A before and after study at the University of Vermont Medical Center found that a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes. More than 12,000 cases were studied, and outcomes included: mortality, death among surgical inpatients with serious treatable complications, sepsis, respiratory failure, wound dehiscence, postoperative venous thromboembolic events (VTE), postoperative hemorrhage or hematoma, transfusion reaction and retained ...

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What is grit? In an article in The Guardian, Angela Duckworth, a psychologist often called the guru of grit, defined it as the commitment to finish what you start, to rise from setbacks, to want to improve and succeed, and to undertake sustained and sometimes unpleasant practice in order to do so. She said in a paper that grit is perseverance and passion for long-term goals. I think we’d ...

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According to the Residency Review Committee for Surgery, "A resident may be considered the surgeon only when he or she can document a significant role in the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative care, selection, and accomplishment of the appropriate operative procedure, and direction of the postoperative care." In nearly all instances, resident "determination or confirmation of the diagnosis, provision of preoperative ...

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A recent story in U.S. News & World Report described how a Seattle hospital is taking a systems approach in improving health care quality and cutting costs. It said, "Virginia Mason Health System ... has looked to adopt many of the much-admired and often-emulated business philosophies from Toyota." The best-known of those philosophies is the so-called lean methodology which is based on eliminating waste and focusing on things that add value. Attempts ...

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The wrong body was cremated by the county coroner’s office in Los Angeles. Jorge Hernandez died of an overdose, and the body of another Jorge Hernandez, an indigent patient, scheduled for cremation, was also present in the morgue. The distraught family of overdose victim Jorge Hernandez had planned a funeral with a viewing and were shocked when they were told his body had been cremated by mistake because a morgue attendant ...

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It was an interesting fortnight for the debate about the treatment of appendicitis. On November 1, David Agus, a medical oncologist, and director of the University Of Southern California's Center for Applied Molecular Medicine, had some thoughts about how appendicitis should be treated. He cited the Finnish randomized trial of antibiotics vs. surgery and said a 70 percent cure rate was good enough. In a brief article on the Fortune magazine website, ...

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What is one of the rules that medical people comply with the least? My vote goes to "translation." The rule is that you must use a qualified medical interpreter for any interview or discussion with a patient who does not understand English. How is “lack of understanding” defined? It is usually fairly obvious. If you aren't sure whether the patient gets it, he probably doesn't. Why can't family members act as translators? There is ...

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Speech recognition errors occurred in 71 percent of emergency department notes, and 21.1 percent of notes with errors were judged as critical with potential implications for patient care says a recent study in the International Journal of Medical Informatics. Investigators looked at a random sample of 100 dictated notes and found 128 errors or 1.3 errors per note. More than half of the errors were ascribed to speaker mispronunciation. Although ...

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A South Carolina jury awarded a woman $4,618,500 for a needlestick injury she sustained in the parking lot of a Target store. She had parked her car, and while walking to the store, her daughter picked up a hypodermic needle. As she swatted the needle out of the child’s hand, it punctured the woman’s palm. She went into the store and notified an employee. HIV post-exposure prophylaxis medications were prescribed which she ...

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By now you've probably heard about the hospital that charged $39.35 for a woman who just had a cesarean section to hold her baby. The baby's father posted a copy of the bill on Reddit, and it drew over 11,800 comments. The story was also widely circulated on Twitter. At least one labor and delivery nurse on Reddit and a spokesperson for Utah Valley Hospital where the baby was born stated that ...

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