Journal of general internal medicine
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Communication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based practice, are particularly challenged to address these important skills. ⋯ We developed a multidisciplinary teamwork training program that was highly rated by all participating disciplines. The key was creating a shared forum to learn about and discuss interdisciplinary communication and teamwork.
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Comparative Study
Correlates of sexual satisfaction among sexually active postmenopausal women in the Women's Health Initiative-Observational Study.
Satisfaction with sexual activity is important for health-related quality of life, but little is known about the sexual health of postmenopausal women. ⋯ Among postmenopausal women, the variables selected for examination yielded modest ability to discriminate between sexually satisfied and dissatisfied participants. Further study is necessary to better describe the cofactors associated with sexual satisfaction in postmenopausal women.
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Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. ⋯ Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.
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Comparative Study
Patients with multiple chronic conditions do not receive lower quality of preventive care.
The implications of measuring and rewarding performance for patients with multiple chronic conditions have not been explored empirically. ⋯ Diabetic patients with more chronic conditions may receive better quality of preventive care, partly due to their higher number of office-based physician visits.
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Comparative Study
The increasing number of clinical items addressed during the time of adult primary care visits.
Primary care physicians report that there is insufficient time to meet patients' needs during clinical visits, but visit time has increased over the past decade. ⋯ The volume of work associated with primary care visits has increased to a greater extent than has visit duration, resulting in less available time to address individual items. These findings have important implications for reimbursing physician time and improving the quality of care.