Michael D Howell

Summary

Affiliation: Harvard University
Country: USA

Publications

  1. ncbi request reprint Performance of severity of illness scoring systems in emergency department patients with infection
    Michael D Howell
    Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Acad Emerg Med 14:709-14. 2007
  2. doi request reprint Managing ICU throughput and understanding ICU census
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
    Curr Opin Crit Care 17:626-33. 2011
  3. pmc Sustained effectiveness of a primary-team-based rapid response system
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Crit Care Med 40:2562-8. 2012
  4. doi request reprint Intensivist time allocation: economic and ethical issues surrounding how intensivists use their time
    Michael D Howell
    Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    Semin Respir Crit Care Med 33:401-12. 2012
  5. ncbi request reprint Iatrogenic gastric acid suppression and the risk of nosocomial Clostridium difficile infection
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
    Arch Intern Med 170:784-90. 2010
  6. ncbi request reprint Occult hypoperfusion and mortality in patients with suspected infection
    Michael D Howell
    Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Medicine, KB 23, 330 Brookline Avenue, Boston, MA 02215, USA
    Intensive Care Med 33:1892-9. 2007
  7. ncbi request reprint A 37-year-old man trying to choose a high-quality hospital: review of hospital quality indicators
    Michael D Howell
    Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
    JAMA 302:2353-60. 2009
  8. pmc Identifying infected emergency department patients admitted to the hospital ward at risk of clinical deterioration and intensive care unit transfer
    Maura Kennedy
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Acad Emerg Med 17:1080-5. 2010
  9. ncbi request reprint Mortality in Emergency Department Sepsis (MEDS) score predicts 1-year mortality
    Nathan I Shapiro
    Department of Emergency Medicine, Pulmonary and Critical Care Division, Beth Israel Deaconess Medical Center, Boston, MA
    Crit Care Med 35:192-8. 2007
  10. doi request reprint Proton-pump inhibitor use is associated with low serum magnesium concentrations
    John Danziger
    Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
    Kidney Int 83:692-9. 2013

