Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

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In my previous post, I discussed some of the evidence linking general anesthesia in childhood to cognitive problems later in life. To recap, both humans and animals who received a general anesthetic early in their development appear to have trouble with recollection, the act of retrieving events and information from the past.
Experts and professional societies are sufficiently concerned to recommend these risks be discussed with parents and caregivers. However, this creates a bind for pediatric anesthesiologists. For one thing, we don't want to cause undue alarm to families who are already anxious about a child's surgery. Second, we're constrained by gaps in the existing evidence. We think there could be a link between general anesthesia and cognitive deficits, but we can't yet say so for certain. Nor can we promise that any of the available alternatives won't cause the same issues. Read More...
3/31/2015 12:18:08 PM | 3 comments

In many settings, provider burnout is becoming not the exception but the new baseline of workplace functioning. It's so pervasive that it threatens the efficacy and sustainability of our healthcare industry. We are well advised to address this debilitating epidemic if we hope to meet the growing demand for accessible, high-quality healthcare services and effective leadership. Read More...
3/26/2015 4:43:22 PM | 1 comments

By René Y. Quashie and Amy F. Lerman

This post originally appeared in Epstein Becker Green's Take 5 Newsletter on Feb. 25, 2015.

Telemedicine, the remote diagnosis and treatment of patients using electronic communications, has gone mainstream, and employers are paying attention. The numbers speak for themselves. A recent Towers Watson study focusing on employers with at least 1,000 employees concluded that U.S. employers could save up to $6 billion per year if their employees routinely engaged in remote consults for appropriate medical problems instead of visiting emergency rooms, urgent care centers, and physicians’ offices.

3/24/2015 4:26:26 PM | 0 comments

There is no doubt that the Affordable Care Act (ACA) has increased the number of Americans covered by health insurance plans. And if the Supreme Court upholds the program in its forthcoming decision, those numbers will continue to grow.

At this point, there are approximately 10 million newly insured in our country. It would logically follow that hospitals would see a proportionate decrease in "self-pay" patients coming through their emergency departments (EDs).  Read More...
3/19/2015 1:42:37 PM | 1 comments

A growing number of animal and human studies have found troubling associations between general anesthesia in childhood and cognitive deficits later in life. On February 25, an article in the New England Journal of Medicine (NEJM) underscored these concerns, calling for further research. The authors also urged physicians to disclose the possible risks to parents, a practice already endorsed by several professional organizations, including the American Academy of Pediatrics and American Society of Anesthesiologists.
As a pediatric anesthesiologist and a researcher in this field, I feel physicians need to take an active role in helping parents weigh the potential risks and benefits of general anesthesia. When safe and feasible, we also need to offer alternatives. However, in my experience, relatively few anesthesia practices are openly addressing this important subject.  Read More...
3/17/2015 1:12:31 PM | 2 comments
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