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Part case study, part manifesto, this groundbreaking new book by a doctor and a healthcare executive uses real-life anecdotes and the logic of lean thinking to make a convincing argument that a revolutionary new kind of healthcare -- lean healthcare -- is urgently needed and eminently doable. In On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out: * How lean techniques of value-stream-mapping and rapid improvement events cut the average "door-to-balloon" time for heart attack patients at two hospitals from 90 minutes to 37. * What ThedaCare leaders did to replace medicine's "shame and blame" culture with a lean culture based on continuous improvement and respect for people. * How the lean principle of "building in quality at the source" broke down divisions among medical specialties allowing teams to develop patient care plans faster. * Why traditional modern management is the single biggest impediment to lean healthcare. * How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six. * How the lean concept of "one piece flow" saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%. * How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did -- and what it would do differently. Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-de
For many years, intensive care has focused on avoiding immediate death from acute, life-threatening conditions. However, there are increasing reports of a number of lingering consequences for those who do indeed survive intensive care. Examples include on-going high risk of death, neurocognitive defects, significant caregiver burden, and continued high healthcare costs. Surviving Intensive Care, written by the world's experts in this area, is dedicated to better understanding the consequences of surviving intensive care and is intended to provide a synopsis of the current knowledge and a stimulus for future research and improved care of the critically ill.
Evidence-Based Practice of Critical Care, edited by Drs. Clifford S. Deutschman and Patrick J. Neligan, provides objective data and expert guidance to help answer the most important questions challenging ICU physicians today. It discusses the clinical options, examines the relevant research, and presents expert recommendations on everything from acute organ failure to prevention issues. An outstanding source for "best practices" in critical care medicine, this book is a valuable framework for translating evidence into practice. Gain valuable evidence-based recommendations on key topics such as acute organ failure, infection, sepsis and inflammation, and prevention issues pointing the way to the most effective approaches. Get an overview of each question, an outline of management options, a review of the relevant evidence, areas of uncertainty, existing management guidelines, and authors’ recommendations. Navigate a full range of challenges from routine care to complicated and special situations. Find the information you need quickly with tables that summarize the available literature and recommended clinical approaches.
Thoroughly updated for its Sixth Edition, this classic reference remains an unsurpassed source of definitive, practical guidance on adult patient care in the ICU. It provides encyclopedic, multidisciplinary coverage of both medical and surgical intensive care and includes a "how-to" atlas of procedures and a new section on noninvasive monitoring. Each Sixth Edition chapter, for the first time, identifies Advances in Management based on randomized controlled clinical trials. The cardiology section has been completely rewritten to reflect advances in management of acute coronary syndromes. Also included are extensive updates on management of COPD, diabetes, oncologic emergencies, and overdoses and poisonings. A companion Website will provide instant access to the complete and fully searchable online text.
2010 AJN Book of the Year Award Winner in Critical Care--Emergency Nursing! Designated a Doody's Core Title! "This evidence-based book is an excellent reference for ensuring high-quality management of the elderly and of their particular needs in the critical care setting." --AJN "[This] book's contents run the gamut of elder problems and care: physiology, pharmacology, nutrition, restraints, substance abuse....it is a compendium that can be used as a text or a resource." --Claire M. Fagin, PhD, RN, FAAN (From the Foreword) This book is an evidence-based, best-practices guide that directs the bedside care of critically ill elders. The book serves as a reference on major clinical issues for nurses working at the forefront of care-from nurses in critical care and step-down units to those in trauma and emergency departments. Nurse educators at all degree levels will also find this book to be useful as a textbook and resource for students. The authors provide evidence-based, practical guidelines for both the complex clinical and management aspects of care. The book offers comprehensive coverage of all the issues caregivers need to be up to date on, including the standards of practice for geriatric care, new technologies, pharmacotherapy, pain management issues, ethical issues, and much more. Key topics discussed: Strategies for patient safety for older patients in the intensive care setting Family responses to critical care of the older adult Infection, sepsis, and immune function Understanding and managing sleep disorders in older patients in the ICU Heart failure in the critically ill older patient Substance abuse and withdrawal in elderly patients
Intensive Care Medicine has been continuously growing and expanding, culturally, technically and geographically. Monitoring and instrumentation are continuously improving and more and more hospitals are getting Intensive Care facilities. The costs have proportionally increased over the years, so that ICUs represent today a major cost for health structures. Since the available resources are limited, a real need is emerging to set the limits and indications of Intensive Care. It is understood that the problem not only involves medical considerations, but also ethical and economical aspects of the utmost importance. For the first time in Europe, this book edited by Reis Miranda and his colleagues tackles systematically the many structural aspects of the European Intensive Care. The organisation and financing of health care in the Old Continent is deeply different from the American one, and the results and consequent proposals obtained in the USA cannot simply be transferred to this side of the Atlantic Ocean. Weare extremely pleased to welcome this first European attempt to discuss the Intensive Care problem. It lays no claims to giving definite replies in a continuously developing field, but it will surely become the basis for future discussions and proposals. I am particularly happy that this work has mainly developed within the European Society of Intensive Care, whose final target is to ensure a common standard of therapy in our old Europe, beyond national differences. We warmly congratulate the authors, and I am sure that their work will find wide diffusion and consent.