Letter from the Editor

A study published earlier this year in the New England Journal of Medicine had some sobering news for hospitals. Almost of a third of 6,789 hospitalized patients who developed ventricular fibrillation or ventricular tachycardia didn't receive defibrillation within two minutes of their arrest (the timeline recommended by the American Heart Association), and 11% didn't get a shock until after six minutes had passed. Time to defibrillation had a substantial effect on survival: 39% of those who were defibrillated in two minutes or less survived to discharge compared with 22% of those whose shocks were delayed. What can hospitals, and hospitalists, do to improve these times? In our cover story, Stacey Butterfield talks to experts to see what's being done and what new efforts could be on the horizon.

Formal efforts to improve fall rates in hospitals increased in 2005, when The Joint Commission added inpatient fall prevention to its National Patient Safety Goals and began to require fall prevention programs as a condition of accreditation. Now the stakes have been raised even higher: Medicare has included injuries resulting from certain hospital falls to its do-not-pay list, which goes into effect Oct. 1. But many hospitals have already met this challenge by implementing new and innovative ways to decrease patients' fall risk. Read our story to learn more.

In our latest Expert Analysis, where experts weigh in on best practices, Zeina N. Chemali, MD, director of neuropsychiatry in the division of cognitive and behavioral neurology at Brigham and Women's Hospital and assistant professor of psychiatry at Harvard Medical School, examines acute hospital management and behavioral and placement issues in a patient with Lewy body dementia.

We'd like to know what other topics you want to read about in the magazine. Do you have a suggestion for our next Expert Analysis, or a career issue you'd like to see addressed? If so, let us know. We look forward to hearing from you.

Jennifer Kearney-Strouse Editor
ACP Hospitalist