MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'inpatient'. Sat, 03 Sep 2011 02:17:10 +0100 http://www.medworm.com/index.php?rid=4828882&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-psychiatrists-approach-wrist-cutting-cries-for-help%2F2011.05.16 When Roy and I were on Talk of the Nation this past week, a called phoned in to ask about her sister. The question was about care in the Emergency Room/Department, so it was a perfect Roy question and he fielded it. I’ve been playing with it since, and wanted to talk more about this particular scenario, because the scenario was very common, and the question was more complicated than it seems. From the transcript of the show: ANN (Caller): Hi, thank you very much. I would like to ask Dr. Roy (oh, I gave him his blog name here) a question: My sister was admitted to emergency when she cut her wrists, and the doctor on call pulled me aside and said, do you think she was trying to kill herself? And I said – because my sister is very intelligent – I said, if my sister really wa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828882 Mon, 16 May 2011 21:00:00 +0100 4828882 http://www.medworm.com/index.php?rid=4501586&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpostoperative-care-and-the-black-swan%2F2011.02.20 This is a guest post by J. Paul Curry, M.D. I was inspired when I lost my best friend 15 years ago to a common medical-error phenomenon: The lack of monitoring patients in the hospital. Losing Mark altered my entire career in medicine and started me on a long journey of trying to understand how this particular problem happens. The journey has been eye-opening for me for many reasons, and probably most importantly by striving to learn and understand how the human brain can deceive itself into believing that thoughtful, rational, goal-directed tactics are always the solution to finding the answers to highly-complex enigmas. Actually, the blockbusting solutions that change the course of our culture — how we do things — are most often totally unpredictable and discovered by a... Better Health blogs http://www.medworm.com/rss/comments.php?id=4501586 Sun, 20 Feb 2011 20:00:51 +0100 4501586 http://www.medworm.com/index.php?rid=4482759&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-cost-of-treating-kidney-disease%2F2011.02.15 Medical spending to treat kidney disease totaled on average $25.3 billion annually from 2003 to 2007 (in 2007 dollars). Almost half of the expenditures ($12.7 billion) were spent on ambulatory visits. On average, 3.7 million adults (1.7 percent of the population) annually reported getting treatment for kidney disease, reports a statistical brief from the Agency for Healthcare Research and Quality. During 2003-2007, for those ages 18 to 64, more than half of the total kidney disease expenditures were from ambulatory visits (53.1 percent) compared with about one third (30.3 percent) from inpatient visits. Among those age 65 and older, ambulatory visits accounted for 46 percent of the total kidney disease expenditures and hospital stays were 43 percent. Similar amounts were spent on prescri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4482759 Tue, 15 Feb 2011 18:00:00 +0100 4482759 http://www.medworm.com/index.php?rid=4337941&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-have-a-pain-free-hospital-stay%2F2011.01.11 This is a guest post from Dr. Anita Gupta. ********** How To Have A Pain-Free Hospital Stay Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care. One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain comes second. Fortunately, this doesn’t need to be the situation. Here are a few tips for patients to ensure that their pain does not go overlooked: – Let someone know if you are in pain. This may seem obvious, but patients often hesitate to question their doctor... Better Health blogs http://www.medworm.com/rss/comments.php?id=4337941 Tue, 11 Jan 2011 18:00:55 +0100 4337941 http://www.medworm.com/index.php?rid=3880861&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcommunication-gap-widens-between-doctors-and-patients%2F2010.08.18 In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted. If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap. Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patient’s fears and anxieties with them, only 54 per... Better Health blogs http://www.medworm.com/rss/comments.php?id=3880861 Wed, 18 Aug 2010 16:00:00 +0100 3880861 http://www.medworm.com/index.php?rid=3556096&cid=t_100700_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-helpful-guide-for-discharge-planning%2F2010.05.11 Medicare has a handy guide to help patients and their caregivers take control of the discharge planning process. It might be good for hospitals to have a stack of these at the ready and a plan to make sure every patient gets one: Planning for your discharge: A checklist for patients and caregivers preparing to leave a hospital, nursing home, or other health care setting *This blog post was originally published at ACP Hospitalist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3556096 Tue, 11 May 2010 20:00:00 +0100 3556096 http://www.medworm.com/index.php?rid=3552305&cid=t_100700_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F10%2Fwhen-violence-strikes-on-a-psychiatric-ward%2F Milwaukee County’s Mental Health Complex features a short-term inpatient psychiatric facility that seeks to help those with serious mental health issues — including survivors of trauma and sexual abuse — get better. Patients stay an average of 11.5 days while at the facility and more than 90 percent of them are discharged back