Detail Information

Publications41

  1. ncbi request reprint Performance of severity of illness scoring systems in emergency department patients with infection
    Michael D Howell
    Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Acad Emerg Med 14:709-14. 2007
    ....
  2. doi request reprint Managing ICU throughput and understanding ICU census
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
    Curr Opin Crit Care 17:626-33. 2011
    ..Therefore, ICUs need additional tools to manage census, inflow, and throughput...
  3. pmc Sustained effectiveness of a primary-team-based rapid response system
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Crit Care Med 40:2562-8. 2012
    ..We sought to determine whether a rapid-response system that relied on a patient's usual care providers, not a critical-care-trained rapid-response team, would improve patient outcomes...
  4. doi request reprint Intensivist time allocation: economic and ethical issues surrounding how intensivists use their time
    Michael D Howell
    Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    Semin Respir Crit Care Med 33:401-12. 2012
    ..balance these issues with the very real workforce concern of accelerated professional burnout? (2) What are the hidden financial impacts of intensivist participation in quality improvement programs, given current reimbursement systems?..
  5. ncbi request reprint Iatrogenic gastric acid suppression and the risk of nosocomial Clostridium difficile infection
    Michael D Howell
    Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
    Arch Intern Med 170:784-90. 2010
    ..The incidence and severity of Clostridium difficile infections are increasing. Acid-suppressive therapy has been suggested as a risk factor for C difficile, but this remains controversial...
  6. ncbi request reprint Occult hypoperfusion and mortality in patients with suspected infection
    Michael D Howell
    Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Medicine, KB 23, 330 Brookline Avenue, Boston, MA 02215, USA
    Intensive Care Med 33:1892-9. 2007
    ..To determine, in the early stages of suspected clinically significant infection, the independent relationship of the presenting venous lactate level to 28-day in-hospital mortality...
  7. ncbi request reprint A 37-year-old man trying to choose a high-quality hospital: review of hospital quality indicators
    Michael D Howell
    Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
    JAMA 302:2353-60. 2009
    ..Nevertheless, hospital quality information and metrics are an important component of the strategy Mr A should take to solve this challenging problem...
  8. pmc Identifying infected emergency department patients admitted to the hospital ward at risk of clinical deterioration and intensive care unit transfer
    Maura Kennedy
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Acad Emerg Med 17:1080-5. 2010
    ..Understanding risk factors leading to undertriage would be useful, but these factors are not well characterized...
  9. ncbi request reprint Mortality in Emergency Department Sepsis (MEDS) score predicts 1-year mortality
    Nathan I Shapiro
    Department of Emergency Medicine, Pulmonary and Critical Care Division, Beth Israel Deaconess Medical Center, Boston, MA
    Crit Care Med 35:192-8. 2007
    ..To assess the predictive performance for 1-yr mortality of the previously derived and validated Mortality in Emergency Department Sepsis (MEDS) score...
  10. doi request reprint Proton-pump inhibitor use is associated with low serum magnesium concentrations
    John Danziger
    Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
    Kidney Int 83:692-9. 2013
    ..Thus, we verify case reports of the association between PPI use and hypomagnesemia in those concurrently taking diuretics. Hence, serum magnesium concentrations should be followed in susceptible individuals on chronic PPI therapy...
  11. pmc Empirical relationships among oliguria, creatinine, mortality, and renal replacement therapy in the critically ill
    Tal Mandelbaum
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Deaconess Rd CC 470, Boston, MA 02215, USA
    Intensive Care Med 39:414-9. 2013
    ....
  12. pmc Risk factors for nosocomial gastrointestinal bleeding and use of acid-suppressive medication in non-critically ill patients
    Shoshana J Herzig
    Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    J Gen Intern Med 28:683-90. 2013
    ..It is unknown whether there exist certain subsets of patients outside of the intensive care unit in whom the risk of nosocomial gastrointestinal bleeding is high enough that prophylactic use of acid-suppressive medication may be warranted...
  13. pmc Diabetes is not associated with increased mortality in emergency department patients with sepsis
    Philipp Schuetz
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Ann Emerg Med 58:438-44. 2011
    ..Our aim is to investigate the association of diabetes and initial glucose level with mortality in patients with suspected infection from the ED...
  14. doi request reprint The costs and cost-effectiveness of an integrated sepsis treatment protocol
    Daniel Talmor
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA, USA
    Crit Care Med 36:1168-74. 2008
    ..Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown...
  15. doi request reprint Initial management of septic patients with hyperglycemia in the noncritical care inpatient setting
    Philipp Schuetz
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    Am J Med 125:670-8. 2012
