Walmart Rounds Helping Train Nation's Young Doctors.
Little Rock, AK - Doctors at the University of Arkansas Medical Center celebrated the three year anniversary of Walmart Rounds on Friday, a one-of-a-kind initiative exposing student doctors to a wide variety of conditions rarely seen anywhere else in the world.Attending physicians, residents, interns and medical students  from most specialities have donned their white coats and headed to their favorite local Walmart isle for the last three years to observe the stunning pathology of Walmartians in their natural environment."During Walmart rounds, we try and tell our students to be as discrete as possible when...
Source: The Happy Hospitalist - March 13, 2015 Category: Internal Medicine Authors: Tamer Mahrous Source Type: blogs

Work and wellbeing in the NHS: why staff health matters to patient care
This report shows that staff health and wellbeing in the NHS is often seen as an optional extra - as less than two thirds of trusts have a staff health and wellbeing plan in place. It says that high quality patient care relies on skilled staff who are not only physically and mentally well enough to do their jobs, but also feel valued, supported and engaged. It also states that good staff health, wellbeing and engagement can reap significant benefits for patient safety including reduced MRSA infection rates and lower patient mortality rates. Report Royal College of Physicians - press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - March 13, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Workforce and employment Source Type: blogs

Timing Discharges to Maximize Revenue - "Corruption" of Corporate Long-Term Hospitals?
A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients.Discharging Patients at Particular Times Maximizes Hospital RevenueHere is how the rule works: Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatment.Th...
Source: Health Care Renewal - February 23, 2015 Category: Health Management Tags: corporate physician health care corruption Kindred Health mission-hostile management Select Medical Source Type: blogs

How The Ebola Crisis Could Help Save 75,000 Patients
It has taken an epidemic in West Africa to expose a troubling issue for U.S. hospitals and health policy: the short shrift given infection prevention. In a thoughtful December Health Affairs Blog post, Dr. Leonard Mermel, an epidemiologist and infection control specialist, noted that over a three-month period his hospital’s work on Ebola preparedness “significantly strained our ability to manage other infection control challenges.” That is a red flag for health care policymakers. As hospitals focus on Ebola preparations, we can’t lose sight of the fact that more than 700,000 Americans contract health care associat...
Source: Health Affairs Blog - February 4, 2015 Category: Health Management Authors: Jennie Mayfield Tags: All Categories Global Health Health Care Delivery Hospitals Prevention Public Health Workforce Source Type: blogs

MOC – how should we define maintenance
Maintenance – the process of maintaining or preserving someone or something, or the state of being maintained. Our certification documents that we have trained (in my case in Internal Medicine) and that we can pass a test on the breadth of Internal Medicine knowledge. We accept that the ABIM has developed a test the evaluates our entire exposure to the many diseases and treatments that reflect our patients. The idea of Maintenance of Certification is that over time knowledge changes and thus we need to update our knowledge, our diagnostic processes and our treatments. Internists often care for differing types of pa...
Source: DB's Medical Rants - February 4, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Healthcare Update Satellite — 01-19-2015
Penicillin allergy? It’s associated with increased bad outcomes, but not for the reasons you think. The allergies themselves are mostly not allergies. And no, “my mother said I had a rash when I was a baby” isn’t an allergy. However, when compared with patients who don’t have penicillin “allergies”, patients with penicillin allergies have longer hospital stays and are between 14% and 30% more likely to get resistant infections while in the hospitals – possibly because the penicillin “allergic” patients are being treated with much stronger antibiotics that kill of...
Source: WhiteCoat's Call Room - January 19, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

MKSAP: 46-year-old woman undergoing a dental cleaning
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 46-year-old woman is evaluated before undergoing a dental cleaning procedure involving deep scaling. She has a history of mitral valve prolapse without regurgitation and also had methicillin-resistant Staphylococcus aureus(MRSA) aortic valve endocarditis 10 years ago treated successfully with antibiotics. The patient notes an allergy to penicillin characterized by hypotension, hives, and wheezing. The remainder of the history is noncontributory. On physical examination, vital signs are normal. Cardiopulmonary...
Source: Kevin, M.D. - Medical Weblog - January 10, 2015 Category: Journals (General) Authors: Tags: Conditions Heart Infectious disease Source Type: blogs

