Concept: Hospital accreditation
Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown.
Surgical training has always been hard on residents. During my own residency more than 20 years ago, 100-hour workweeks and in-house call every other night were routine. A resident’s life outside the hospital was simply not a priority. Residency may be even harder on patients. A large body of research has linked sleep deprivation in resident physicians to poor performance in neurobehavioral testing and, more alarmingly, to higher rates of attention failure in patient care.(1),(2) Reacting to concerns about both resident well-being and patient safety, the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour reforms in 2003 that . . .
In the United States, hospitals receive accreditation through unannounced on-site inspections (ie, surveys) by The Joint Commission (TJC), which are high-pressure periods to demonstrate compliance with best practices. No research has addressed whether the potential changes in behavior and heightened vigilance during a TJC survey are associated with changes in patient outcomes.
This article describes the processes and tools used by WellStar Paulding Hospital to plan and design a new intensive care unit (ICU) as part of a 108-bed replacement hospital on a new site. Seeking to create a culture of safety centered around patient care, quality, and efficiency, the team used multiple external resources to increase their effectiveness as participants in the design process and to ensure that the new ICU achieves the functional performance goals identified at the beginning of planning and design. Specific focus on evidence-based design was assisted through participation in the Center for Health Design’s Pebble Project process as well as the Joint Commission International Safe Health Design Learning Academy Pilot Program.
To test the effect of a high reliability organization (HRO) intervention on patient lengths of stay in the CVICU and hospital. The authors proposed that (1) higher safety related evidence based protocol (SREBP) team compliance scores and (2) lower SREBP milestone scores are associated with shorter lengths of CVICU and hospital stay.
Ernest Amory Codman had an early penchant fondness for recording surgical complications and analyzing these recordings to determine a surgeon’s ability along with a hospital’s efficiency. This idea and the actions that followed suit in his career were not well received by his fellow colleagues. However, Codman’s influence and spirit remained and helped shape important institutions in American medicine such as the The Joint Commission on Accreditation of Healthcare Organizations.
Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care.
Directors of nursing (DONs) have an important influence in the dissemination of evidence-based practice (EBP) in hospital settings. The current study examined how the knowledge, skills, and behaviors of DONs changed when EBP was implemented during a 5-year, nationwide promotional campaign providing EBP-related information resources and promotional activities in regional hospitals in Taiwan.
Review of dose metrics as part of the routine evaluation of CT protocols has become commonplace and is required by the Joint Commission and the American College of Radiology for accreditation. Most CT quality assurance programs include a review of CTDIvol and/or SSDE, both of which are affected by changes in mAs and kV. mAs, and sometimes kV, are largely determined by the Tube Current Modulation (TCM) functions of the scanner. TCM, in turn, relies on localizer scans to provide an accurate estimate of patient size. When patient size estimates are inaccurate, TCM and SSDE calculations are affected, leading to errors in both. It is important that those who are involved in reviewing CT dose indices recognize these effects to properly direct quality improvement initiatives.
Medicare typically spends as much or more in the 90 days after discharge as it does for the initial hospitalization, and post-acute care spending varies widely. This variation highlights opportunities for bundled payments to help improve quality and reduce spending.