    ..The impact of hyperglycemia and glycemic control in patients with infection before developing severe sepsis or shock remains undefined...
  16. ncbi request reprint Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol
    Nathan I Shapiro
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Crit Care Med 34:1025-32. 2006
    ....
  17. doi request reprint Proof of principle: the predisposition, infection, response, organ failure sepsis staging system
    Michael D Howell
    Pulmonary and Critical Care Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Crit Care Med 39:322-7. 2011
    ..The objective of this investigation was to derive and validate a sepsis staging system based on the PIRO concept that risk stratifies patients with suspected infection...
  18. doi request reprint When policy gets it right: variability in u.s. Hospitals' diagnosis of ventilator-associated pneumonia*
    Jennifer P Stevens
    1Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA 2Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA 3Harvard Medical School, Boston, MA 4Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA 5Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 6Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL
    Crit Care Med 42:497-503. 2014
    ....
  19. ncbi request reprint Simple triage scoring system predicting death and the need for critical care resources for use during epidemics
    Daniel Talmor
    Trauma Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
    Crit Care Med 35:1251-6. 2007
    ..To date, no standardized method for allocating scarce resources when the number of patients in need far exceeds capacity exists. We sought to derive and validate such a triage scheme...
  20. pmc Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry
    Michael W Donnino
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, W CC 2, MA, 02215, USA Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA
    BMJ 348:g3028. 2014
    ..To determine if earlier administration of epinephrine (adrenaline) in patients with non-shockable cardiac arrest rhythms is associated with increased return of spontaneous circulation, survival, and neurologically intact survival...
  21. doi request reprint Acid-suppressive medication use and the risk for hospital-acquired pneumonia
    Shoshana J Herzig
    Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
    JAMA 301:2120-8. 2009
    ..The use of acid-suppressive medication has been steadily increasing, particularly in the inpatient setting, despite lack of an accepted indication in the majority of these patients...
  22. pmc Predictors and correlates of dissatisfaction with intensive care
    Sabina Hunziker
    Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and the Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, Children s Hospital Boston, and Harvard Medical School, Boston, MA, USA
    Crit Care Med 40:1554-61. 2012
    ..Dissatisfaction is an important threat to high-quality care. The aim of this study was to identify factors independently associated with dissatisfaction with critical care...
  23. doi request reprint Red cell distribution width and mortality in newly hospitalized patients
    Sabina Hunziker
    Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Am J Med 125:283-91. 2012
    ..Less research has focused on the prognostic utility of red cell distribution width in an acutely hospitalized population...
  24. ncbi request reprint Serum lactate as a predictor of mortality in emergency department patients with infection
    Nathan I Shapiro
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    Ann Emerg Med 45:524-8. 2005
    ..We determine whether a serum venous lactate is associated with an increased risk of death in ED patients with infection...
  25. ncbi request reprint The association of sepsis syndrome and organ dysfunction with mortality in emergency department patients with suspected infection
    Nathan Shapiro
    Department of Emergency Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA 02215, USA
    Ann Emerg Med 48:583-90, 590.e1. 2006
    ....
  26. pmc Acid-suppressive medication use and the risk for nosocomial gastrointestinal tract bleeding
    Shoshana J Herzig
    Division of General Medicine, Beth Israel Deaconess Medical Center, Brookline, MA 02446, USA
    Arch Intern Med 171:991-7. 2011
    ..We aimed to define the incidence of nosocomial GI bleeding outside of the intensive care unit and examine the association between acid-suppressive medication use and this complication...
  27. pmc Structure, process, and annual ICU mortality across 69 centers: United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study
    William Checkley
    1Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD 2Division of Pulmonary, Allergy, and Critical Care, Emory University, Atlanta, GA 3Division of Pulmonary and Critical Care, Intermountain Medical Center and University of Utah, Salt Lake City, UT 4Division of Pulmonary and Critical Care, University of Medicine and Dentistry of New Jersey, Newark, NJ 5Division of Pulmonary, Critical Care, and Environmental Medicine, University of Missouri Columbia, Columbia, MO 6Division of Pulmonary and Critical Care, Meharry Medical College, Nashville, TN 7Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 8Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 9Department of Surgical Critical Care, University of Maryland, Baltimore, MD 10Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ohio State University, Cleveland, OH 11Division of Acute Care Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI 12Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, USA
