David M. Angaran

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The era of assessment and accountability is upon us. The health care system is being asked to measure and monitor medical care in terms that are meaningful to patients and society. Hopefully, this effort will allow us to construct a medical care system that will achieve the safe, efficient, effective, and appropriate use of medical resources in the most(More)
A process for selecting and evaluating indicators for use in monitoring the quality of patient care is described. An indicator is a quantitative measure that provides information and reveals ways in which care could be improved. It is a specific set of conditions whose presence signals that the care being provided should be examined. A sample medication-use(More)
Objectives: The objectives of this preliminary study were to identify a cohort of patients receiving outpatient prescriptions for a class of medications, benzodiazepines, that are known to increase the risk of adverse events, and to analyze the temporal association between outpatient benzodiazepine usage and inpatient and outpatient injury-related health(More)
Angaran: We have two main goals in this panel discussion. First, to describe the current status of the health care delivery environment, the medication use system, and the pharmacy profession. And second, to discuss the specific challenges and opportunities for pharmacy over the next 5–10 years. Our hope is that you identify at least one specific action(More)
The crystalloid vs. colloid controversy is based on a disagreement as to the most effective, safest, and most economical method of maintaining an effective plasma volume in shock patients. This review discusses Starling's law of fluid movement, with a definition of each term in the normal physiological state, and presents examples of how each component of(More)
The ultimate goal of therapeutic intervention in a critically ill patient is to maintain oxygen homeostasis where delivery of oxygen to the cells is greater than, or at least equal to, the oxygen demand of the cells. Oxygen demand varies from organ to organ. Total body oxygen demand is the sum of all oxygen required by all tissues and organs for aerobic(More)
The side effects and adverse reactions associated with the use of positive pressure volume cycle ventilators are described with a focus on information the pharmacist needs to know to monitor patient drug therapy. Mechanical ventilation is discussed with regard to pulmonary and blood gases, infections, cardiovascular effects, renal-fluid status, metabolic(More)