to their own care or home. By far, most people who are admitted to the facility carry a diagnosis within the “psychoses” category of diagnoses — which usually means schizophrenia or a related disorder. Over one-third of their patients are under 19 years old — teens and children. About half the patients they treat are men, the other half women. More than half the people who seek out treatment at a facility like this will have ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3552305 Mon, 10 May 2010 19:36:00 +0100 3552305 http://www.medworm.com/index.php?rid=3018993&cid=t_100700_88_f&fid=38264&url=http%3A%2F%2Fms2group.blogspot.com%2F2009%2F11%2Facute-ed-decompression-plans_22.html This is part of the support material for the ED Overcrowding Solutions Presentation at the bottom of this Post.An important management element to consider whenever we attempt to improve ED operations is the implementation of acute ED decompression plans. This involves the design of pro-active strategies that are aimed to facilitate prompt movement of ED admitted patients and/or Holdovers to non-typical or underutilized areas of the Hospital which may be able to take care of these patients at the time. The purpose is to avoid ED overcrowding by promptly redistributing a limited number of patients across several areas of the Hospital without overwhelming any particular unit involved.Even though operationally efficient Emergency Departments can manage and control the flow of about 80% of thei... Emergency Room Efficiency blogs http://www.medworm.com/rss/comments.php?id=3018993 Mon, 23 Nov 2009 03:53:00 +0100 3018993 http://www.medworm.com/index.php?rid=2904926&cid=t_100700_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F10%2F19%2Fwhat-is-a-nervous-breakdown%2F A nervous breakdown refers to a mainstream and often-used term to generically describe someone who experiences a bout of mental illness that is so severe, it directly impacts their ability to function in everyday life. The specific mental illness can be anything — depression, anxiety, bipolar disorder, schizophrenia, or something else. But the reference to a “nervous breakdown” usually refers to the fact that the person has basically stopped their daily routines — going to work, interacting with loved ones or friends, even just getting out of bed to eat or shower. A nervous breakdown can be seen as a sign that one’s ability to cope with life or a mental illness has been overwhelmed by stress, life events, work or relationship issues. By disconnecting from the... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2904926 Mon, 19 Oct 2009 14:55:47 +0100 2904926 http://www.medworm.com/index.php?rid=2035589&cid=t_100700_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F12%2F13%2Fmass-closing-4-of-6-state-institutions%2F For years, Massachusetts has attempted to catch up with the rest of the nation in de-institutionalizing some of its most disabled residents. It runs six institutions — full-time, inpatient settings where people spend most of their lives — for people with developmental disabilities and mental retardation. The state has targeted four of these institutions, housing nearly 500 residents, for closure within the next few years, starting with its most notorious one, Fernald. The ARC of Massachusetts hailed the planned closures — “It’s a victory!” said its executive director yesterday. While most residents will, by choice, be moved to community settings — group homes — the state thinks about 160 residents will choose to move instead to one of the ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2035589 Sat, 13 Dec 2008 12:16:30 +0100 2035589 http://www.medworm.com/index.php?rid=1984813&cid=t_100700_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F11%2F24%2Fpsychiatric-solutions-hospitals-under-fire%2F Sometimes, mental health treatment means having to go into a modern psychiatric hospital. Unlike psychiatric hospitals of old, modern facilities are meant to help stabilize an individual and provide a safe and protected environment for a person to heal with around-the-clock care. But modern psychiatric hospitals still have their share of troubles, as illustrated in an in-depth piece today in the Los Angeles Times which examines Psychiatric Solutions Inc (PSI), a chain of psychiatric hospitals across the country. In the article, the problems with the chain are laid out: Since 2005, the 10 hospitals PSI has owned longest have compiled almost twice as many patient-care deficiencies as 10 similar hospitals owned by its closest competitor, Universal Health Services Inc. The PSI hospitals we... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1984813 Mon, 24 Nov 2008 15:21:46 +0100 1984813 http://www.medworm.com/index.php?rid=1552966&cid=t_100700_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2008%2F06%2Ftrue-emotions.html In case you haven't already seen it, be sure to check out our clicky iPhone Grand Rounds!It was years ago.  I was a resident on an inpatient unit and the patient was floridly manic.  I don't remember the details, what I do remember was that she was running on empty, high as a kite, going 99 revolutions per minute, you name the cliche.  There was a reason why she was on an inpatient unit and not being seen by an out patient doc.  She wasn't getting better and, as is often the case with people suffering from mania, she had no insight that she was ill, she was feeling good-- really good-- and oh so energetic, and even louder than that, and so what's the problem here? Let me outta this joint!  We're talking, I'm trying to reason with her, and finally, she screams at me in a way that stays... