American journal of medical quality : the official journal of the American College of Medical Quality
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Little evidence exists about the use of electronic documentation (ED) in hospice and its relationship to quality improvement (QI) practices. The purposes of this study were to (1) estimate the prevalence of ED use in hospice, (2) identify organizational characteristics associated with use of ED, and (3) determine whether quality measurement practices differed based on documentation format (electronic vs nonelectronic). ⋯ Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of ED. Use of ED may help hospices monitor quality and compliance.
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Adverse events occur in 3% to 16% of hospital patients, half of these during surgery and related to human error. The authors' objective was to determine the impact of a crew resource management program in collaboration with Swiss International Airlines. Participants included operating room personnel: surgeons, anesthesiologists, nurses, and technicians. ⋯ Less improvement was seen for all specialties in stress recognition areas. Crew resource management is valuable in improving operating room staff knowledge regarding teamwork, safety climate, and stress recognition. However, program impact varies with participant specialty.
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In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.