Vignette: An 88-year-old woman visiting from out of town, and out of network, presents to the emergency department with chest pain and rapidly progressing. Delays in the emergency department due to bed capacity lead the patient to be placed under the care of a hospitalist and emergency department physician while waiting for a floor bed. She develops increasing hemodynamic instability and is “upgraded” to an ICU bed with a presumptive diagnosis of septic shock. The ICU team is called.
Get full access to this article
View all access options for this article.
References
1.
ApkerJMallakLAGibsonSC. Communicating in the “gray zone”: perceptions about emergency physician hospitalist handoffs and patient safety. Acad Emerg Med. 2007;14(10):884-894.
2.
SharmaGFletcherKEZhangDKuoYFFreemanJLGoodwinJS. Continuity of outpatient and inpatient care by primary care physicians for hospitalized older adults. JAMA. 2009;301(16):1671-1680.
Henderson-McLennanL. A day in the life of a tele-intensivist. ICU Director. 2010;1(1):35-37.
7.
AngusDCShorrAFWhiteA. Critical care delivery in the United States: distribution of services and compliance with Leapfrog recommendations. Crit Care Med. 2006;34(4):1016-1024.
8.
MorrisPE. Assessing ICU transfers at night: a call to reduce mortality and readmission risk. Am J Crit Care. 2009;18(1):6-8.
9.
DukeGJGreenJVBriedisJH. Night-shift discharge from intensive care unit increases the mortality-risk of ICU survivors. Anaesth Intensive Care. 2004;32(5):697-701.
10.
LeeSKLeeDSAndrewsWL. Higher mortality rates among inborn infants admitted to neonatal intensive care units at night. J Pediatr. 2003;143(5):592-597.
11.
LigtenbergJJArnoldLGTullekenJJvan der WerfTSZijlstraJG. Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit. Crit Care Med. 2003;31(11):2715.
12.
MoralesIJPetersSGAfessaB. Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit. Crit Care Med. 2003;31(3):858-863.
13.
MorganROVirnigBADeVitoCAPersilyNA. The Medicare-HMO revolving door: the healthy go in and the sick go out. N Engl J Med. 1997;337(3):169-175.
14.
WareJEJrBrookRHRogersWH. Comparison of health outcomes at a health maintenance organisation with those of fee-for-service care. Lancet. 1986;1(8488):1017-1022.
15.
ShulkinDJ. Like night and day: shedding light on off-hours care. N Engl J Med. 2008;358(20):2091-2093.
16.
NadzamD. Nurses’ role in communication and patient safety. J Nurs Care Qual. 2009;24(3):184-188.
HeislerM. Hospitalists and intensivists: partners in caring for the critically ill: the time has come. J Hosp Med. 2010;5(1):1-3.
19.
AngusDCKelleyMASchmitzRJWhiteAPopovichJJr, Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS). Caring for the critically ill patient: current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population?JAMA. 2000;284(21):2762-2770.
20.
HyzyRCFlandersSAPronovostPJ. Characteristics of intensive care units in Michigan: not an open and closed case. J Hosp Med. 2010;5(1):4-9.
21.
IrwinRSMarcusLLeverA. The critical care professional societies address the critical care crisis in the United States. Chest. 2004;125(4):1512-1513.
PronovostPJJenckesMWDormanT. Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery. JAMA. 1999;281(14):1310-1317.
24.
SapirsteinANeedhamDMPronovostPJ. 24-hour intensivist staffing: balancing benefits and costs. Crit Care Med. 2008;36(1):367-368.
25.
Leapfrog: 87% of hospitals fail to take all recommended steps to avoid four common infections. Hosp Health Netw. 2007;81(10):66, 68.
26.
PronovostPBerenholtzSDormanTLipsettPASimmondsTHaradenC. Improving communication in the ICU using daily goals. J Crit Care. 2003;18(2):71-75.
27.
O’LearyKJKulkarniNLandlerMP. Hospitalized patients’ understanding of their plan of care. Mayo Clinic Proc. 2010;85(1):47-52.
MillerKRileyWDavisS. Identifying key nursing and team behaviours to achieve high reliability. J Nurs Manag. 2009;17(2):247-255.
31.
AroraVGangireddySMehrotraAGindeRTormeyMMeltzerD. Ability of hospitalized patients to identify their in-hospital physicians. Arch Intern Med. 2009;169(2):199-201.
NortonSAHoganLAHollowayRGTemkin-GreenerHBuckleyMJQuillTE. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Crit Care Med. 2007;35(6):1530-1535.
34.
SchillingPL. A comparison of in-hospital mortality risk conferred by high hospital occupancy, differences in nurse staffing levels, weekend admission, and seasonal influenza. Med Care. 2010;48(3):224-232.
35.
ChenPW. When is the worst time to go to the hospital?New York Times. March18, 2010; Health section.