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=1552966 Sat, 28 Jun 2008 22:37:00 +0100 1552966 http://www.medworm.com/index.php?rid=1439526&cid=t_100700_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2008%2F05%2Floss-of-psychiatric-beds-in-vancouver.html From the Nanaimo Daily News in Canada:"VIHA said they had to shut the [psychiatric] unit for as long as a year because they cannot find a replacement for a departing psychiatrist. It's hard to believe that VIHA has allowed itself to end up in this position.In fact, Alberni-Qualicum MLA Scott Fraser is right when he says, "It's not acceptable . . . . It's not an option. You cannot shut down essential services."To add to Fraser's incredulity, closing a mental health ward approaches irresponsible if not outright negligent.VIHA might argue they have no control over the comings and goings of doctors, but it's pretty hard to believe that they did not or could not foresee this long enough ago to take appropriate action.Either way, the fact that they could not negotiate to have the current psychia... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=1439526 Tue, 13 May 2008 13:12:00 +0100 1439526 http://www.medworm.com/index.php?rid=1378018&cid=t_100700_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2008%2F04%2Fbits-of-work-or-passover-primary-care.html Yesterday I taught a class to (better: had a discussion with) my colleagues in the Primary Care program about risk perception.Today I gave a presentation about some ongoing research: (to what extent) do patients and the medical chart differently report the doctors' reason for their hospital admission?You can attend the talk too! (Source: Zackary Sholem Berger) Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=1378018 Thu, 17 Apr 2008 03:33:00 +0100 1378018 http://www.medworm.com/index.php?rid=1146556&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2008%2F01%2Fblue-in-baltimore.html This week in Baltimore, the fire department issued a rare “blue alert” – usually seen during only the most severe weather emergencies. It overrides all other directives and allows medics to take patients to the nearest ER regardless of how crowded it is.Why?Across Maryland, beds are full in the ERS – many filled by those in psychiatric crisis.Dr. Jeff Sternlicht, director of emergency services at the Greater Baltimore Medical Center … said that the unusual issuance of a blue alert in Baltimore County is the direct result of a growing problem in Maryland and across the country."There are not enough emergency beds or hospital beds in Maryland right now or nationwide. But the problem is worse in Maryland," he said.Sternlicht admitted the problem is complex.He said that overcrowding ... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=1146556 Fri, 11 Jan 2008 19:29:00 +0100 1146556 http://www.medworm.com/index.php?rid=1079813&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2007%2F12%2Fhow-can-my-loved-one-get-inpatient-care.html The above question is commonly raised by families seeking treatment for someone they love. Unfortunately, the reality of treatment in the United States is that care too often only comes once they’ve committed a crime. A recent study in the journal of Psychiatric Services looked at the psychiatric and criminal histories of individuals in a large urban county jail and what psychiatric services they received while incarcerated. Their conclusion? One that is not at all surprising – a large percentage of persons with a severe mental illness receive their acute inpatient treatment in the criminal justice system rather than in the mental health system. The study’s specifics are sadly familiar: 75% of the random sample were diagnosed as having a severe mental illness; 92% had a history of no... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=1079813 Fri, 07 Dec 2007 21:38:00 +0100 1079813 http://www.medworm.com/index.php?rid=767639&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2007%2F07%2Fno-more-options.html An op-ed in The Day in New London, Connecticut had the following to say about deinstitutionalization:At the threshold of the 21st century, a disturbing trend has become evident. As the number of hospitalized adults decreased during the second half of the 20th century, the number of prison inmates with serious mental illness was on the rise. In fact, the federal Bureau of Justice Statistics (BJS) reports that the number of inmates in jails and prisons with mental illness quadrupled in just six years — from 283,000 in 1998 to 1.25 million in 2006. This surge coincided with the closure of the last of the hospitals.The magnitude of the problem is evident upon examination of prison statistics in Connecticut, where the adult population of people incarcerated with moderate to severe mental illn... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=767639 Mon, 30 Jul 2007 21:24:00 +0100 767639 http://www.medworm.com/index.php?rid=687772&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2007%2F06%2Fincreasing-population-decreasing.html Peg Falcone, a licensed clinical social worker who works at Southern Illinois Regional Social Services, brings up an excellent point in a recent op-ed – the care in psychiatric hospitals is not what it used to be. It is better.Improved medications and methodologies of care make the experience of a patient in a modern-day facility far removed from what inspired Ken Kesey to write One Flew Over The Cuckoo's Nest. Indeed, much of the trepidation still invoked by the possibility of psychiatric hospitalization is an echo of conditions in some – but by no means all – facilities from decades past.It is not only the hospital conditions themselves that have changed; so too have the characteristics of the patients and the purpose of their stay.In 1955, there were 560,000 patients in state psyc... