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OBJECTIVE The purpose of this study was to define patterns of morbidity that are experienced by women in the postpartum period who seek care in the emergency department within 42 and 100 days of discharge. STUDY DESIGN We conducted a retrospective examination of discharge diagnosis codes and descriptions for emergency department visits and analyzed(More)
After 2 years of experience with a basic computerized system for documenting care, the nursing leaders in an inner city hospital undertook a redesign process to create an effective and efficient system for documentation that also provided data for monitoring care processes, patient outcomes, and staff performance. The basic system was a source of(More)
OBJECTIVE No studies exist that have examined the effectiveness of different approaches to a reduction in elective early term deliveries or the effect of such policies on newborn intensive care admissions and stillbirth rates. STUDY DESIGN We conducted a retrospective cohort study of prospectively collected data and examined outcomes in 27 hospitals(More)
CONTEXT Bureaucratic organisational culture is less favourable to quality improvement, whereas organisations with group (teamwork) culture are better aligned for quality improvement. OBJECTIVE To determine if an organisational group culture shows better alignment with patient safety climate. DESIGN Cross-sectional administration of questionnaires.(More)
Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a(More)
BACKGROUND Ventilator-associated pneumonia (VAP) is widely recognized as a serious and common complication associated with high morbidity and high costs. Given the complexity of caring for heterogeneous populations in the intensive care unit (ICU), however, there is still uncertainty regarding how to diagnose and manage VAP. OBJECTIVE We recently(More)
OBJECTIVE The objective of this study was to demonstrate efficacy of universal predischarge neonatal bilirubin screening in reducing potentially dangerous hyperbilirubinemia in a large, diverse national population. METHODS This was a 5-year prospective study directed at neonates who were aged < or =28 days and evaluated at facilities of the Hospital(More)
BACKGROUND Collaborative and toolkit approaches have gained traction for improving quality in health care. OBJECTIVE To determine if a quality improvement virtual collaborative intervention would perform better than a toolkit-only approach at preventing central line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonias (VAPs).(More)
PURPOSE To develop a definition of basic nursing care for the hospitalized adult patient and drive uptake of that definition through the implementation of an electronic health record. DESIGN AND METHODS A team of direct care nurses, assisted by subject matter experts, analyzed nursing theory and regulatory requirements related to basic nursing care. The(More)
In light of consumers' and regulators' increasing focus on infection prevention, infection control practices and resources were surveyed at 134 hospitals owned by the Hospital Corporation of America. Infection control practices and resources varied substantially among hospitals, and many facilities reported difficulty acquiring the data they needed to(More)