Critical care clinics
-
The clinical management database utilizes ICU patient data in aggregate to examine quality of care and resource utilization at the population level. As clinicians become accountable for efficiency and quality, this type of database is essential to understand the results of care. This article reviews the challenges of evaluating cost and quality including the potential for bias and measurement error. A practical approach to starting a database is outlined with examples and suggestions.
-
Critical care clinics · Jul 1999
ReviewSeverity scoring and outcome assessment. Computerized predictive models and scoring systems.
Severity of illness scoring systems and standardized death ratios are being used with increasing frequency as markers of quality of care and to compare and contrast the performance of ICUs. However, numerous factors unrelated to the quality of care delivered may impact the severity of illness score and standardized death ratios. This article reviews the commonly used severity scoring systems and factors that affect their predictive performance.
-
The Internet was created in 1969, when the Advanced Research Projects Agency of the United States Department of Defense fired up an experimental network consisting of only four computers. Over the past five years there has been an exponential explosion in the number of computers added to this network. It is estimated that Internet traffic doubles every 100 days with more than 100 million people worldwide now on-line. ⋯ From recreation to applied science and technology, and from Critical Care Medicine case scenarios to digitized radiology images and pathology specimens, the Internet has become increasingly useful for critical care practitioners. To date, no resource is better equipped to assist critical care providers in many of their daily tasks. This article presents some of the historical developments of the Internet as well as common applications that are useful for critical care practitioners.
-
The Internet holds great promise for clinicians because of its ability to access and consolidate large amounts of knowledge quickly and easily. As a result, information overload is occurring and physician users are finding it necessary to use creative and selective methods to digest this data. Physician users will have to discover new skills to determine authenticity and substance of data as they sift through mountains of coal looking for diamonds. Users will become an integral part of the evolution process, guiding the Internet towards merit and magnitude.
-
Submersion accidents continue to be a significant cause of morbidity and mortality in children and adults. The key to successful management is prevention of these accidents. Proactive efforts to minimize submersion accidents in the community should be made by medical and legislative groups. ⋯ Despite aggressive care, neurologic injury with long-term sequelae secondary to hypoxic ischemic injury remains a major problem in the management of victims of submersion accidents. It is important for the clinician to keep the pathophysiologic and cellular mechanisms of CNS injury in mind, because future interventions are likely to be based on these pathways. Besides providing care for the patient, it is important for the ICU physician to be sensitive to the needs of the family and to support them through this catastrophe that is likely to place a tremendous financial and emotional burden on most of them.