Editorial
Editorial
For the last few decades there has been an increasingly louder and more urgent discussion underway in the healthcare sector –that of our aging population and moreover, the difficulties and costs involved with treating this expanding group of patients. As critical care managers we are faced with a growing challenge to maintain a high level of quality of care within our units, while dealing with increas...
Research News
Scientists Discover Gene Responsible for Brain's Aging
Will scientists one day be able to slow the aging of the brain and prevent diseases such as Alzheimer's and Parkinson's? Perhaps -- at least once the genetic coding associated with neuronal degeneration has been unraveled. According to a new study published in The Journal of Neuroscience, a research team from the Université de Montréal, Maisonneuve-Rosemont Hospital and Lawrence Berkeley National Labo...
Predicting Risk of Stroke From One's Genetic Blueprint
A new statistical model could be used to predict an individual's lifetime risk of stroke, finds a study from the Children's Hospital Informatics Program (CHIP). Using genetic information from 569 hospital patients, the researchers showed that their predictive model could estimate an individual's overall risk of cardioembolic stroke -- the most common form of stroke -- with 86 percent accuracy. The findings...
Exhibitors @ RSNA 2010
Covidien Announces the Integration of Nellcor "OXIMAX" Sp02 System into Drager Patient Monitors
Combined Technology Offers Excellence in Patient Monitoring Solutions Covidien, a leading global supplier of healthcare products, with its Nellcor™ OxiMax™ oximetry system is now integrated into Dräger bedside monitors with the new Infinity® SmartPod® with Nellcor™ OxiMax™ oximetry system. Physicians now have access to the flexibility to choose the OxiMax™ system with Dräger patient monit...
Cover Story
Cost-Effectiveness of Providing Quality ICU Care to Elderly Patients
The Aging Population Creates an Ever-Increasing Demand for Quality Healthcare, Which has its Effect on Critical Care Services as Well. Limiting Care to the Elderly Would Raise Ethical Issues – so, it is Best to First Explore Whether Quality ICU Care is Cost-Effective or not? It is well known by clinicians that both expenditures on intensive care and the percentage of the elderly population are dramatica...
Some Thoughts on Intensive Care for Elderly Patients at the End of Their Lives
Over the last decades, increasingly more elderly and often chronically ill patients are being cared for in hospitals during the last weeks or months of their lives. "Elderly patients" in this article refers to patients above 65 years of age. There are other cutoff ages used, yet with regards to treatment options and prognoses, the numerical age of elderly patients is less influential than their biological...
The Aging of our ICU's Part III
In our third and final instalment in a series of articles in ICU Management concerning the impact of the aging population in our ICUs, we focus on an important subgroup whose special requirements in the critical care environment need to be addressed: The frail elderly. The frail elderly is a particularly problematic group of patients. Multiple definitions existed over the years. Frailty concerns the combi...
The Importance of Understanding IT Values in Elderly Care
Elderly care is one area where information technology (IT) is rapidly gaining ground. An increase in the number of elderly, and a demand for more advanced help and support, together with a desire to make it possible for the elderly to live in their own homes for as long as possible, force decision makers and healthcare professionals to develop better and more efficient elderly care. Many advocate the use o...
Hypothermia Series
Pre-Hospital Therapeutic Hypothermia: Will it Save a Life
Therapeutic hypothermia has emerged as one of the hottest topics in critical care medicine and although a few continue to debate the proven benefits of induced hypothermia, many have accepted its use as a treatment modality for multiple illnesses and injuries. As the benefit has become more evident within the hospital, practitioners have looked for ways to expand this treatment to even more patients. One...
Series
A Matter of Cost or of Effectiveness?
In this article, we will firstly present the case of two patients for whom, despite similar medical conditions, different therapies were advised, to highlight the inequality in access to medical technologies in Europe. Then, we will look at the matter of cost-effectiveness – are patients being differently treated in the same cases, due to financial pressures and despite thorough guidelines? The case w...
Matrix
Measuring Quality of Life
Patients developing critical illness have been associated with substantial attributable mortality rates. However, it may drastically impact quality of life (QOL) as well. Therefore, intensivists should also be concerned with health status and functioning after discharge of the critical care department. In this overview, the impact of critical illness on QOL, and potential ways to measure QOL before and aft...
Cost-Effectiveness Analysis: What Every Manager Needs to Know
Author Associate Hospital Director Teknon Medical Center Barcelona, Spain [email protected] also: Adjunct Assistant Professor Boston University School of Medicine Boston, USA The fundamental principle of economic analysis is that choices have to be made between alternative uses of resources, as there is a finite pool of resources with which to provide all medical care possible to each indiv...
Management
How to Save Lives and Influence People
Dr. Peter Pronovost, Medical Director at the Center for Innovation in Quality Patient Care, Professor in the Department of Anaesthesiology/ Critical Care Medicine at Johns Hopkins University's School of Medicine and ICU Management Editorial Board Member explains to Sherry Scharff how one simple strategy has not only saved patients and improved safety in his institution – but made some people rethink the...
Interview
The French Healthcare System
Social Protection System The social protection system was created in 1945 aimed primarily at workers and their families. The expansion of health insurance coverage was implemented in stages during the 1960s. The Universal Health Coverage Act (CMU) concluded this process in 1999 by establishing universal health coverage. Today, three main health insurance schemes are dominant: the general scheme for employ...
Governance and Geriatrics
Can hospitals deal with an aging population and a rising prevalence of Alzheimer's disease? The new governance structure, Hospital 2007*, strives to meet this pressing challenge. It will undoubtedly produce other care sections, more gerontology networks, provide better support for the local hospital and regulations for general and regional hospitals. However, beyond the structural level, these governance p...
Effective Organisation: National Union of Hospital Managerial Staff
The National union of hospital managerial staff (SNCH) is an organisation, which exclusively represents managerial staff working in hospitals. The SNCH was founded in 1947 by head storekeepers. Gradually, it started accepting all hospital managerial staff, and now covers administrative and technical staff, as well as doctors and nurses. The definition of "manager" was already set out in our charter in 1994...
TTM Review
Report from the 2nd Therapeutic Temperature Management Congress
The attention for the role of temperature in the development of tissue injury is increasing. Large observational studies show that development of fever is linked to an increase in the severity of neurological injury, and to an increased risk of adverse outcome in ischaemic stroke, subarachnoid haemorrhage, traumatic brain injury and post-anoxic injury following cardiac arrest. Numerous studies have shown t...
Meeting Preview
Euroanaesthesia Meeting: Milan, Italy June 6th - 9th, 2009
For the first time in 2009, the Euroanaesthesia congress will be held in Milan, Italy, at the Milano Convention Centre (MIC). This meeting, the largest anaesthesiology congress in Europe, will again have a large programme of intensive care topics. It will be organised once more under the leadership of Professor Gernot Marx, recently appointed to the Chair of Intensive Care at the University of Aachen, Germ...