Technology meets tradition: The perceived impact of the introduction of information and communication technology on ward rounds in the intensive care unit.

Background: Public policy in many health systems is currently dominated by the quest to find ways to 'do more with less'-to achieve better outcomes at a reduced cost. The success or failure of initiatives in support of this quest are often understood in terms of an adversarial dynamic or struggle between the professional logics of medicine and of management. Here, we use the case of the introduction of information and communication technology (ICT) to a well-established ritual of medical autonomy (the medical ward round) to articulate a more nuanced explanation of how and why new ways of working with technology are accepted and adopted (or not).

What do ICU doctors do? A multisite time and motion study of the clinical work patterns of registrars.

Objective: To quantify the time that intensive care unit registrars spend on different work tasks with other health professionals and patients and using information resources, and to compare them with those of clinicians in general wards and the emergency department (ED).

Design, Setting And Participants: A prospective, observational time-and-motion study of two ICUs with a total of 71 beds at two major teaching hospitals in Sydney. Twenty-six registrars were observed between 08:00 and 18:00 on weekdays for a total of 160.

The effect of endotracheal tube size on voice and swallowing function in patients with thermal burn injury: an evaluation using the Australian Therapy Outcome Measures (AusTOMS).

The objective of this study was to determine if intubation using larger endotracheal tube sizes in mechanically ventilated patients with thermal burn injury adversely affects voice and swallowing function. This prospective, observational study was conducted in patients with thermal burn injuries, who were mechanically ventilated via an endotracheal tube. The primary outcome measures were changes in voice and swallowing function, assessed using the Australian Therapy Outcome Measures (AusTOMS), immediately before the burn injury, and 12 months after the removal of the endotracheal tube.

An ICU clinical information system - clinicians' expectations and perceptions of its impact.

The Intensive Care Unit (ICU) is an information intense environment where Clinical Information Systems (CISs) can greatly impact patient care and the workload of clinicians. With the introduction of an ICU CIS imminent across New South Wales hospitals, we aimed to understand how ICU clinicians perceived a new system would impact on work practices in Australian ICUs, as much of the current evidence is generated from overseas. We conducted interviews with 66 doctors and nurses in 3 ICUs without a CIS.

Expansion of a medical emergency team system to a mental health facility.

Background: Clinical emergency response systems such as medical emergency teams (MET) are used in many hospitals worldwide, but the effect that these systems have in mental health facilities is unknown. This study examined the rate and nature of MET calls to a mental health facility that had relocated to the campus of a tertiary referral hospital.

Methods: This study was a prospective, observational study of MET calls to a newly constructed 170 bed mental health facility.

Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study.

Objectives: To determine whether palliative care teams can improve patient, family and staff satisfaction for patients receiving end-of-life care in the intensive care unit and reduce surrogate markers of health care costs.

Design: Randomised controlled, feasibility study.

Setting: 14-bed general ICU over 29 months in 2006-2008.

Effect of implementation of a weekly multidisciplinary team meeting in a general intensive care unit.

Objective: To determine whether the introduction of a weekly multidisciplinary team meeting (MDTM) to a general intensive care unit improved selected clinical indicators of patient outcome, and staff satisfaction with patient care.

Design: A single-centre, observational, before-and-after study.

Setting: A 14-bed general ICU in an urban, tertiary teaching hospital.

Operator anaesthesiology training and complications after endotracheal intubation in the intensive care unit: a 3-year, prospective, observational study.

Objective: To determine whether operators with less than 3 months' formal anaesthesiology training have higher rates of complications when performing endotracheal intubation (ETI) in the intensive care unit than operators with longer formal anaesthesiology training.

Design And Setting: Prospective, single-centre, observational study of consecutive ETIs performed in a general, urban, tertiary ICU between May 2005 and May 2008. Data were collected by self-reported, written questionnaire.

Survival after out-of-hospital cardiac arrest in Sydney, Australia.

Background: Out-of-hospital cardiac arrest (OHCA) is a significant cause of death, but there is little published information on its incidence and outcomes in Australia.

Aim: This study was undertaken to determine the incidence and survival from OHCA in Sydney, New South Wales.

Methods: Patients listed on the Ambulance Service of NSW database as having an OHCA during the 12-month period 1 June 2004 to 31 May 2005 were matched with the NSW Registry of Births, Deaths and Marriages to determine if they had died, and how long they survived.