An extended interview with Dr. Christopher Begley, Pulmonary Critical Care Physician, on Great Outcomes at Memorial Medical Center
Q. COPD is an area that we’ve done well. What’s going on there? Why do you think we have such great outcomes?
A. Well the physicians in this area are well aware of making the early diagnosis of chronic obstructive lung disease and are up to date on the most recent therapeutic treatments and the newer medications. In addition, Memorial Medical Center has a pulmonary rehabilitation program that patients with chronic obstructive pulmonary disease may benefit from participating in the program.
Q. And pneumonia, the same thing there. We show outstanding outcomes. Why do you think that is?
A. Well with pneumonia the physicians in this area are well aware that different organisms can cause pneumonia, and these organisms are based upon whether the patient comes in from the community without risk factors, whether they’ve been in the hospital in the last several months or whether they are currently in the hospital. They key with pneumonia is to treat appropriately early. The antibiotics at Memorial are started in the emergency room. The assessment is made for the potential type of organism that the patient may have and therefore the antibiotics are not only started early but are adjusted based upon the risk factors that we just mentioned.
Q. Has this changed, both of these treatments? Is this something that has progressed in the last five or ten years? Are things different today?
A. With chronic obstructive pulmonary disease there are new medications. There has been a great emphasis on the early diagnosis by the primary care physicians. With pneumonia we’ve become more attuned to the fact that we have to initiate the antibiotic therapy early and that we have to adjust the antibiotics based upon risk factors for the patient.
Q. One of the areas in general that we’ve done very well is just in critical care and obviously that’s such a team effort. What’s your confidence in the level of care provided in the ICU here at Memorial?
A. Well in the intensive care unit at Memorial it is a team effort. So that every day the, when the team makes rounds they have an attending physician who is certified in critical care medicine. In addition, we have a clinical pharmacologist who reviews all of the medications. We have participation with the physicians in the residency program, with the primary nurse who’s involved in the care of the patient, and with the primary respiratory therapist. So it’s actually a rather large team that participates in the patient care. In addition, because we have a residency program where the residents are specifically assigned to the intensive care unit they’re at the bedside 24 hours a day.
In point of fact the residents seek our consultation frequently during the day so it’s truly a team effort. The other thing that’s done at Memorial Medical Center is the fact that we go upon evidence based medicine for the treatment of patients in the intensive care unit. So we are aware of the current updated therapies and medications for particular problems. In addition, we’ve initiated several actually quite a few protocols which are standard protocols which are the best treatment protocols for particular problems and those are initiated immediately when the patient is admitted to the intensive care unit.