    Crit Care Med 42:344-56. 2014
    ..Hospital-level variations in structure and process may affect clinical outcomes in ICUs. We sought to characterize the organizational structure, processes of care, use of protocols, and standardized outcomes in a large sample of U.S. ICUs...
  28. doi request reprint Lactate clearance as a predictor of mortality in trauma patients
    Stephen R Odom
    Division of Acute Care Surgery, Trauma and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
    J Trauma Acute Care Surg 74:999-1004. 2013
    ..Initial serum lactate has been associated with mortality in trauma patients. It is not known if lactate clearance is predictive of death in a broad cohort of trauma patients...
  29. ncbi request reprint Estimated nursing workload for the implementation of ventilator bundles
    Westyn Branch-Elliman
    Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    BMJ Qual Saf 22:357-61. 2013
    ..However, the nursing resources required to implement these bundles, and their effect on other aspects of intensive care unit patient care, are unknown...
  30. pmc Outcome of critically ill patients with acute kidney injury using the Acute Kidney Injury Network criteria
    Tal Mandelbaum
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
    Crit Care Med 39:2659-64. 2011
    ..Accurate urine output measurements as well as serum creatinine values from our database were used to detect patients with acute kidney injury and calculate their corresponding mortality risk and length of stay...
  31. doi request reprint International validation of the out-of-hospital cardiac arrest score in the United States
    Sabina Hunziker
    Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
    Crit Care Med 39:1670-4. 2011
    ..The aim of this study is to externally validate this score in an independent patient population in the United States...
  32. doi request reprint Teamwork and leadership in cardiopulmonary resuscitation
    Sabina Hunziker
    Medical Intensive Care Unit, University Hospital Basel, Basel, Switzerland
    J Am Coll Cardiol 57:2381-8. 2011
    ..g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients...
  33. ncbi request reprint Elements of a high-quality inpatient consultation in the intensive care unit. A qualitative study
    Jennifer P Stevens
    Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
    Ann Am Thorac Soc 10:220-7. 2013
    ..Inpatient consultation by specialists is one of the most common medical interventions in the modern intensive care unit (ICU), but few data exist on components of high-quality consultation...
  34. doi request reprint Residents' and nurses' perceptions of team function in the medical intensive care unit
    Julia Adler-Milstein
    Harvard University PhD Program in Health Policy, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
    J Crit Care 26:104.e7-15. 2011
    ..Therefore, we compared residents' perceptions to those of nurses', the other predominant direct caregiver group, in the medical ICU...
  35. doi request reprint Commentary: Is the glass half empty? Code blue training in the modern era
    Julius Yang
    Silverman Institute for Healthcare Quality and Safety, Beth Israel Deaconess Medical Center, One Deaconess Road, Boston, MA 02215, USA
    Acad Med 86:680-3. 2011
    ..Finally, the authors consider the question of whether code blue training remains an appropriate goal for general medicine trainees in the face of evolving trends in health care systems...
  36. ncbi request reprint Reappraisal of routine oral care with chlorhexidine gluconate for patients receiving mechanical ventilation: systematic review and meta-analysis
    Michael Klompas
    Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts2Department of Medicine, Brigham and Women s Hospital, Boston, Massachusetts
    JAMA Intern Med 174:751-61. 2014
    ....
  37. pmc Trends in Severity of Illness on ICU Admission and Mortality among the Elderly
    Lior Fuchs
    Intensive Care Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America Clinical Research Center, Soroka University Medical Center and Faculty of Health Science, Ben Gurion University of the Negev, Beer Sheba, Israel
    PLoS ONE 9:e93234. 2014
    ..We sought to describe the temporal trends in elderly admissions and outcomes in a tertiary hospital before and after the addition of an 8-bed medical ICU...
  38. ncbi request reprint Inadequate blood volume collected for culture: a survey of health care professionals
    Michael W Donnino
    Department of Emergency Medicine, Beth Israel Deaconess Hospital, One Deaconess Road, Boston, MA 02215, USA
    Mayo Clin Proc 82:1069-72. 2007
    ..Because volume remains the most important determinant for the optimal yield of organisms, these findings raise an important quality assurance issue...
  39. ncbi request reprint Surviving sepsis outside the intensive care unit
    Michael D Howell
    Crit Care Med 35:1422-3. 2007
  40. ncbi request reprint Sick? Or, not sick?
    Nathan Shapiro
    Crit Care Med 33:1151-3. 2005
  41. ncbi request reprint Th2 cytokines act on S100/A11 to downregulate keratinocyte differentiation
    Michael D Howell
    Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
    J Invest Dermatol 128:2248-58. 2008
    ..S100/A11 and p21 gene expression was also found to be significantly lower in acute and chronic AD skin. This study demonstrates an important role for S100/A11 and p21 in regulating skin barrier integrity and the innate immune response...