N D L I N G
FROM THE HIMSS12 ANNUAL CONFERENCE
A new patient-safety poster campaign is a good sign, blogs A. Maria Hester, M.D. 8
LAS VEGAS – P lan for a dramatic loss
Cashing in on concierge care.
Hospitals must meet social and educational obligations somehow, writes Sidney Goldstein, M.D. 8
of productivity and drop in revenue when anticipating the myriad changes that accompany rapid deployment of an electronic health record system. “We thought volume would drop like a rock, 50% for the first 2 weeks, and then everybody would get used to the system, and volume would pop right
back up. But that’s not what happened at all,” Frank DiSanzo, chief information officer of the Saint Peter’s Healthcare System in New Brunswick, N.J., said at the Healthcare Information and Management Systems Society annual conference. When the system’s 478-bed acute care Saint Peter’s University Hospital and its 81 clinics switched to a single electronic health record (EHR) system, patient volume dropped 30% in the first month, another 16% in the second month, and an-
other 5% in the third month. The losses were additive, and despite the urging of vendors to plan for this eventuality, the hospital was unprepared for the accompanying loss in revenue. “You really have to plan for this on a cash-flow basis,” said Mr. DiSanzo, also vice president for the health system. The hospital, a “Marcus Welby–like” facility, as he described it, had involved a multidisciplinary, multispecialty project management team from the inception See EHR page 22
Screen kids for MRSA. Children
should be tested before open airway surgery to reduce postoperative complications. 10
‘Drip and ship’ for stroke. Data say
itÕs a safe way to manage acute ischemic stroke patients. 12
Protocol IDs VTE Risk in Trauma Patients
BY DIANA MAHONEY
Health IT staff shortage. Cash is no
longer the top obstacle for meeting technology goals. 20
FROM THE ANNUAL CONGRESS OF THE SOCIETY OF CRITICAL CARE MEDICINE
C ATHERINE H ARRELL /IMNG M EDICAL M EDIA
HOUSTON – Nearly 30% of trauma
Eye on Quality Improvement
Dr. Peter K. Lindenauer says hospitalists are prime for valuable research topics such as cost and utilization, patient satisfaction, and lab testing and imaging. 24
patients who were identified upon admission as being high risk for venous thromboembolism using a validated risk assessment tool went on to develop the thrombotic condition during their ICU stay, a study has shown. Importantly, the deep vein thromboses in most of these patients were asymptomatic and might have gone undetected with potentially life-threatening consequences but for periodic ultrasound screening, Dr. Chad Thorson reported at the meeting. “Routine venous thromboembolism screening in the trauma population has been widely debated, and there currently is no protocol for it,” according to Dr. Thorson of the Ryder Trauma Center at the University of Miami. Although the principal diagnostic screening tool – venous duplex ultrasound (VDU) – is not considered cost effective for screening all See VTE Risk page 18
Dr. Carpenter discusses how his hospital’s CDT program came to be. Watch an interview at ehospitalistnews.com
Catheter-Directed Thrombolysis Program Thrives at Community Hospital
Dr. Brian A. Carpenter collaborates with at team to make catheter-directed thrombolysis available to pulmonary embolism patients at Shady Grove Adventist Hospital, a community facility. Story, Page 16.
Looking for Hospitalist News?
HOSPITALIST NEWS 60 Columbia Rd., Bldg. B, 2nd flr. Morristown, NJ 07960
CHANGE SERVICE REQUESTED
Presorted Standard U.S. Postage PAID Permit No. 384 Lebanon Jct. KY
If you would like to try to load the digital publication without using Flash Player detection, please click here.