Impact of Palliative Care Screening and Consultation in the ICU: A Multihospital Quality Improvement Project.

Context: There are few multicenter studies that examine the impact of systematic screening for palliative care and specialty consultation in the intensive care unit (ICU).

Objective: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria.

Methods: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was used to estimate the conditional probability of receiving a PCC and to balance important covariates.

Can regulation improve safety in critical care?

This article examines national and state safety practice initiatives, including the Centers for Medicare and Medicaid Services quality focus, federal and state outcomes reporting, and consumer access to outcomes data. The efforts of national and regional legislators and health care institutions to create regulations for staffing and technology to reduce medical errors is reviewed. The potential of a unified cooperative effort from all stakeholders to implement the above initiatives to improve intensive care unit safety practices is discussed.

Pulmonary embolism.

Pulmonary embolism is a commonly suspected but underdiagnosed condition of clinical significance. Preventable deaths continue to occur. We begin this article with an overview of prognosis, clinical evidence, signs and symptoms, and risk factors, followed by an in-depth evaluation of diagnostic techniques and treatment modalities.