Institute for Healthcare Improvement (IHI)

Author in the Room: Bacterial Coinfection in Influenza: A Grand Rounds Review

February 2013 Author in the Room® Teleconference

 

Author: Daniel S. Chertow, MD, MPH

 

Article: Bacterial Coinfection in Influenza: A Grand Rounds Review

 

Summary Points:

• Influenza vaccine remains the best available tool for prevention of severe influenza illness commonly associated with bacterial coinfection.
• Early empirical antiviral and antibiotic therapy should be administered to all individuals with suspected coinfection.
• Vancomycin or linezolid should be administered in addition to standard therapy for community-acquired pneumonia to patients with severe or necrotizing pneumonia and or evidence of sepsis.

Author in the Room: Insomnia

March 2013 Author in the Room® Teleconference

 

Author: Daniel J. Buysse, MD

 

Article: Insomnia

 

Summary Points:

• Insomnia is a frequent co-morbid condition.
• It increases costs and worsens outcomes.
• Insomnia is a chronic condition for which we have effective and widely-available acute treatments (medication); and effective, but hard-to-find long-term treatments (behavioral).
• Treatment modalities need to consider other health professionals such as nurses, physician assistants, and behavioral health managers to assess the effects of smoking, obesity, diet, exercise, sleep/insomnia.

 

Author in the Room: Computed Tomography Screening for Lung Cancer

April 2013 Author in the Room® Teleconference

 

Author: Phillip M. Boiselle, MD

 

Article: Computed Tomography Screening for Lung Cancer

 

Summary Points:

• Computed tomography (CT) screening reduced lung cancer-specific mortality by 20 percent in a large randomized trial of a high-risk population
• CT is associated with a high false-positive rate, with associated risks and costs associated with follow-up CT and the potential for more invasive diagnostic procedures
• Physicians should consider discussing CT screening with their high-risk patients who meet criteria in published guidelines

Author in the Room: Bariatric Surgery Complications Before vs After Implementation of a National Policy Restricting Coverage to Centers of Excellence

May 2013 Author in the Room® Teleconference

 

Author: ​Justin B. Dimick, MD, MPH

 

Article: Bariatric Surgery Complications Before vs After Implementation of a National Policy Restricting Coverage to Centers of Excellence

 

Summary Points:

• Bariatric surgery has become much safer over the past decade, likely due to better techniques, training in advanced laparoscopy, and tighter credentialing of surgeons.
• The CMS policy of restricting care to Centers of Excellence has not improved outcomes, but may have had the unintended consequence of reducing access to care.
• Referring patients to Centers of Excellence for bariatric surgery will not lower the risk of adverse outcomes and decisions should be based on other factors, such as a surgeon’s training, experience, and outcomes.

Human Factors in Everday Life

Learn more from Dr. Bob Wachter: The Tenerife Disaster

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