American journal of medical quality : the official journal of the American College of Medical Quality
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Observational Study
Dependence of All-Cause Standardized In-Hospital Mortality on Sepsis Mortality Between 2005 and 2010.
Sepsis is the 11th leading cause of death in the United States. The authors evaluated the dependence of all-cause in-hospital mortality on sepsis mortality. A retrospective observational cohort design and All Patient Refined Diagnosis Related Groups were used to evaluate 150 410 patients (>17 years of age) over 6 years. ⋯ The mortality rate for sepsis declined from 14.54 ± 1.60% to 8.57 ± 1.88% (P < .002), and the SSMR decreased from 0.82 ± 0.09 to 0.48 ± 0.07 (O/E; P < .002). The months of sepsis mortality matched the months of hospital mortality for the lowest of each (odds ratio = 0.30, 95% confidence interval = 0.14-0.65; P < .003) and the highest of each (odds ratio = 1.47, 95% confidence interval = 1.18-1.84; P < .0007). Monitoring monthly mortality of sepsis can provide insight for timely intervention into variation of total in-hospital mortality.
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Radial arterial line placement is an invasive procedure that may result in complications. Validated checklists are central to teaching and assessing procedural skills and may result in improved health care quality. The results of the first step of the validation of a radial arterial line placement checklist are described. ⋯ The internal consistency coefficient using Cronbach α was .99. Developing a 22-item checklist for teaching and assessing radial arterial line placement is the first step in the validation process. For this checklist to become further validated, it should be implemented and studied in the simulation and clinical environments.
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Long waits for appointments decrease patient satisfaction. Administrative wait-time measures are used by managers, but relationships between these measures and satisfaction have not been studied. Data from the Veterans Health Administration are used to examine the relationship between wait times and satisfaction. ⋯ Logistic regression models predict patient satisfaction using these measures. The new-patient capacity, new-patient time stamp measures using CD, and the returning-patient desired-date prospective measure were significantly associated with patient satisfaction. Standard practices can be improved by targeting wait-time measures to patient subpopulations.