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BACKGROUND Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific(More)
BACKGROUND Incorporating shared medical appointments (SMAs) or group visits into clinical practice to improve care and increase efficiency has become a popular intervention, but the processes to implement and sustain them have not been well described. The purpose of this study was to describe the process of implementation of SMAs in the local context of a(More)
CONTEXT The Surgical Care Improvement Project (SCIP) aims to reduce surgical infectious complication rates through measurement and reporting of 6 infection-prevention process-of-care measures. However, an association between SCIP performance and clinical outcomes has not been demonstrated. OBJECTIVE To examine the relationship between SCIP(More)
High dose dexamethasone suppression testing has been widely employed in the differentiation between pituitary ACTH-dependent hypercortisolism [Cushing's disease (CD)] and the ectopic ACTH syndrome. We hypothesized that the high dose dexamethasone suppression test as it is performed in practice does not improve the ability to differentiate between these two(More)
Background: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific(More)
T HE MANAGEMENT OF diabetes poses challenges at all levels, from affected individuals to society as a whole. Microvascular complications of diabetes have been attributed to poor glycemic control since the Joslin era. This hypothesis was confirmed for patients with type 1 diabetes mellitus by the results of the Diabetes Control and Complications Trial 1 and(More)
BACKGROUND Intestinal colonization by Staphylococcus aureus among hospitalized patients has been associated with increased risk of staphylococcal infection and could potentially contribute to transmission. We hypothesized that S. aureus intestinal colonization is associated with increased frequency of S. aureus on patients' skin and nearby environmental(More)
BACKGROUND The importance and complexity of handovers is well-established. Progress for intervening in the emergency department change of shift handovers may be hampered by lack of a conceptual framework. The objectives were to gain a better understanding of strategies used for change of shift handovers in an emergency care setting and to further expand(More)
This article shows how sentiment analysis (an artificial intelligence procedure that classifies opinions expressed within the text) can be used to design real-time satisfaction surveys. To improve participation, real-time surveys must be radically short. The shortest possible survey is a comment card. Patients' comments can be found online at sites(More)
BACKGROUND The Institute of Medicine has suggested that related individual measures of quality be combined into summary measures. Averages of adherence on dichotomous measures for intermediate outcomes have shortcomings because control of individual risk factors differs in their health benefit. Therefore, a common metric is necessary to weight measures(More)