New Antibiotic Teixobactin Holds Promise Against Resistant Organisms
Researchers at Northwestern University have found and grown a new type of antibiotic that kills many of the deadly antibiotic organisms that are developing today, such as MRSA, tuberculosis, and Clostridium difficile. The antibiotic, dubbed teixobactin, is still in clinical trials with animals. The post New Antibiotic Teixobactin Holds Promise Against Resistant Organisms appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - January 8, 2015 Category: Surgery Authors: Editor Tags: Infectious Disease Pharmacology antibiotic MRSA resistance teixobactin tuberculosis Source Type: blogs

A scary new medical intervention…
This is a story about a new medical intervention. It’s an important one because it affects all doctors—and therefore all patients. 1. It’s expensive. Of course. 2. There is no credible evidence that it works. But its marketing is aggressive. 3. The overwhelming majority of physicians disapprove of it. 4. Cheaper alternatives exist. 5. The company that makes the treatment is rich and influential. It’s hard to believe something like this could be approved in the United States. But not only is this new intervention approved; it is being forced on physicians—and patients—by eminence-based fiat. The treatment is the...
Source: Dr John M - January 8, 2015 Category: Cardiology Authors: Dr John Source Type: blogs

Fat Cells in Skin Kill Bacteria
Scientists reported today that adipocytes in mouse and human skin produce an antimicrobial peptide (AMP) called cathelicidin is response to Staph aureus infections, including MRSA. Experimental animals that were deficient in the AMP were more susceptible to skin infections. Adipocytes may recognize S. aureus by detecting bacterial peptides with toll-like receptors (TLRs), but more work is needed to fully understand the mechanisms.This finding adds more to our understanding of human skin as a vital part of our body's defenses against infection.  It also opens the door to understanding how diabetes, metabolic syndrome, ...
Source: The A and P Professor - January 2, 2015 Category: Physiology Authors: Kevin Patton Source Type: blogs

MRSA, VRE, EVD and C Diff, Oh My!
By Aaron J. Moore, MSN, RN-BC, travel nurse expert Staff nurses have it hard enough, keeping up with all of the protocols, guidelines and best practices required by their facility. Travel nurses have the added pressure of having to deal with many changing protocols every 13 weeks or so, as they move from one facility to the next. Some of these protocols can be tough to deal with, such as (Source: NurseZone Blog: Ask the Expert)
Source: NurseZone Blog: Ask the Expert - December 4, 2014 Category: Nurses Authors: NurseZone Source Type: blogs

MRSA, VRE, EVD and C Diff, Oh My!
By Aaron J. Moore, MSN, RN-BC, travel nurse expert Staff nurses have it hard enough, keeping up with all of the protocols, guidelines and best practices required by their facility. Travel nurses have the added pressure of having to deal with many changing protocols every 13 weeks or so, as they move from one facility to the next. Some of these p rotocols can be tough to deal with, such as (Source: NurseZone Blog: Ask the Expert)
Source: NurseZone Blog: Ask the Expert - December 4, 2014 Category: Nursing Authors: NurseZone Source Type: blogs

Addressing The Threat Of Antibiotic Resistance: Policy Solutions To Fix A Broken Pipeline
Recently, the White House released a major new national strategy to combat antibiotic resistance. As efforts begin to translate that unprecedented announcement into action, it is critical that any strategy to address resistance contain a plan to ensure an adequate antibiotic development pipeline. The overall number of antibiotics reaching the market has declined over time, with 29 and 23 new antibiotics approved in the U.S. in the 1980s and 1990s, respectively, but only nine between 2000 and 2010. Meanwhile, the evolution of drug-resistance has outpaced the development of new antibiotics. Doctors routinely encounter patien...
Source: Health Affairs Blog - November 6, 2014 Category: Health Management Authors: Rachel Zetts and Allan Coukell Tags: All Categories Pharma Policy Public Health Research Source Type: blogs

The New Heroin Epidemic - The Atlantic
In a beige conference room in Morgantown, West Virginia, Katie Chiasson-Downs, a slight, blond woman with a dimpled smile, read out the good news first. "Sarah is getting married next month, so I expect her to be a little stressed," she said to the room. "Rebecca is moving along with her pregnancy. This is Betty's last group with us.""Felicia is having difficulties with doctors following up with her care for what she thinks is MRSA," Chiasson-Downs continued. "Charlie wasn't here last time, he cancelled. Hank ...""Hank needs a sponsor, bad," said Carl Sullivan, a middle-aged man with auburn hair and a deep drawl. "It kind ...
Source: Psychology of Pain - October 30, 2014 Category: Psychiatrists and Psychologists Source Type: blogs