Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

Tracking a Trend: Nursing Home Specialists

Apr. 12, 2019

The world of health care is divided into many areas of specialization. At one point or another, we may have seen a podiatrist for a foot problem or a dermatologist for skin issues. Not all of us realize that – in addition to specializing in, say, the lungs – clinicians can devote their practice to providing general care to patients in a specific setting. For example, some physicians, called ‘hospitalists,’ see all or most of their patients in a hospital environment.

Patient-Centered Preference Assessment to Improve Satisfaction With Care Among Patients With Localized Prostate Cancer: A Randomized Controlled Trial

Mar. 20, 2019

Ravishankar Jayadevappa, Sumedha Chhatre, Joseph J. Gallo, Marsha Wittink, Knashawn H. Morales, David I. Lee, Thomas J. Guzzo, Neha Vapiwala, Yu-Ning Wong, Diane K. Newman, Keith Van Arsdalen, S. Bruce...

Abstract [from journal]

Purpose: To study the effectiveness of the Patient Preferences for Prostate Cancer Care (PreProCare) intervention in improving the primary outcome of satisfaction with care and secondary outcomes of satisfaction with decision, decision regret, and treatment choice among patients with localized prostate cancer.
 
Methods: In this multicenter randomized controlled study, we randomly assigned patients with localized prostate cancer to the PreProCare intervention or
...

Factors Underlying Racial Disparities in Sepsis Management

Feb. 14, 2019

Matthew DiMeglio, John Dubensky, Samuel Schadt, Rashmika Potdar, and Krzysztof Laudanski

Abstract [from journal]

Sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. While standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against...

How Liability Insurers Protect Patients and Improve Safety

Tom Baker, JD
Jan. 29, 2019

Tom Baker, Charles Silver

Abstract [from journal]

Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact...

Improving End of Life Care – Ask the Nurses

Dec. 7, 2018

Everyone wants a dignified death – yet few actually experience one. Despite preferring to remain at home, most older adults spend their final days in hospitals, where they often undergo medical care that neither improves survival, quality of life, nor satisfaction and is often incongruent with their wishes and goals. A new study in the Journal of the American Geriatrics Society describes these problems in end of life care in nearly 500 U.S.

Intensive Care Unit Capacity Strain and Outcomes of Critical Illness in a Resource-Limited Setting: A 2-Hospital Study in South Africa

Dec. 5, 2018

George L. Anesi, Nicole B. Ga...

Abstract [from journal]

Objective: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting.

Methods: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country’s first published multicenter electronic critical care database. We assessed the
...

Detecting BS in Health Care

Issue Brief
Nov. 26, 2018

In the past several months, we have observed several notable signs of deceptive, misleading, unsubstantiated, and foolish statements — what we will call “BS” — in the health care industry. Here we present our Top 10 BS candidates, in both pictures and words. First we present each picture, untitled and without text, thereby inviting readers to discern what the BS message is and engage them in the BS detection process. Then we offer an explanation of what the picture conveys. This will help the reader become a more skilled “BS Hunter.” We reserve the option to expound further as we step in more BS in the future.

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