Delivery Innovation

The search for new and innovative ways to deliver health care more efficiently and effectively. 

Questioning Dogma: Does a GCS of 8 Require Intubation?

May. 7, 2020

Justin S. Hatchimonji, Ryan P. Dumas, Elinore J. Kaufman, Dane Scantling, Jordan B. Stoecker, Daniel N. Holena 

Abstract [from journal]

Background: There is no evidence supporting intubation for a Glasgow Coma Scale (GCS) of 8. We investigated the effect of intubation in trauma patients with a GCS 6-8, with the hypothesis that intubation would increase mortality and length of stay.

Methods: We studied adult patients with GCS 6-8 from the 2016 National Trauma Data Bank. Intubated and non-intubated patients were compared using inverse probability weighted regression adjustment (IPWRA) to control for injury severity and patient characteristics.


Life-Sustaining Treatment Decisions Initiative: Early Implementation Results of a National Veterans Affairs Program to Honor Veterans’ Care Preferences

Feb. 24, 2020

Cari Levy, Mary Ersek, Winifred Scott, Joan G. Carpenter, Jennifer Kononowech, Ciaran Phibbs, Jill Lowry, Jennifer Cohen, Marybeth Foglia

Abstract [from journal]

Background: On July 1, 2018, the Veterans Health Administration (VA) National Center for Ethics in Health Care implemented the Life-Sustaining Treatment Decisions Initiative (LSTDI). Its goal is to identify, document, and honor LST decisions of seriously ill veterans. Providers document veterans’ goals and decisions using a standardized LST template and order set.

Objective: Evaluate the first 7 months of LSTDI