An Interdepartmental Care Model to Expedite Admission from the Emergency Department to the Medical ICU.

Background: Early evidence suggests that multidisciplinary programs designed to expedite transfer from the emergency department (ED) may decrease boarding times. However, few models exist that provide effective ways to improve the ED- to-ICU transition process. In 2012 Christiana Care Health System (Newark, Delaware) created and implemented an interdepartmental program designed to expedite the transition of care from the ED to the medical ICU (MICU).

Interunit handoffs of patients and transfers of information: a survey of current practices.

Study Objective: We describe the current state of emergency department to inpatient handoffs and assess handoff best practices between emergency physicians and hospitalist medicine physicians.

Methods: A survey was distributed electronically to emergency medicine and internal medicine physicians at 10 hospitals across the United States. Descriptive and quantitative analysis was performed on survey results.

Patient satisfaction surveys and quality of care: an information paper.

With passage of the Patient Protection and Affordable Care Act of 2010, payment incentives were created to improve the "value" of health care delivery. Because physicians and physician practices aim to deliver care that is both clinically effective and patient centered, it is important to understand the association between the patient experience and quality health outcomes. Surveys have become a tool with which to quantify the consumer experience.

Correlations between first documented cardiac rhythms and preceding telemetry in patients with code blue events.

Background: Among in-hospital cardiac arrest (IHCA) patients, the first cardiac rhythm documented on resuscitation records (FDR) is often used as a surrogate for arrest etiology. Although the FDR generally represents the electrical activity at the time of cardiopulmonary resuscitation initiation, it may not be the ideal rhythm to infer the arrest etiology. We hypothesized that a rhythm present earlier-at the time of the code blue call-would frequently differ from the FDR, because the FDR might represent the later stage of a progressive cardiopulmonary process.

Antecedent bradycardia and in-hospital cardiopulmonary arrest mortality in telemetry-monitored patients outside the ICU.

Background: Patients with in-hospital cardiopulmonary arrest (IHCA) precipitated by respiratory insufficiency often exhibit bradycardia before the arrest. We hypothesized that bradycardia frequently occurs in the 10 min preceding IHCA and is associated with poor outcomes when IHCA occurs outside the intensive care unit (ICU).

Objectives: To determine the prevalence and association of antecedent bradycardia with outcome in adult patients with IHCA occurring outside the ICU.

A case of relapsed disseminated cutaneous MALT lymphoma.

A 50-year-old African American woman, with a history of hepatitis C and prior Mucosal Associated Lymphoid Tissue (MALT) lymphoma of the hard palate, presented to the Emergency Department with a chief complaint of fatigue and "bumps on my skin." Examination revealed multiple subcutaneous nodules on her extremities, torso, and back including a 10 by 6 cm mass on her left anterior thigh. Cytology from one of these subcutaneous nodules was consistent with extranodal marginal zone B cell lymphoma.

Resident perceptions of a tele-intensive care unit implementation.

Objective: Remote intensive care unit (ICU) monitoring (tele-ICU) may provide a means to address the shortage of intensive care physicians. However, the consequences of implementing a tele-ICU system for house staff education and clinical experience are unknown. The purpose of this study was to determine resident perceptions of the impact of a tele-ICU implementation on patient care, education, and the overall work environment.