Mouth-to-Mouth Not Key to CPR Effectiveness
CPR is just as effective without the mouth-to-mouth as with, two new studies suggest. The American Heart Association said the same thing two years ago, but the latest research, published in the New England Journal of Medicine, may be the most compelling evidence to date. It involved more than 3,200 people who went into cardiac arrest and needed CPR; bystanders got directions from 911 dispatchers to either administer hands-only CPR or the conventional method, NPR reports. Victims survived at roughly the same rate for both types, suggesting that chest compressions are the most important element of CPR. Mouth-to-Mouth resuscitation may only be necessary in cases where someone has stopped breathing after choking or nearly drowning, according to NPR.
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Danger: Health Insurance Scams on the Rise
One afternoon in 2008, as Glenda Hey, 61, was going about her business as a receptionist with the Oklahoma City Police Department, she noticed a faxed offer she couldn't refuse. "I just happened to pick it up," says Hey, who at the time was struggling to afford $545 a month in health insurance premiums. "The price jumped out at me." Health insurance for hundreds less—a deal that was about to expire. After filling out a brief application that asked for her bank account details, Hey was told her policy would start on Jan. 1, 2009.
But later that spring, when Hey experienced chest pain so severe that she was rushed to the hospital for five test-filled days, her finances took a devastating hit as she recovered, U.S. News's Lindsay Lyon writes. Even though $314 was being withdrawn from her account each month for premiums, she says, the company was refusing to pay the bill—which, at more than $31,000, totaled almost what she and her husband earn together in a year. After complaining to the state's insurance department, Hey heard some unsettling news. Nearly 70 other Oklahomans were in the same boat, one man with nearly $100,000 in unpaid claims. And the outfit they'd enrolled with appeared not to be licensed to sell insurance anywhere in the country.
Regulators now accuse the Tennessee-based entity, the American Trade Association, and affiliated firms of selling fake health insurance to at least 26,000 households in all 50 states; they raked in upwards of $14 million in premiums over a span of 16 months, according to court documents. More than a few of those dollars appear to have been spent on personal items such as cars, real estate, and loan payments, says Leslie Newman, Tennessee's insurance commissioner. At least 12 other states have taken action to stop the entities from operating. Although a Tennessee judge has ordered the liquidation of the companies, whose unpaid claims are estimated at more than $5 million, regulators aren't optimistic there will be much money left for victims like Hey, some of whose care has been covered by her hospital. [Read more: Danger: Health Insurance Scams on the Rise.]
A Team Effort to Re-Engineer Care at Hospitals
Kelly Labby, an attorney from Bemus Point, N.Y., suffers from a rare type of brain tumor and resulting epileptic seizures that almost ended her career. In most places in America, the surgery and radiation that gave Labby her life back, plus ongoing treatment for seizures, skin rashes, ear infections, and myriad other problems, would mean endless visits to endless specialists in different locations. But Labby arrived at the Cleveland Clinic in 2006, when its new quality-improvement program was changing the place in large ways and small, U.S. News contributor Catherine Arnst writes. The Epilepsy Center was one of 25 centers newly organized around diseases or organ systems rather than specialties. It brings together the surgeons, neurologists, endocrinologists, psychologists, and internists expert in seizures. "It's amazing to get such coordinated care. I go there for everything," says Labby.
That transformation is part of an unusual effort to bring the best practices of manufacturing to the hospital setting. Over the past five years, the clinic has assembled a 50-person team focused solely on "continuous improvement," or Kaizen, the Japanese word for "making things better." Most of the team members are engineers with experience far removed from healthcare. The efficiency experts quickly found out why healthcare isn't just another industry. Whereas higher profits might be the unambiguous goal at a corporation, doctors and nurses were not about to embrace any change that improved work flow without proof that it wouldn't lower the quality of care. "You cannot issue an edict," says team director Darryl Greene, who arrived at the clinic after a career spent improving processes at appliance makers and financial institutions. "You have to sell each doctor on the value, using data and results." [Read more: A Team Effort to Re-Engineer Care at Hospitals.]
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