Intensive Care

It seemed so obvious: Patients in intensive care improve faster if doctors and nurses set specific goals for their recovery. But until two years ago, no one had explicitly tried this approach. Now, a Johns Hopkins University study has found that setting daily goals for all patients can help them get better sooner. The method Hopkins tested also requires that everyone involved in a patient's care - doctors, residents, nurses, attending physicians, pharmacists and others - go on rounds together, visiting each patient.

A day after Shady Grove Adventist Hospital announced that a nurse may have caused the death of one or more critically ill patients, the public flooded the Montgomery County facility yesterday with dozens of calls, including some from anxious former patients or their relatives. Hospital officials said it could take months to learn of any other implications against the nurse, Coleen M. Thompson. One caller said she told the hospital that her 72-year-old father-in-law was recently on life support in the 26-bed intensive care unit where Thompson, 34, was assigned.

New moms in Howard County will finally get to see daylight today when the hospital opens its revamped and relocated labor and delivery area and neonatal intensive care unit. Hidden in the basement for the past 20 years, the birthing rooms have been moved to the second floor above the recently opened emergency department. All have windows, along with a lot of luxury and high-tech equipment to make the experience as painless as possible. "An awful lot of babies are born in this hospital," said Mary Hogan, chairwoman of obstetrics and gynecology at Howard County General.

Two years ago, IC-USA, a startup launched by two Johns Hopkins doctors, had an intriguing idea - using telemedicine to oversee intensive-care patients - and was bringing its first customer on line. Results were dramatic: lower mortality, shorter hospital stays and cost savings for the hospital. But no other customers signed up. Now, the company has a new name, VISICU, a new chief executive and a new business model. And the customers are coming. In recent weeks, VISICU has announced deals with two high-profile clients.

She thought it was just a cold. Her throat was sore, and she felt tired all over. But as JoAnn Barr got her son ready for school that morning in March, she started gasping for breath. Within a few hours, Barr was on a ventilator in intensive care, her blood pressure bottoming out, her kidneys failing. For a month, the 41-year-old Westminster woman hovered near death, a victim of the fast-moving, often-lethal condition known as sepsis. It's an illness that rages through the victim's bloodstream, unleashing a fury of reactions that kill tissues and shut down organs.

EVERY NINE weeks during the school year, pupils in Peg Dear's seventh-grade home economics class at Harper's Choice Middle School make a delivery to Howard County General Hospital. Each quarter, they donate about 25 quilts they have made in class to infants in the hospital's Neo-natal Intensive Care Unit (NICU). "The parents love having these quilts for the babies," said Debbie Fleischmann, nurse manager for the unit. "The staff likes them because it helps us create a more homey atmosphere in the unit, to balance some of the impersonal sorts of things that they see."

In the new intensive care unit at Howard County General Hospital - where the beds will give massages, visitors can sleep on folding sofas and nurses can chart notes on computers outside the door of each room - the financial problems dogging America's health industry seem far away. The renovated ICU, which was previewed for the media this week and will open Tuesday, is the first phase of a $31.5 million expansion designed to meet the widely varying needs of the fast-growing county, including the growing number of senior citizens and the state's highest proportion of children younger than age 5. Over the next two years, the Columbia hospital, a member of Johns Hopkins Medicine, expects to unveil a larger diagnostic imaging department and an emergency department that will be three times its current size.

Annapolis City Attorney Paul G. Goetzke remains in intensive care at a Virginia hospital after a diving accident in shallow water in the Potomac River on Thursday left him partially paralyzed. Surgery to fuse a fractured vertebra near the base of his neck was postponed Monday when Goetzke, 40, started having difficulty breathing, said his brother George Goetzke. Doctors at Inova Fairfax Hospital performed a tracheotomy early Monday. "He didn't have the strength to keep pushing the air with his diaphragm," George Goetzke said.

PATCHWORK QUILTS - made with lacy, pink fabrics, shimmering gold designs and colorful cloths with teddy bear prints - are blanketing incubators in the neonatal intensive care unit of Howard County General Hospital. "They're just big, bright blocks of color, so there's something for the babies to look at," says Dorothy Kitt, coordinator of the volunteer group that makes the quilts. The vibrant patches bring comfort to a sterile, white-walled hospital room and to the families of these infants of fragile health.