These are but a few of the possible solutions to this growing problem. Nursing administration at the highest levels in this country should be deeply involved in helping medical and surgical specialties solve these critical care problems. The nursing profession will be in a defensive position on this issue if it does not take a positive, creative stand on implementing programs to increase numbers of qualified nurse intensivists. A multidisciplinary approach to seek better job satisfaction for critical care personnel will be important steps toward the improvement of the delivery of high-technology services. If these or similar programs are not instituted, the many tens of thousands of patients requiring high-technology medical and surgical services will be poorly served. Here Continue reading
Delivery of High-Tech Health Care
In addition to ethics and cost concerns, a problem in the delivery of high-tech health care is now a major public issue. As more patients require critical care, the shortage of critical care nursing personnel grows. As we expand further into artificial hearts, LVADs, R\ADs, BI\ADs, etc, requiring more highly trained skilled personnel to monitor and manage these patients, we have a smaller available personnel pool for this purpose. Thus, at the same time the public expects a higher, more efficient performance level, we are in the position of having to reduce services in some instances. canada health and care mall Continue reading
To maintain our high standard of high-tech health care we must find some way to reduce the cost without reducing the quality. Your President, with the Government Liaison Committee of ACCP was privileged to meet with some of the advisors to the Congress on the DRG system (PROPAC), and it was evident that in the year since this system was instituted, some hospitals, particularly those specializing in high-tech health care, have done well because of the “unbundling” of high-tech health services and the implementation of increasingly new and sophisticated technology, which the government has as yet seen fit to reimburse reasonably well. It may, however, soon change so that some of the costs of these services may not be fully reimbursed under new DRG levels. itat on Continue reading
Ethics committees are an important part of hospitals and should have important decision-making capabilities. They should include house officers, clergy, physicians and surgeons, and all other types of health care workers in the high-tech health scene. Medical malpractice must be controlled to allow decreases in the cost of health care and to allow rational thought about and care for patients with hopeless prognoses. In the elderly age group we must strive for short hospital stays, with emphasis on posthospitalization home care, prevention of symptomatology, and the individualization of high-tech health care, including surgical procedures. Finally, we must collect more long-term data on the elderly to define the effects of high-tech health care on the survivors of operations and intensive care. All prospective randomized studies to date, particularly in cardiology and cardiac surgery, have excluded patients over 70. We need new studies to include elderly patients to begin to make rational decisions for the future. alta white teeth whitening Continue reading
More subtle, perhaps, is the application of the most intensive forms of health care treatment modalities to patients with diseases for whom we clearly know the prognosis is hopeless. For example, patients in their 70s and 80s with a ruptured abdominal aneurysm, renal shutdown, and shock have had almost a 100 percent fatality rate with operation, yet any patient who comes into the emergency room with this diagnosis usually receives the ultimate in intensive care, the most intensive operative intervention, long-term respirator therapy, and costly hospitalization. Will younger patients with more salvageable disease and better long-term prognosis, as acutely ill, go untreated because facilities are lacking in a particular facility, having treated the hopeless older patient? Continue reading
Has Our Technology Outstripped Our Ability to be Ethical, Cost Effective and Timely in its Delivery?
It has been a privilege and an honor to serve as the President of the American College of Chest Physicians this past year. I have learned a great deal about cardiopulmonary disease and the interrelationship oi government and medicine, and have made a number of long-lasting friendships with some very motivated and intelligent people in the American College of Chest Physicians. Seeking a subject for a Presidential Address, particularly in a College with so many diverse specialties, was a challenge. However, because of this diversity, many colleagues suggested that this College is a particularly good forum for discussion of high-tech health care and the ethical, financial, and logistic factors associated with its delivery. In other words, have our technologic capabilities outstripped our ability to be rational about it, to pay for it, and to deliver it? buy avandia online Continue reading