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=687772 Thu, 21 Jun 2007 14:34:00 +0100 687772 http://www.medworm.com/index.php?rid=552232&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2007%2F04%2Fclosing-state-hospitals-doesnt.html The use of general hospitals to treat serious mental illnesses increased 34.7% between 1995 and 2002 according to a new study published in Psychiatric services this month. This raises a number of questions, not the least of which is whether psychiatric units in general hospitals are equipped to provide the kind of treatment, rehabilitation and discharge planning that state psychiatric hospitals can provide.Take Virginia for instance. In 2006, the average length of stay for acute admissions to a state psychiatric hospital was 47.2 days compared to 5.4 days in community psychiatric inpatients beds. The abbreviated treatment provided in general hospital psychiatric beds may account for these hospitals’ “revolving doors” through which 3,514 patients passed 3 or more times in 2002 at a co... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=552232 Mon, 09 Apr 2007 16:07:00 +0100 552232 http://www.medworm.com/index.php?rid=508234&cid=t_100700_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2007%2F03%2Fmanaged-care-sources-of-evil-and-p4p-or.html Sandra blogged about Philip Zimbardo's post, Situational Sources of Evil, about Milgram's studies from the 1960s and the 10 behavioral methods or steps which are used to get good people to do bad things. As I read this, it made me think of the failed promise of Managed Care, and the next evolutionary change in U.S. medicine, Pay For Performance (P4P).Here are my tangential thoughts about these 10 steps, as they relate to the whole managed care experience.1. Prearranging some form of contractual obligation, verbal or written, to control the individual’s behavior in pseudo-legal fashion. In Milgram’s obedience study, subjects publicly agreed to accept the tasks and the procedures.Managed Care (MC) involves establishing contracts with physicians and other health care practitioners, detail... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=508234 Thu, 29 Mar 2007 05:12:00 +0100 508234 http://www.medworm.com/index.php?rid=470315&cid=t_100700_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2007%2F01%2Fmy-planned-nervous-breakdown.html Now I'm done thinking about the whole issue of who should get care, how, where, and by whom. Tired of ranting.Okay, so I got this e-mail from ClinkShrink. She says that if I need to be psychiatrically hospitalized, The Retreat is out for me, apparently Rock Climbing is part of the package. As part of my blurred blog/real life dimensional problems, I tried wall climbing a few months back after Shiny Happy Person (of Trick-Cycling for Beginners) posted about the wonder of it. I couldn't get to the first foot-hold. I stood there, unable to lift myself, wondering why I'd want to do this anyway. My twelve-year-old daughter, who was kind enough to accompany me, scrambled to the top. Repeatedly. Clink ended her email by offering to be my roommate if I needed inpatient care. How sweet to have such... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=470315 Fri, 26 Jan 2007 15:33:00 +0100 470315 http://www.medworm.com/index.php?rid=470313&cid=t_100700_109_f&fid=34730&url=http%3A%2F%2Fpsychiatrist-blog.blogspot.com%2F2007%2F01%2Fmy-three-shrinks-podcast-7-fireside.html Blame Roy on the delay in getting this podcast out. We strive to get these out on Sundays, but life just gets in the way sometimes. We recorded this on Sunday, Jan 21, in front of Dinah's fireside studio, when we had our first snow of the season (not even an inch). Go to the bottom of these Show Notes for a picture of us in front of the fire (the crackles and pops you hear in the audio are from the fire). Roy (our podcast producer) has added a new "feature" where the music which is played as we transition from one carefully planned subject to the next will change from week to week. Feel free to figure out where each week's song snippet comes from. The first one to figure it out will receive the dubious distinction of a link to their blog or site in the following week's Show Notes. (Extra p... Shrink Rap blogs http://www.medworm.com/rss/comments.php?id=470313 Thu, 25 Jan 2007 05:13:00 +0100 470313 http://www.medworm.com/index.php?rid=552254&cid=t_100700_140_f&fid=35465&url=http%3A%2F%2Fpsychlaws.blogspot.com%2F2006%2F06%2Fyour-tax-dollars-and-hospital-closures.html "Deinstitutionalization is a thing of the past" – at least that is what most people think. But, in fact, psychiatric hospital closures have proceeded at a furious pace over the last 15 years. There were so few beds when this new assault started that the people who remain in institutions are those who really need intensive care. Some can be “integrated” with sufficient support, but for others, life becomes a living hell once they are “freed.”There are many factors driving the closures, but the most egregious is that the very groups that are paid by the federal government to “protect” the mentally ill, Protection and Advocacy (P&As) are the ones forcing many of the closures. And when the doors are closed, the displaced residents are on their own. In his book Crazy, Pete Earley ... Treatment Advocacy Center blogs http://www.medworm.com/rss/comments.php?id=552254 Tue, 13 Jun 2006 13:21:00 +0100 552254