Monthly Archives: April 2011

In this single institution case-control study, researchers found that none of the discharge processes studied had any effect on 30 day readmission rates, including discharge summary completion / content, discharge instruction completion / content, medication reconciliation, presence of caretaker for discharge instructions, and arranged follow up. Although disappointing that this failed to discern which components […]

In this analysis of several hundred patients at one institution before and after the initiation of early goal directed therapy for sepsis patients in the ED, although the overall costs were higher after initiation, it was found to be cost-effective with a mean increase in 1.3 QALYs (for a cost of about $5,400 per QALY, […]

We’ve all had the experience of hearing someone we know well say or write something totally out of character, and wondering, “what was that about?” Don Berwick said such a thing last week, all-but-contradicting President Obama’s support for a strengthened, independent Medicare payment board. After a little head scratching, I began to wonder whether this […]

“Clinical microsystems are the small,  functional frontline units that provide most health care to most people. They are the essential building blocks of larger organizations and of the health system. They are the place where patients,  families, and careteams meet. The quality and value of care produced by a large health system can be no […]

Recently, because of some injuries and need to purge a few items of clothing from my usual code of adornment, I was tieless and shoeless (sneakers instead) for several weeks.  No decorum faux pas here, as my generation of practitioners seem to have adapted to this style of dress, say, on holidays or weekends—right or […]

In this single institutional study, audit and feedback on foley prevalence and duration was provided to nurses on post-operative patients. Although CA-UTI rates were unchanged after the intervention, the % of patients with foley catheters for <3 days was significantly higher following the intervention. This is one reasonable strategy to reduce foley prevalence and duration in […]